The concern that gonorrhea strains may develop resistance to antibiotics has surfaced in recent years, and now England’s chief medical officer is warning that it may become a completely untreatable disease in the future.

“Gonorrhea is at risk of becoming an untreatable disease due to the continuing emergence of antimicrobial resistance,” Professor Dame Sally Davies, chief medical officer in the UK, said in a letter to general practitioners and pharmacies. Due to reports that gonorrhea is developing resistance very quickly, and the “super-gonorrhea” outbreak earlier this year, Davies is emphasizing the importance of prescribing the correct drugs.

“Gonorrhea has rapidly acquired resistance to new antibiotics, leaving few alternatives to the current recommendations,” Davies wrote. “It is therefore extremely important that suboptimal treatment does not occur.”

In England, 16 cases of “super-gonorrhea” have been confirmed since March of this year, including an outbreak in Leeds, according to the British Association for Sexual Health and HIV. The strain is resistant to an antibiotic called azithromycin, which is typically used in collaboration with a drug called ceftriaxone. According to the CDC, “cephalosporin antibiotics have been the foundation of recommended treatment for gonorrhea,” and “the emergence of cephalosporin-resistant gonorrhea would significantly complicate the ability of providers to treat gonorrhea successfully, since we have few antibiotic options left that are simple, well-studied, well-tolerated, and highly effective.”

Gonorrhea is a sexually transmitted disease that can be transmitted to anyone who is sexually active, generally infecting the genitals, throat, or rectum. Symptoms of the disease involve green or yellow discharge from genitals, as well as pain while urinating. Sometimes there are no symptoms, and a person may spread the disease to others without realizing it.

Typically, gonorrhea is treated with one or a combination of drugs, but once an antibiotic becomes more popular among patients, it loses its potency. Bacteria are constantly evolving and mutating, so it’s only a matter of time before certain strains develop resistance to common antibiotics.

"This azithromycin highly resistant outbreak is the first one that has triggered a national alert," Peter Greenhouse, a consultant in sexual health, told the BCC during the Leeds outbreak. "It doesn't sound like an awful lot of people, but the implication is there's a lot more of this strain out there and we need to stamp it out as quickly as possible. If this becomes the predominant strain in the UK we're in big trouble, so we have to be really meticulous in making sure each of these individuals has all their contacts traced and treated."