The UK has called for a nationwide health alert after detecting a highly drug-resistant gonorrhoea outbreak in the north of England.
Gonorrhoea is a venereal disease involving inflammatory discharge from the urethra or vagina.
It is a serious infection of the genital tract in both men and women, caused by a bacterium Neisseria gonorrhoeae, sometimes called gonococcus.
According to the British Association for Sexual Health and HIV (BASHH) , so far the Public Health England (PHE) has detected 15 cases in heterosexual patients.
Twelve have been confirmed in Leeds, while four have been reported in patients from Macclesfield, Oldham, and Scunthorpe.
The outbreak was initially detected in Leeds this March, but has now spread to neighbouring areas in the north of England. There are likely to be more undiagnosed cases of this sexually transmitted infection.
Reports to PHE's sexually transmitted bacteria reference unit (STBRU) reference cases with high-level azithromycin resistance, which have previously been rare.
PHE is concerned that the effectiveness of current frontline dual therapy for gonorrhoea will be threatened if this resistant strain continues to spread unchecked.
A statement from BASHH read: "We will be issuing an alert to microbiologists through our regional microbiology network to raise awareness and encourage reporting of high-level azithromycin strains to STBRU for confirmation.
"We would like to highlight to clinicians that if a strain of high level azithromycin resistant gonorrhoea is detected in one of their patients that they should make particularly rigorous efforts to ensure patients are followed up and receive a test of cure (TOC) and that all their partners are contacted, tested and, where necessary, treated and followed up for TOC."
PHE said that an outbreak control team meeting has been convene and currently STBRU are performing next-generation sequencing on these strains to better understand the molecular epidemiology.
In England, gonorrhoea is the second most common sexually transmitted infection and cases are increasing.
According to PHE, the number of infections has increased by 19% from 29,419 in 2013 to 34,958 the following year.