In January, 2009, a thirty-one-year-old prostitute visited a clinic in Kyoto, Japan, for a routine checkup. Because sex workers are so likely to acquire sexually transmitted diseases, many have themselves checked for infections even in the absence of symptoms. Indeed, although the woman displayed no outward signs of gonorrhea, her lab test came back positive; she carried the gonococcus microbe in her throat, a common reservoir.
After a second visit, doctors at the clinic gave her an injection of ceftriaxone, an antibiotic considered by infectious-disease experts to be the definitive treatment for gonorrhea. It didn’t work; two weeks later, when she returned to the clinic, a throat culture again tested positive. She was given another dose, but it, too, failed, and, at first, doctors assumed that she had been newly infected.
Now, however, public-health experts view the Kyoto case as something far more alarming: the emergence of a strain of gonorrhea that is resistant to the last drug available against it, and the harbinger of a sexually transmitted global epidemic. “The microbe appears to be emerging as a superbug,” Dr. Magnus Unemo, the head of the World Health Organization’s Collaborating Center for Gonorrhea and Other Sexually Transmitted Infections, in Sweden, told me recently. “This is what we have feared for many years.
This is alarming.