Drug resistant strains of gonorrhoea are on the rise with many linked to travel to South East Asia – the UKHSA has warned Brits to get tested if they have casual sex
Super gonorrhoea is on the rise amid warnings the sexually transmitted infection could become untreatable. The UK Health Security Agency says the STI known as “the clap” is increasingly becoming resistant to the main antibiotic used by the NHS to treat it.
It says most cases detected are linked to travel to Asia-Pacific countries such as Thailand but the increase raises the risk of significant spread within England. Dr Katy Sinka, Consultant Epidemiologist and head of the STI section at UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, which could make it untreatable in future. If left untreated, it can cause serious problems like pelvic inflammatory disease and infertility.”
There were 85,000 gonorrhoea diagnoses reported in England in 2023, up 7.5% from 79,000 diagnoses in 2022, and the highest since records began in 2018. The UKHSA released latest data showing 54,965 gonorrhoea diagnoses at sexual health services in the first nine months of 2024.
Symptoms include painful urination, abdominal pain, yellow or green discharge, bleeding in between periods and pain or swelling in the testicles. However many people infected with gonorrhoea will have no symptoms so the UKHSA says it is vital to test regularly when having sex with new or “casual partners”.
Neisseria gonorrhoeae, the bacteria that causes gonorrhoea, appears on the UKHSA’s list of viruses and bacteria which pose the greatest threat to public health.
The number of cases of super gonorrhoea is small but growing. Ceftriaxone is the primary antibiotic used to treat gonorrhoea and since first being detected in England in 2015 there have been 42 cases of resistant gonorrhoea reported. Worryingly 15 of these cases were extensively drug-resistant, which means that they were resistant to ceftriaxone and to second line treatment options.
In the 15 months from January 2024 to 20 March 2025, there were 17 cases of ceftriaxone resistant gonorrhoea reported – 13 in 2024 and 4 in 2025 so far. This compares to 16 across the previous two years during 2022 and 2023.
Super gonorrhoea is generally considered to be the extensively drug-resistant (XDR) form and this is also on the rise. From January 2024 to March 2025 there were 9 XDR cases. This compares to 5 cases in total in the previous two years.
The UKHSA also said 7,000 syphilis cases were recorded between January and September 2024, compared to 9,513 during 2023. The UKHSA is reminding healthcare professionals to remain vigilant for syphilis symptoms, as untreated infections can lead to serious complications affecting the brain, heart, and nerves.
Dr Sinka added: “The best way to stop STIs is by using a condom. If you’ve had condomless sex with a new or casual partner, get tested, whatever your age, gender or sexual orientation. This includes when you are having sex abroad.
“Early detection not only protects your health but prevents transmission to others. Many STIs show no symptoms, which is why regular testing is so important. Testing is quick, free and confidential.”
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