There were 4,486 diagnoses of gonorrhoea in Greater Manchester in 2023 – a 153% increase compared to cases in 2012
Cases of antibiotic-resistant gonorrhoea are on the rise(Image: PA)
A sexually transmitted infection (STI) could become “untreatable” as it becomes resistant to antibiotics, health officials have warned – amid rising cases of gonorrhoea in Greater Manchester.
There were 4,486 diagnoses of gonorrhoea in Greater Manchester in 2023, according to the latest figures available.
That is only a slight increase from 4,493 the previous year, but a 153% increase on 2012 (1,773), when regional records began.
While most infections can be effectively treated, certain resistant strains, particularly ceftriaxone-resistant gonorrhoea, present a much greater challenge.
As the primary antibiotic used to treat gonorrhoea – an ancient STI referenced in the Bible and early Greek and Roman writing – resistance to ceftriaxone can make infections difficult to heal.
Since it was first detected in England in 2015, 42 cases of ceftriaxone-resistant gonorrhoea have been reported. Fifteen of these cases were XDR, which means that they were resistant to ceftriaxone and alternative treatment options.
Although numbers remain low, cases are being detected more frequently. Thirteen cases were diagnosed last year and four in 2025 so far, compared to 16 cases in the previous two years combined.
XDR cases are also rising. Nine cases have been reported in the last fifteen months, compared to five in the two years to December 2023.
Dr Katy Sinka, Consultant Epidemiologist and Head of the STI section at the UK Health Security Agency (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.
“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.”
A gonorrhoea infection is caused by the bacteria Neisseria gonorrhoeae(Image: Getty Images)
The UKHSA says most antibiotic-resistant cases are linked to travel to or from the Asia-Pacific region, where ceftriaxone resistance is common. While transmission within England has been limited so far, the increasing number of cases in recent years is concerning as it increases the chance of wider spread and treatment challenges.
In 2023 there were a record 85,000 cases of all strains of gonorrhoea in England, the highest number in more than 100 years. That’s more than triple the number of cases a decade earlier.
The infection rate – the number of cases per 100,000 people, which measures the risk of catching a disease – has trebled from 50.3 infections per 100,000 people in 2012 to 149 per 100,000 in 2023. The latest regional data on gonorrhoea infections shows that the risk of catching this ancient STI in Greater Manchester is highest in Manchester, where there were 1,573 diagnoses of gonorrhoea in 2023.
Compared to the population size that adds up to 276 infections per 100,000 people. That’s the fourth highest rate in England outside London, the highest rate in Greater Manchester and the equivalent of about one in 362 people catching gonorrhoea.
Salford has the next highest rate in Greater Manchester with 229 infections per 100,000 of the population, well above the national average.
You can see the cases and rate of gonorrhoea where you live, and how that has changed over the last decade, using our interactive map.
Typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when peeing and, in women, bleeding between periods. It is normally spread by having unprotected sex or, in some cases, by sharing sex toys, but it can also be passed from a pregnant woman to her baby.
However, many people infected with gonorrhoea will have no symptoms, so it is important to test regularly when having sex with new or casual partners.
If untreated, complications can include pelvic inflammatory disease, ectopic pregnancy and infertility in women; scrotal swelling, urethral stricture – which can make it painful to pass urine and can lead to infection – and infertility in men.
Without treatment, gonorrhoea can cause permanent blindness. Gonorrhoea can be traced back to biblical times, and mentions of this sexual infection can be found in the earliest records of the human race.
The disease is thought to be referenced several times in the Bible, particularly in the Old Testament Book of Leviticus, which warns: “The man that hath an issue of seed, shall be unclean.”