WORLD NEWS
Resistant gonorrhoea is spreading within Europe: who faces higher risk?
ECDC says ceftriaxone-resistant gonorrhoea is now spreading within the EU/EEA and UK. Overall risk is low for the general population, but rises with condomless sex involving multiple or new partners and similar exposure during travel to higher-circulation areas.
What changed and how large is the risk?
On 16 July 2026, ECDC concluded that ceftriaxone-resistant gonorrhoea is now transmitting within the EU/EEA and the UK. Earlier detections were mainly sporadic and travel-associated, but increases and locally acquired clusters emerged in France, Germany, Sweden and the UK during 2025-2026. ECDC rates risk as low for the general sexually active population, low-to-moderate for people with multiple or frequently changing partners or condomless sex with casual or new partners, and moderate for similar exposure while travelling to areas with higher circulation.
Resistance does not yet mean untreatable
Ceftriaxone is central to recommended first-line treatment in Europe, so wider resistance could narrow treatment choices. But every reported infection has so far been treated successfully. “Resistant” must not be rewritten as “untreatable.” The concern is that sustained spread could reduce the effectiveness of standard regimens and make it harder to select effective treatment for each patient.
The warning signs in surveillance data
Euro-GASP’s 2024 surveillance included 24 countries. Laboratories submitted 4,516 isolates and 3,371 entered the analysed dataset. Two ceftriaxone-resistant isolates were found in that dataset and both were extensively drug-resistant. The azithromycin resistance indicator was 19.1% and appeared in 23 of 24 countries. More than 106,000 gonorrhoea cases were reported in the EU/EEA in 2024. Small resistant-isolate counts still matter when options for treatment are limited.
What to do after possible exposure
After possible exposure or symptoms such as discharge or painful urination, seek STI testing rather than taking antibiotics without medical advice. Gonorrhoea can cause no symptoms, and the correct samples depend on the exposed sites, so tell the clinician about oral, genital and rectal exposure. Treatment should follow national guidance. Culture, susceptibility testing and a test-of-cure are especially important for suspected resistant infection or treatment failure. Partner notification and testing help prevent reinfection and onward transmission.
What to verify in ECDC sources
ECDC’s risk assessment explains the evidence for domestic transmission, risk by exposure and recommendations for testing, treatment and test-of-cure. The Euro-GASP report provides the isolate counts and resistance data, while the surveillance portal links annual updates. The assessment is not a reason to blame a country or group, and it does not mean Europe has entered an untreatable epidemic. Individual testing and treatment should follow local public-health and clinical guidance.
ECDC risk assessment and risk by exposure