“It is time to sound the alarm,” said Dr. Judy Wasserheit, vice chair of the Department of Global Health at the University of Washington, who wrote the article with Dr. Gail Bolan of the U.S. Centers for Disease Control and Prevention and Dr. P. Frederick Sparling of the University of North Carolina School of Medicine, Chapel Hill.

Gonorrhea bacteria - Photo CDC

Gonorrhea is a sexually transmitted disease that can infect the genital tract, throat and anus.

There are more than 600,000 cases of gonorrhea a year in the U.S., making it one of the most common reportable infections in the country.

Untreated, gonorrhea can cause a number of serous complications, including infertility, a chronic painful pelvic condition in women called pelvic inflammatory disease, and ectopic pregnancy, a serious complication in which the fetus develops in the fallopian tube instead of the uterus.

In rare cases, the bacteria can travel through the bloodstream and infect joints, heart valves and the brain.

The bacteria that causes gonorrhea, Neisseria gonorrhoeae, has a history of quickly acquiring the ability to resist antibiotics. In the 1940s it became resistant to sulfa drugs, in the 1980s to penicillins and tetracyclines, and by 2007 to flouroquinolones.

Today, treatment with a class of antibiotics called cephalosporins is considered the most reliable option, but resistance to this class of drugs is on the rise both abroad and in the U.S., raising concerns that doctors here will soon begin seeing cases they cannot cure.

Untreatable cases have not yet been reported in the U.S., but they have appeared in Asia and Europe and a worrying number of strains in the U.S. are showing signs of resistance to cephalosporins.

Resistance to one of the cephalosporins has risen 17-fold in the U.S. over the past few years, Dr. Wasserheit and her colleagues write, increasing from just 0.1 percent of cases in 2006 to 1.7 percent in the first part of last year.

Resistance has been increasing even faster in the western U.S., reaching 3.6 percent of all cases last year and 4.7 percent of cases among men who have sex with men.

Although higher doses may overcome the ability of these strains to resist cephalosporins for a time, Dr. Wasserheit and her colleagues write, urgent action is needed now to prevent the spread of these strains and to develop new treatments.

“There is much to do, and the threat of untreatable gonorrhea is emerging rapidly,” they conclude.

 To learn more:

• Visit the National Library of Medicine’s Medline Plus information page on gonorrhea.

• Visit the Public Health – Seattle & King County’s page on Sexually Transmitted Infections.

Photo: Sigurd Decroos

The good news: Teen pregnancies are at their lowest rate in nearly 40 years, resulting in fewer abortions and births, according to data from the Guttmacher Institute, a research organization focused on sexual and reproductive health.

The report shows that about 7 percent of U.S. teen girls between the ages of 15 to 19 were pregnant in 2008 — a decline from the high of more than 11 percent in 1990.

Abortions among teen girls fell from a peak of more than 4 percent in 1988 to about 1.8 percent in 2008, the lastest year for which data is available.

The bad news: While overall rates have dropped, there is still a major gap among white, Hispanic and black teenagers. Non-Hispanic white teen pregnancy rates fell by 50 percent from their peak; Hispanic teen pregnancy rates, 37 percent; black teen pregnancy rates, 48 percent.

Yet, according to the report, “the abortion rate among black teenagers was four times the rate for non-Hispanic whites, while the rate among Hispanic teenagers was twice the rate for non-Hispanic white teenagers.”

“The disparity has pretty much been unchanged,” said Kathryn Kost, co-author of the report. “If you think of these rates as lines on a graph, they are all going down, but the distance between them is pretty much unchanged.”

Kost said the increase in contraceptive marketing has helped to reduce pregnancies, but Heather Boonstra, a senior public policy associate at Guttmacher said the cost of contraceptives continues to be a factor. Boonstra said increasing the age limit for dependent health care coverage to 26 will increase access to birth control for many teens.

“There’s plenty of evidence that shows that if you take away cost in the equation,there is going to be better contraceptive use, fewer unintended pregnancies, fewer abortions, better birth outcomes,” she said. “The health care reform law was not designed with teens in mind, but … the more parents that are insured, the more teens or their dependents are insured, so certainly that will help.”

Bill Albert, the chief program officer of The National Campaign to Prevent Teen and Unplanned Pregnancy, said the decreased rates are a sign of progress, but more remains to be done. He noted that three out of 10 girls are pregnant by the age of 20.  Among the campaign’s initiatives is one focused on the Latino community and a new website geared to educating young women about birth control.

