Meningitis vaccine can stop the progression of gonorrhea, making it increasingly resistant to treatment

There are more and more gonorrhea in the world. It is growing at a dizzying pace: its impact has multiplied by 10 in a few decades. In addition, traditional treatments are losing effectiveness and the disease does not have a specific vaccine, a combination of factors that are troubling the medical community as this may end up being a drug used against this sexually transmitted disease is useless, however this is a problem. , For the time being, is localized in certain parts of the world. Even worse news: if gonorrhea is not treated, it can lead to serious health problems, ranging from infertility in women in the medium term to an increased risk of contracting AIDS.

But there is also good news: three studies have just been published in the journal Infectious diseases of the lancet The meningitis vaccine also shows good results against gonorrhea, especially in young people – the most affected people – and homosexual men, the magazine explains. In 2020, more than 80 million cases of this disease were reported worldwide. The incidence in Spain has multiplied by 15 in a few decades, from 805 cases per 100,000 population in 2001 to 12,359 in 2019 (latest data available).

Decreased effectiveness of treatment against responsible bacteria –Neisseria gonorrhoeae– and the lack of a vaccine to prevent infection has raised concerns that gonorrhea may become more resistant to treatment, or even incurable in the future.

Matilde Sanchez Conde, an infectious disease specialist and head of the STD at Ramón y Cajal Hospital in Madrid and a member of the Spanish Society for Infectious Diseases and Clinical Microbiology, describes the impact of gonorrhea in a global context: “In Spain it grows by 20. % Annual. At the US Centers for Disease Control and Prevention (CDC), they include it among the top five health problems that need to be addressed. “It’s a global health problem that affects a lot of young people and it ‘s worrying,” he said. “The risk of HIV infection is tripled if you have another sexually transmitted disease,” he said.

The expert also explains that the situation in Spain is not the same as in other countries of the world. “Resistance to antibiotic therapy is less developed in our environment, which usually works. They are described in some parts of Asia, such as Japan or the United States. There was a mini-epidemic of a traveler from Japan in Europe who infected two women with gonococcus, which was mostly resistant to everything. But in Spain and Europe in general, this does not happen, “he explained. The risk in such areas may be insufficient detection, he adds, because sometimes the disease is confused with other diseases or is asymptomatic.

The Lancet It is reported that the World Health Organization (WHO) recommends that meningitis vaccines be used to reduce the impact of the disease, including in children, as part of a national vaccination strategy. . “Even partial protection can significantly reduce infections,” he explains. The Lancet In the press release.

“In 2016, WHO set a goal of reducing gonorrhea cases by 90% by 2030, but there is still no effective vaccine,” the magazine recalls. “Three studies suggest that 4CMenB is a vaccine [para la meningitis B] May offer significant protection for young people and men who have sex with men who may be at high risk for infection.

Protection from 33% to 40%

The first surveys were conducted in New York State, including the city and Philadelphia. The team, led by Dr. Winston Abara of the CDC, evaluated more than 110,000 young people with laboratory-confirmed infection with gonorrhea, chlamydia (or other STDs), of which 7,692 were vaccinated, about half with one dose, the other half. In combination with two of them, according to the doctor’s observation, the full course of meningitis vaccine (two doses) offered 40% protection and a single injection 26%.

“Our findings suggest that meningitis vaccines that are only moderately effective in protecting against gonorrhea can have a major impact on disease prevention and control,” explains Winston Abara. “Clinical trials on the use of 4CMenB against gonorrhea are needed to better understand its protective effect and also to move on to developing a specific gonorrhea vaccine.

A similar conclusion was reached by Professor Helen Marshall’s team from Adelaide, Australia, Women and Children Hospital, the country says. The Lancet, With the largest 4CMenB vaccination program in the world, including children, teens and young adults. In this case, protection against gonorrhea was established at 33%, although the author himself acknowledges that his research has some limitations. For example, a small number of subjects.

A slightly different approach was taken in the UK, where they wondered what cost-effective financial savings and health might be affected by vaccine use in reducing gonorrhea cases. Peter White, a professor at Imperial College, has developed a model that compares three possible ways to vaccinate a group prone to gonorrhea: Men who have sex with men. The question was whether it is better to vaccinate those who go to sexual health clinics with proven gonorrhea or those at high risk of infection.

Based on the analysis conducted, the study authors concluded that vaccination of risk profiles with 4CMenB is most effective and that this measure could save the British system 110,000 cases and eight million pounds -9.6 million euros in ten years. “With the gonorrhea-specific vaccine, which will take years to develop, the key question is whether the 4CMenB meningitis vaccine should be used against gonorrhea. “Our analysis suggests that giving it to those most at risk for infection is the most effective way to prevent large numbers of infections.”