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Experts discuss whether kissing is blamed for the spread of gonorrhea

In Australia, the percentage of gonorrhea has more than tripled between 2008 and 2017 from 36 to 118 reports per 100,000, according to the Australian Institute of Health and Welfare.

"Understanding how it's sent is the key to understanding how to control it – if killing is a key transmission route, it's important to explore new control methods," says Professor Fairleysaid.

The gonor indicator has tripled in 2008-2017.

The gonor indicator has tripled in 2008-2017. Credit:Australian Institute of Health and Welfare

Gonorrhea is a bacterial infection that can affect the urinary tract in the penis as well as the throat, cervix and anus. Usually there are only symptoms of gonorrhea in the penis, which include oil-like secretion and irritation during urination. Professor Fairley said that this is an important aspect of his argumentation, because these symptoms cause rapid treatment.

"The meaning of this is that when it comes to transmission, people find out about it quite quickly, so they are treated, so there are not many opportunities to pass it on," he said.

"The incidence of gonorrhea is so high in men who have sex with men because transmission is not always associated with the penis, so symptoms do not always appear."

Professor Handsfield, who is an expert in sexually transmitted infections, said the studies adopted showed that gonorrhea was transmitted through the penis, and transmission through kisses or saliva during oral sex was "scarcely thin".

"All available research or basic knowledge was that this is happening, but the transmission is less efficient," he said.

However, Professor Fairley said that an example of a gonorrhea outbreak at a music festival between seven people who had some form of sexual contact, including kissing, strengthened his arguments.

"There were six cases of pharyngeal gonorrhea with the same type of gonorrhea. None of the seven people had genital gonorrhea, he said.

"I do not know how it reached six throats if it did not get there by the kiss."

Professor Handsfield said Professor Fairley's research on the importance of oral transmission is likely to prove correct in the future, but not to the extent that the Melbourne team is saying.

"I think they have something to do, I think they are raising questions that deserve close research, which the world must take seriously, but I do not believe that their research shows that oral infections account for more than half of men who have sex with men, Professor Handsfield said.

Professor Fairley's argument is published in Lancet infectious diseases daily on Thursday.

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