“In a way the message is let’s celebrate today, and then get back to work this afternoon,” Albert said. “I think this underscores the need to continue to invest as the current admin has in proven efforts to prevent teen pregnancy.”

Photo by Sigurd Decroos of CobraSoft.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Time: Gingrich Wants Scrutiny Of IVF Clinics: Why That’s Not The Worst Idea

Republican presidential contender Newt Gingrich hit upon a reproductive minefield on Sunday when he called for deeper scrutiny of in vitro fertilization (IVF) clinics, where women go for high-tech help to conceive. Gingrich, who believes life begins at conception, wants a commission to dissect the ethical issues attendant with assisted reproductive technology. Ostensibly, it’s not the babies born from IVF he’s got a problem with; it’s the potential babies — and there are lots and lots of them — who aren’t. … The creation of excess embryos is central to the IVF process. … For most women, no more than two embryos are recommended for transfer. Considering that hyperstimulation can yield more than a dozen embryos — hello, Octomom — the question of what to do with the leftovers is one that can’t be ignored (Bonnie Rochman, 1/30).

Columbia Journalism Review: Medicare Versus Obamacare

In the last few days, three mainstream news outlets elevated “Medicare: The Political Story” into the headlines. It was good to see that The New York Times, PBS’s Need To Know, and Reuters, all of which reach large audiences, have realized Medicare may be the most important health story of the campaign. (Yes, perhaps more important than the Supreme Court’s ruling on the individual mandate.) During the 2008 campaign, as Campaign Desk pointed out at the time, the candidates ignored Medicare. … Now that large outlets have anointed Medicare politics as legitimate news, we’ll probably see a lot more similar stories. That’s fine, but a diet of nothing but political stories shortchanges the public, since those stories omit crucial information about what Medicare is and what opponents want it to become (Trudy Lieberman, 1/30).

National Review: Free Birth Control Vs. Freedom Of Religion

When Pliny the Younger was a provincial governor in the Roman Empire, he wrote a letter to Emperor Trajan asking whether he should execute Christians who refused to burn incense in worship of the emperor. I thought of Pliny when I read that the Obama administration, in creating specific rules to implement Obamacare, will require all employers (with a very narrow exemption discussed below) to offer their employees health insurance that provides FDA-approved contraception, female sterilization, and other “reproductive” services free of charge — even if the employer is a religious organization and doing so violates its doctrine. … The birth-control rule is the latest and most egregious example of government forcing religious organizations to conform their operations to reigning secular moral values. In this sense, faith organizations are being compelled to participate in a metaphorical Caesar worship (Wesley J. Smith, 1/30).

Photo courtesy of Rasiel Suarez/Creative Commons license

Governing: School-Based Health Centers Reap Benefits

In more than 2,000 schools throughout the country, students can get free comprehensive medical, mental health and sometimes dental care without ever leaving school property. School-based health centers (SBHCs) are fully staffed clinics located in or on school property. Each one is different, but most offer a full range of services, including primary care, mental health and social services. Most are in schools that serve the neediest students and are funded by state governments, the feds and private foundations. … Having a full-service health clinic in schools has many benefits. … Luckily, virtually every entity that applied for the new federal SBHC grants received at least a portion of the funds. Unlike the rest of the federal health law, advocates argue, school-based health centers are a nonpartisan solution to a pervasive problem (Caroline Cournoyer, February 2012).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

The foundation, which focuses on raising money for breast cancer research and prevention, said it was pulling about $700,000 in breast cancer screening and service grants from the Planned Parenthood Federation of America under a new policy that forbid support for organizations under investigation.

Planned Parenthood is the under investigation that was launched last fall by House Energy and Commerce Investigative Subcommittee Chairman Cliff Stearns, R-Fla.

But Planned Parenthood’s supporters argued the investigation is politically motivated and based on allegations proved to be unsubstantiated.

Komen, they charged, was simply knuckling under to pressure from anti-abortion groups and using the new policy as cover.

Reaction was swift and fierce with abortion-rights supporters denouncing Komen from the floor of Congress to Facebook pages.

In a statement, released today the Komen board for directors said:

We want to apologize to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women’s lives. The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.

Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation. We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.

