
Gonorrhea Is Becoming Untreatable, U.N. Health Officials Warn - bootload
http://www.npr.org/sections/thetwo-way/2016/08/30/491969011/u-n-health-officials-warn-gonorrhea-is-becoming-untreatable
======
zackmorris
Keep in mind that media outlets are unlikely to point out the fact that
antibiotic resistance is mainly caused by antibiotic overuse on farms for
livestock (due to the conflict of interest when so many ad dollars come from
food).

Yes, humans failing to finish their run for the time prescribed for them, and
use of antibiotics for viral infections have been a problem too. But those are
completely dwarfed by farm use.

Funding for new antibiotic research should come from taxes on big agribusiness
and there should be more regulation on antibiotic use for livestock.

~~~
flashman
I highly doubt, jokey rural stereotypes aside, that antibiotic resistant
gonorrhea is being transmitted from livestock to humans.

~~~
Wicher
That's not how it works.

Eating the livestock (or drinking the milk) transfers antibiotics to our
bodies, and then _we_ become the environment in which bacteria are selected
for resistance to antibiotics.

~~~
refurb
That's not how it works at all. The amount of antibiotics in slaughtered
livestock is miniscule. In fact, the FDA requires a "clean out" phase for
livestock treated with certain drugs to ensure the levels in the final meat
are low enough.

~~~
chris_va
Ok, to clarify:

Antibiotic resistance is generally spread via plasmid-mediated resistance.
Overuse of antibiotics in any capacity, regardless of ingestion into humans,
causes _some_ bacteria to evolve resistance. Bacteria are promiscuous with
their DNA, and resistance by one organism on one context (e.g. livestock) can
easily get transmitted to a completely different organism in a completely
context (e.g. humans).

Having said all of that, there are many potential antibiotics out there that
haven't been fully researched (almost all currently prescribed antibiotics are
beta lactam variants, which is only one small class), and this "cannot be
treated" stuff is mostly just bad journalism.

------
ChuckMcM
And then there are these stories :
[http://www.medicalnewstoday.com/articles/287745.php](http://www.medicalnewstoday.com/articles/287745.php)
talking about how there are all sorts of Antibiotics we don't even know about
(yet). Or drugs that also kill bacteria ([http://phys.org/news/2016-02-major-
breakthrough-antibiotic-r...](http://phys.org/news/2016-02-major-breakthrough-
antibiotic-resistance.html)) or even this
([https://www.theguardian.com/commentisfree/2015/nov/20/antibi...](https://www.theguardian.com/commentisfree/2015/nov/20/antibiotics-
apocalypse-research-resistance-threat-breakthrough))

Basically as we get to understand exactly how cells work and how bacteria do
what they do, and how they change. We won't need to scrounge around in the
dirt to find something, hopefully, that will kill bacteria. We'll engineer
what ever we need to kill what ever cells we want to kill.

~~~
coldtea
So, basically, nothing to worry, technology will save us in the end.

And it might -- long term.

Only, as things are now, between an antibiotic stopping working and finding a
replacement, there could be tens of millions of deaths...

Aside from wishful thinking there's nothing that guarantees that we'll find
the next cure as soon as an old one becomes obsolete.

~~~
ChuckMcM
Everything is a probability right? I generally don't spend my days worrying
about how I'm going to survive the next asteroid strike on the planet
(guaranteed to to be an issue at some point). I also get in my car and drive
on the highway between here and there even though I know there are people
driving under the influence that can kill me if they hit my car at speed.
There are people who are getting shot by other people trying to shoot still
other people all over the place, but I don't strap on the kevlar vest when
ever I go out. It's all probabilities.

The risk is out there that at some point Gonorrhea can become the scourge of
the human race. It is instructive to review how the staph bacteria has gone
from nuisance to menace. But the exposure isn't there for Gonorreha to get
ahead of us. Read that opinion piece in the Guardian.

It is important to respect that things in the world can kill you, it is also
important to not let your fear drive you to action that is counter productive.

~~~
coldtea
> _Everything is a probability right?_

Perhaps, but not everything gives the same odds and stakes.

> _I generally don 't spend my days worrying about how I'm going to survive
> the next asteroid strike on the planet _

If there were legitimate news of an asteroid en route to earth, you probably
would.

And there are legitimate studies of antibiotics crapping out.

And even if you don't "spend your days worrying" about the latter (which I
didn't suggest everybody should), doctors, biology researchers, drug companies
etc, better DO worry.

~~~
ChuckMcM

       > And even if you don't "spend your days worrying" 
       > about the latter (which I didn't suggest everybody 
       > should), doctors, biology researchers, drug companies
       > etc, better DO worry.
    

