French kissing could help spread drug resistant gonorrhoea, warns a new study.
But gargling with antiseptic mouthwash could help stop the spread of the disease, say scientists.
Previously it had been thought the bacteria was spread through unprotected sex in straight or gay people, and it had been understood it could not be spread by kissing.
The bacteria mostly infects the entrance to the womb (cervix), the tube that passes urine out of the body (urethra), and the rectum, with infections less common in the throat or eyes.
But as antibiotic resistant strains of the STI spread across the globe, Australian researchers say “deep kissing” with tongues may be an important and neglected route for passing on throat, or oropharyngeal, gonorrhoea.
Associate Professor Eric Chow, of the Melbourne Sexual Health Centre, said: “Antibiotic-resistant Neisseria gonorrhoeae isolates have increasingly been documented in many countries, and a recent genomic analysis demonstrated that antibiotic-resistant strains of N. gonorrhoeae transmit between sexual partners, raising the concern that gonorrhoea will become increasingly difficult to treat.
“To combat this trend, better evidence-based public health strategies are needed
to prevent the spread of gonorrhoea
“A number of pieces of evidence suggest that transmission from the oropharynx may be more common than previously thought.
“N. gonorrhoeae can be cultured from saliva, suggesting that the exchange of saliva between individuals may potentially transmit gonorrhoea.
“Several case reports in the 1970s suggested kissing as a mode of transmission for
oropharyngeal gonorrhoea and led to the proposal that gonorrhoea could be transmitted this way.
“It has been proposed that gonorrhoea can be transmitted through kissing, but kissing has always been neglected as a risk factor for gonorrhoea transmission.
“One implication of this finding is that potential interventions such as antiseptic mouthwash, if shown to be effective against oropharyngeal gonorrhoea, could
provide a non-condom and non-antibiotic-based intervention for gonorrhoea control.
“This is particularly relevant in the context of recent reports of highly-resistant N. gonorrhoeae, and known challenges associated with the antimicrobial treatment of oropharyngeal gonorrhoea.”
To assess whether throat gonorrhoea might be passed on through tongue kissing either by itself or as part of sex, researchers asked gay and bisexual patients at a major public sexual health service in Melbourne, Australia in 2017 to 2017.
They were asked if they just kissed, kissed and had sex or had sex without kissing.
But the proportion of men testing positive for throat gonorrhoea was higher than it was for those who had had sex without kissing.
And the more kissing they did with more men, the higher the risk.
After accounting for potentially influential factors, the odds of testing positive for throat gonorrhoea were 46 per cent higher among men who had had four or more kissing only partners, and 81 per cent higher among those with four or more kissing with sex partners, compared with men who had only one or no partners in these categories.
Prof Chow added: “Our results suggest kissing with or without sex may be a risk factor for oropharyngeal gonorrhoea.”
Before the research was published, the NHS claimed gonorrhoea is not spread by kissing, hugging, swimming pools, toilet seats, or sharing baths, towels, cups, plates or cutlery. It added the bacteria cannot survive outside the human body for long.
Gonorrhoea is usually treated with a single antibiotic injection and a single antibiotic tablet and with effective treatment, most symptoms should improve within a few days.
Gonorrhoea is the second most common bacterial STI in the UK after chlamydia.
In 2017, more than 44,500 people were diagnosed with gonorrhoea in England, with most cases affecting young men and women under 25.
The new study was published in the journal Sexually Transmitted Infections.