Gonorrhea historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Sara Mehrsefat, M.D. [2]; Priyamvada Singh, MBBS [3]

Overview

Gonorrhea is an ancient disease with biblical references. However, the exact time of onset of gonorrhea in history cannot be accurately determined from the extant historical record. The term comes from Ancient Greek γονόρροια (gonórrhoia), which literally means "flow of seed." In ancient times, it was incorrectly believed that the pus discharge associated with the disease contained semen.[1] In 1879, gonorrhea was referred to as “the clap” by German bacteriologist Albert Neisser.[2]

Historical perspective

  • Gonorrhea is an ancient disease with biblical references. However, the exact time of onset of gonorrhea in history cannot be accurately determined from the extant historical record.[3]
  • In 150 AD, gonorrhea was first described and given its present day name (gon = semen + rhea = flowa/flow of semen) by Galen, a Greek physician.[4]
  • In 1161, one of the first reliable notations occur in the Acts of the (English) Parliament, which passed a law to reduce the spread of "...the perilous infirmity of burning." The symptoms described are consistent with, but not diagnostic of, the disease we now recognize as gonorrhea.[5]
  • In 1256, a similar decree was passed by Louis IX in France with the intent of reducing the spread of similar symptoms, which were noted at the siege of Acre by Crusaders.[6]
  • In 1378, the term “the clap” was first introduced to refer to gonorrhea. The moniker likely descended from the name of the old Parisian district (Les Clapiers), where prostitutes were housed.
  • In 1879, gonorrhea was referred to as “the clap” by German bacteriologist Albert Neisser.[2]

Historical Trend of Gonorrhea in United States

  • In 2009, the national rate of reported gonorrhea cases reached an historic low.
Source: https://www.cdc.gov/

Historical Perspective of Treatment

  • Historically, treatments for gonorrhea have included thermotherapy, plant-based extracts (e.g., cubebs, copaiba), and metals (mercury and arsenic).[3]
  • Surgeons' tools on board the recovered English warship the Mary Rose included a syringe that, according to some, was used to inject mercury via the urinary meatus into any crewman suffering from gonorrhea.[7]
  • In the 19th century, silver nitrate was one of the most widely used treatments.
  • In 1897, silver nitrate was replaced by collodial silver after its invention by Arthur Eichengrün. This new type of silver was marketed by Bayer.[8]
  • In 1930s, the first reliable antibiotic (sulfonamides) proved effective against gonorrhea.[3]
  • In 1940s, gonorrhea began to show resistance to sulfanomides and penicillin became the treatment of choice.
  • In the late 1960s, gonorrhea showed resistance to penicillin by producing the penicillinase enzyme.
  • In the 1980s, strains of gonorrhea began developing resistance to penicillin by other mechanism rather than making penicillinase. Penicillin and tetracycline were no longer indicated in the treatment of gonorrhea.
  • Since 1986, the United States Gonococcal Isolate Surveillance Project (GISP) has been monitoring antibiotic resistance to gonorrhea.
  • In 2009, the first extensively drug-resistant (XDR) gonococcal strain of gonorrhea (H041) was isolated in Japan.[9]
  • In 2010, it was claimed that 27,000 per 100,000 gonorrhea samples were resistant to penicillin, tetracycline, and ciprofloxacin, or some combination of these drugs.
  • In 2012, the CDC updated its treatment guidelines and recommended combination therapy with ceftriaxone and azithromycin.[10]
  • In 2015, ceftriaxone plus azithromycin is the only recommended treatment for gonorrhea.[11]

References

  1. Definition of the term gonorrhea
  2. 2.0 2.1 Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev 2014;27:587–613.
  3. 3.0 3.1 3.2 Genco, Caroline Attardo. Neisseria: molecular mechanisms of pathogenesis. Horizon Scientific Press, 2010.
  4. Tortora, Gerard J., Berdell R. Funke, and Christine L. Case. Introducción a la microbiología. Ed. Médica Panamericana, 2007.
  5. W Sanger. History of Prostitution. NY, Harper, 1910.
  6. P. LaCroix. The History of Prostitution Vol. 2. NY, MacMillan, 1931
  7. Higgins, John (1587). The Mirror for Magistrates. as cited in the Oxford English Dictionary entry for "clap"
  8. Bender, Max. "Ueber neuere Antigonorrhoica (insbes. Argonin und Protargol)." Archives of Dermatological Research 43.1 (1898): 31-36.
  9. Ohnishi M, Golparian D, Shimuta K, Saika T, Hoshina S, Iwasaku K; et al. (2011). "Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone". Antimicrob Agents Chemother. 55 (7): 3538–45. doi:10.1128/AAC.00325-11. PMC 3122416. PMID 21576437.
  10. Center of Disease Control, Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm?s_cid=mm6131a3_w#box Accessed on September 9, 2016
  11. Center of Disease Control Addressing the Threat of SHEET Drug-Resistant Gonorrhea https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/drug-resistant-gonorrhea.pdf


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