That was the point of my links, I do think it is an important topic, and when
the threat of antibiotic resistant bacteria came up read a lot of different
sources on how people were responding. That lead me to understand that the
threat was being taken seriously, that significant funds were being invested
in the solution, and really smart and dedicated people were working to find
solutions. As those people started reporting on their work I could put it into
the category of big problem, competent people are working on it, and they have
the funding they need.

I spend more time thinking about underfunded efforts that are trying to
address hard problems. For example I believe the development of
tornado/hurricane proof affordable housing is under funded. Every year we (as
a community of tax payers) fund the reconstruction of housing and
neighborhoods destroyed by tornadoes or hurricanes. We reconstruct these
neighborhoods with the same types of housing that were destroyed before
knowing that it will be destroyed again. That is GDP that if we invested some
of it in research and development of weather proof housing we could save in
future years. As the planet warms this is just going to get worse, and
flooding is going to be a huge issue. One thing about warmer air is that it
carries more water, more water, more rain, more rain, more flooding. That is a
problem worth spending time on and investing in.

------
lostlogin
Someone I know described visiting a small rural pharmacy in Nepal and talking
to the pharmacist. Many locals can't afford courses of antibiotics for sick
family members so they buy just a dose or two. This was allowed on even fairly
hardcore, last line antibiotics which required special government ministry
approval back home. If different countries have such different practices,
things are not going to go well.

------
carsongross
As surely as Water will wet us,

as surely as Fire will burn,

The Gods of the Copybook Headings

with terror and slaughter return

[http://www.kiplingsociety.co.uk/poems_copybook.htm](http://www.kiplingsociety.co.uk/poems_copybook.htm)

~~~
exolymph
Scott Alexander's lengthy and masterful followup to / extension of Kipling's
poem: [http://slatestarcodex.com/2014/07/30/meditations-on-
moloch/](http://slatestarcodex.com/2014/07/30/meditations-on-moloch/)

~~~
VladimirGolovin
Can't comment on the followup / extension idea, but Scott Alexander's
Meditations on Moloch is an amazing, possibly life-changing piece of writing.
It's long, so you'll probably need at least an hour of time in a single
uninterrupted chunk - but in the end, it's absolutely worth it.

~~~
throwanem
I don't know about changing my life, but it certainly has changed my opinion
of Scott Alexander, and vastly in his favor.

------
memracom
Rather than weakening the attacker (killing the bacteria) we could look for
ways to strengthen the organism (boost the body's own defense mechanisms). The
health industry as a whole, has been weakened by the discovery of antibiotics
and designer molecules, and as a result now spends too many resources on
looking for killer chemicals (antibiotics and other drugs).

But there are other ways. One way is to follow the thread of research opened
up by William B. Coley who developed Coley's Toxins, a cocktail of bacterial
toxins that sparked the body's own defense mechanisms and in many cases,
caused cancer tumors to turn to jelly within days and start being reabsorbed
by the body.
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888599/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888599/)
has more about him.

Or the way of genome therapy where researchers are studying the active genomes
in both healthy and sick (or cancerous) cells to understand what knobs and
buttons exist in the human organism that we might be able to adjust by means
of various therapies, sometimes even benign ones. There is evidence that one
of the many hundred subtypes of cancer will respond to everyday blood pressure
medication. This is a relatively benign drug that, in the right conditions,
will kill cancer cells. Of course, the right conditions include that the
patient has certain specific genes. But genomic techniques ca discover these
genomic markers and help us sort out the mechanisms by which cells resist
attacks from hostile bacteria. The ultimate outcome for cancer would be that
your doctor takes a biopsy of the cancer cells, their active genomes are
analyzed and this information is used to build a molecular machine that
manufacture a custom drug that will cure your cancer.

Look at the molecular machinery of the Polymerase Chain Reaction which makes
copies of DNA molecules
[https://en.wikipedia.org/wiki/Polymerase_chain_reaction](https://en.wikipedia.org/wiki/Polymerase_chain_reaction)

And there is Reverse Transcription which converts RNA molecules to DNA
molecules
[https://en.wikipedia.org/wiki/Reverse_transcription_polymera...](https://en.wikipedia.org/wiki/Reverse_transcription_polymerase_chain_reaction)

Not to mention the Ribosome which is the molecular machine in your cells which
manufactures protein molecules
[https://en.wikipedia.org/wiki/Ribosome](https://en.wikipedia.org/wiki/Ribosome)

~~~
dfischer
Crazy - I never actually took a step back and wondered if we could boost our
defense as a strategy.

