A drug-resistant strain of gonorrhea may have originated in San Francisco, where new cases of the common sexually transmitted disease are on the rise among gay men and black youths, according to public-health officials.
Gonorrhea infections are much rarer in The City now than in the 1970s and 1980s. There were about 2,300 new reported cases in The City last year, down from a peak of 17,000 annual diagnoses in the mid-1970s, according to the Department of Public Health.
Despite being common -- about 721,000 Americans were infected with the disease in 2011, according to one estimate -- gonorrhea is serious: it can lead to infertility in men and women. A gonorrhea infection can also aid and speed the transmission of HIV/AIDS.
And gonorrhea is on the rise in San Francisco today. The infection rate has risen by nearly one-third since 2008, according to the Department of Public Health.
Most new infections are among sexually active gay men and black adolescents, according to DPH, with the rate of gonorrhea infections among gay men almost 30 times that of the rest of the population.
And there's a troubling twist.
The bacterium that causes gonorrhea is famously adaptive and quickly develops resistance to antibiotics designed to treat it, requiring a steady stream of new and different drugs to quell outbreaks.
At the moment, pharmaceutical companies don't have any new drugs in development, according to a briefing given to Congress last month by Dr. Susan Philip, the DPH's director of Disease Prevention and Control.
And The City has an additional worry: the drug-resistant strain of the disease that's now spread across the United States after originating in "California or Hawaii" in 2006, according to health officials, may have begun in San Francisco.
"San Francisco, along with other cities on the West Coast of the U.S., is a site of possible emergence of drug-resistant gonorrhea," DPH Director Barbara Garcia wrote in a May 20 report to the Health Commission.
Black youths are five to 10 times as likely to come down with gonorrhea than white, Asian or Latino youths, according to DPH.
STD infections correlate strongly with poor communities. Two-thirds of all STD infections occurred in people with no health insurance, according to a 2012 survey.
One reason for the disease's strong return is financial. Funding for STD-prevention initiatives has been steadily cut.
That means less outreach in San Francisco high schools and at the County Jail, where the Black Coalition on AIDS used to conduct regular workshops, said Javarré Wilson, the organization's director of programs.
That's where he heard another reason for gonorrhea's comeback.
"There was a constantly reoccurring theme: 'I don't want to wear a condom,'" he said Thursday.
The disease's return and new drug-resistance are "reasons to be alarmed, and we are alarmed," he added.
Clarification: The strain of gonorrhea present in The City is still treatable with certain antibiotics, public health officials said, and San Francisco is not the site of emergence for the gonorrhea “superbug” present in Asia. Gonorrhea in the U.S. develops resistance to drugs over time but is still treatable.