File photo: The researchers studied questionnaires from more than 3 000 gay and bisexual men at a sexual health centre in Melbourne. Picture: Wikimedia Commons

Washington - It may be possible to pass gonorrhea through kissing, challenging the widely accepted notion that the sexually transmitted disease is spread almost exclusively through sexual contact, a new study says.

Researchers in Australia found that kissing with tongue may be a way to transmit oropharyngeal gonorrhea, or oral gonorrhea, particularly among gay and bisexual men. 

Although the idea has not been well-studied, one expert says the findings, published in the journal Sexually Transmitted Infections, could be important for understanding gonorrhea as it continues to spread and become more resistant to treatment.

Anthony Lutz, a nurse practitioner in the department of urology at Columbia University Medical Center, said that although he has not personally seen such cases, the suggestion that it could be transmitted mouth to mouth has been percolating within the medical community.

"It's a worthwhile topic to continue investigating" so medical practitioners can better screen and treat patients for the disease, he said.

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It can be transmitted among people who have vaginal, anal or oral sex with someone who has it, and it can infect the genitals, rectum and throat, according to the Centers for Disease Control and Prevention.

But gonorrhea - even oral gonorrhea - is not considered to be a kissing disease; rather, public health authorities say, oral gonorrhea is contracted through oral sex.

The researchers studied questionnaires from more than 3 000 gay and bisexual men at a sexual health centre in Melbourne about their recent sexual history. Six percent tested positive for oral gonorrhea,.

The men noted that they had had an average of four kissing-only partners, five kissing-with-sex partners and one sex-only partner over the past three months. 

The researchers found that those with a higher number of kissing-only and kissing-with-sex partners were at a greater risk of testing positive for oral gonorrhea, the study said.

"We found that the more people an individual kissed also placed them at an increased risk of having throat gonorrhoea, irrespective of whether sex occurred with the kissing. This data challenges the accepted traditional transmission routes of gonorrhea held for the past 100 years, where a partner's penis was thought to be the source of throat infection," Eric Chow, the lead author of the study, wrote in an email to The Washington Post. 

He added: "We found after we controlled statistically for the number of men kissed, that 'the number of men someone had sex with but did not kiss was not associated with throat gonorrhoea.' "

The Washington Post