In a geeky way, we keep drinking health potions to recover HP but if we had a
shit ton of armor then we wouldn't need the HP potions to begin with. :)

~~~
dogma1138
This is called immunotherapy and it is not mutually exclusive, and it is being
worked on to treat certain diseases. However it's not nearly as simple as you
might think and many immunomodulatory drugs have considerably worse side
effects.

Immunomodulatory drugs to some extent "predate" modern antibiotics before the
antibiotic boom and the advancement in modern wide spectrum antibiotics
immunomodulatory drugs were commonly used to treat severe infections.

The side effects of these drugs are very very severe, can be fatal, and can
cause hereditary malformations Thalidomide is probably the most famous case of
a "wonder drug" going very very wrong it is still used today in extreme cases
of leprosy and to treat some cancers.

[https://en.wikipedia.org/wiki/Thalidomide](https://en.wikipedia.org/wiki/Thalidomide)

But just to be clear these type of treatments are just as "designer" molecules
as any other drug, there are no magic fixes in medicine you find the most
effective vectors to attack a disease and you use them.

But overall >Crazy - I never actually took a step back and wondered if we
could boost our defense as a strategy.

This is a bit silly, we have had vaccines before we had antibiotics :) we wash
our hands, keep ourselves clean, dress wounds etc. these are all "defense
boosting" strategies, and they both predate and coexist with "offensive"
treatments.

------
DavidWilkinson
Super-gonorrhoea due to antibiotic over-use and treatment non-adherence.

Drug-resistant HIV due to natural mutation and an increase in infection
vectors (courtesy PrEP).

Killer venereal diseases: we missed you, but not that much.

------
hackaflocka
Does oral sex transmit Gonorrhea?

Are there any sex acts that are immune to it?

Is there anything safe (sex-wise) that one can do to prevent it?

~~~
mcjon77
Yes, gonorrhea (as well as chlamydia and syphilis) can be transmitted via oral
sex. In fact, I know of someone who contracted oral gonorrhea (at first she
thought it was a bad sore throat) and passed it to a guy who contracted
genital gonorrhea.

------
siscia
Maybe I am saying something completely out of the world.

But when bacteria become too dangerous why we don't simply vaccinate against
them?

~~~
cfontes
Vaccines are expensive to research and require a very long period of trials
before being release to the public, while this happens people will die by the
millions without antibiotics.

Also because bacteria can mutate making your vaccine useless, so you need to
research again.

~~~
siscia
Sure but once enough people are vaccinated the bacteria will have less surface
to develop further mutations.

We should aim to vaccinate as many people as possible and use antibiotics only
in the rare case of infection, shouldn't we?

------
alanh
And there are still those who deny evolution…

------
milesf
Here's a novel thought: Monogamy. Wait to have sex until you're married, then
have only one sexual partner your entire life. That'll deal with the problem,
and every other sexually transmitted disease out there.

It's almost too simple to work, but I've heard that over time - thousands of
years in fact - it is a strategy humans have used to build not just safe sex,
but many other benefits as well
[http://www.theglobeandmail.com/life/relationships/the-
power-...](http://www.theglobeandmail.com/life/relationships/the-power-of-
monogamy-10-surprising-claims-regarding-modern-love/article16099482/)

~~~
Maskawanian
And then you find that you are sexually incompatible with the person you
married.

~~~
antisthenes
> sexually incompatible with the person you married

That's as much of a myth as monogamy. Incompatible just means they're not
attracted to you, or you to them. Call it what it is.

~~~
PuffinBlue
So both parties are physically/emotionally attracted to each other lets say
but they're both submissive, or one has HL and the other LL (/r/deadbedrooms
if you want more), or one's into monogomy and the other is polyamorous.

Just a few examples that confirm it's not a 'myth'.

~~~
antisthenes
A few anecdotes you mean. Polyamory usually signals a low quality mate, and is
tangential to sexual compatibility at best.

Submissive usually means some disorder with the male.

There are tons of disorders that could impact sexual quality of life, but
between 2 healthy individuals who are attracted to each other, sexual
incompatibility is a myth.

~~~
nommm-nommm
This is some fucked up shit. Submissiveness is a _disorder_? No it's not.

Sure we can play this game because it's a tautology. My sexual preferences are
different from yours? It's a disorder, doesn't count, you aren't healthy.

------
Kenji
If officials from the U.N. or from the WHO warn about something, I sleep
particularly well at night, knowing that it's probably blown out of proportion
by several orders or magnitude. Remember the bird flu? My employer at the time
bought truckloads of sanitizers, plastic bins and related stuff. A complete
waste of money. These people have lost every last shred of credibility for me.

~~~
notadoc
You understand the point of warnings is for action to be taken to hopefully
prevent a further problem, right?

Have street "Stop" signs lost their credibility with you too?

~~~
Fomite
Seriously. This is like complaining that someone called the fire department,
and your house didn't burn down, so it was clearly all for nothing.