In a statement released in response to the Komen decision Planned Parenthood said:

In recent weeks, the treasured relationship between the Susan G. Komen for the Cure Foundation and Planned Parenthood has been challenged, and we are now heartened that we can continue to work in partnership toward our shared commitment to breast health for the most underserved women. We are enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers.

Full text of both statements are below:

Full text of today’s statement from Komen:

We want to apologize to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women’s lives. The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.

Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation. We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.

Our only goal for our granting process is to support women and families in the fight against breast cancer. Amending our criteria will ensure that politics has no place in our grant process. We will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants, while maintaining the ability of our affiliates to make funding decisions that meet the needs of their communities.

It is our hope and we believe it is time for everyone involved to pause, slow down and reflect on how grants can most effectively and directly be administered without controversies that hurt the cause of women. We urge everyone who has participated in this conversation across the country over the last few days to help us move past this issue. We do not want our mission marred or affected by politics – anyone’s politics.

Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work. We ask for the public’s understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve.

We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern.

Statement released by Planned Parenthood:

“The outpouring of support for women in need of lifesaving breast cancer screening this week has been astonishing and is a testament to our nation’s compassion and sincerity.

“During the last week, millions spontaneously joined a national conversation about lifesaving breast cancer prevention care and reinforced shared values about access to health care for all. This compassionate outcry in support of those most in need rose above political, ideological, and cultural divides, and will surely be recognized as one of our nation’s better moments during a contentious political time. Planned Parenthood thanks each and every person who has contributed to elevating the importance of breast cancer prevention for so many women in need.

“In recent weeks, the treasured relationship between the Susan G. Komen for the Cure Foundation and Planned Parenthood has been challenged, and we are now heartened that we can continue to work in partnership toward our shared commitment to breast health for the most underserved women. We are enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers. What these past few days have demonstrated is the deep resolve all Americans share in the fight against cancer, and we honor those who are at the helm of this battle.

“Planned Parenthood has been a trusted partner with the Komen Foundation in early cancer detection and prevention services. In particular, Planned Parenthood helps the Komen Foundation reach vulnerable populations — low-income women, African-American women, and Latinas — especially in rural areas and underserved communities where Planned Parenthood health centers are their only source of health care. With Komen Foundation grants, over the past five years, Planned Parenthood health centers provided nearly 170,000 clinical breast exams and more than 6,400 mammogram referrals. With the outpouring of support over the past week, even more women in need will receive lifesaving breast cancer care.”

The New York Times Magazine: The Fat Trap

For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more.

While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. … it’s clear, from a public-health standpoint, that resources would best be focused on preventing weight gain.

The research underscores the urgency of national efforts to get children to exercise and eat healthful foods. But with a third of the U.S. adult population classified as obese, nobody is saying people who already are very overweight should give up on weight loss. … Studies suggest that even a 5 percent weight loss can lower a person’s risk for diabetes, heart disease and other health problems associated with obesity (Tara Parker-Pope, 12/28).

National Review: Santorum’s Pro-Life Credibility

Santorum truly is an excellent representative of his cause. Perhaps no politician in our national life has been so pointedly forced by circumstances to live up to his creed. If Santorum can seem too blithe and self-assured when he talks the talk, he has painfully walked the walk. The Santorums lost one child shortly after childbirth and have another who survived despite a grave, usually fatal, genetic disorder (Rich Lowry, 1/4).

Salon: Rick Santorum Is Coming For Your Birth Control

Here is an actual Rick Santorum quote: “One of the things I will talk about, that no president has talked about before, is I think the dangers of contraception in this country.”

And also, “Many of the Christian faith have said, well, that’s okay, contraception is okay. It’s not okay. It’s a license to do things in a sexual realm that is counter to how things are supposed to be.”

… while reproductive rights are always cast in terms of pro or against a woman’s right to an abortion and in what circumstances, even liberals are surprised to find out what social conservatives really want to do about contraception (Irin Carmon, 1/4).

American Medical News: Health Reform After 2014: Not-So-Universal Coverage

The national health system reform law is expected to reduce the nation’s uninsured population to what could be an all-time low. But even after the major reforms take effect starting in 2014, millions will remain without coverage, whether by choice or by circumstance. … each region of the U.S. is expected to see its uninsured population shrink by roughly half  …  he health reform law’s true impact on the final tally and demographics of the uninsured will be shaped by the decisions of consumers, employers, federal health officials and states (Doug Trapp, 1/2).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.