A West Country city is seeing a rise in cases of the sexually transmitted disease gonorrhoea - and a leading expert blames it on swingers and homosexuals and warns that it will be untreatable in five years.
A leading expert has warned that Bristol has just five years left to bring the disease under control before it is expected to become immune to the last remaining effective treatment.
A consultant at the Bristol Sexual Health Centre Peter Greenhouse said he has seen a rise in Bristol's swingers coming into his clinic on Tower Hill in the city centre.
He said the last gonorrhoea outbreak from a swingers' club saw 20 people affected after members shared sexual partners for unprotected sex.
The number of patients contracting gonorrhoea went up from 167 in the city in 2012 to 225 last year, according to figures released by Public Health England. That represents a rise of more than a third in a single year.
One of the main ways the bacterial infection is spread is through oral sex and one in ten people infected will not know they have contracted it.
There is now only one antibiotic left which can treat the disease and its effectiveness is likely to end as the disease evolves, developing resistance.
Before the 1970s penicillin was widely used to treat gonorrhoea. When its effectiveness dwindled, other antibiotics were used but one by one they have lost their potency.
Mr Greenhouse said: "We are in real trouble with gonorrhoea – it's a matter of around five years before it becomes untreatable. Unless a new class of drugs is developed, it's going to be a really big problem."
Antibiotic resistance accelerated with gonorrhoea because lots of sufferers have the infection in their throat, which is harder for drugs to tackle.
Mr Greenhouse said that in addition to swingers, the surge in sexually transmitted diseases in the city had been fuelled by gay men having sex with multiple partners.
He said: "You only need to have one man who has multiple (male) partners and you soon see an increase in numbers.
"The number of people we see from the swingers' population fluctuates from week to week. If one person in the group has something then they are all likely to come down with it."
Mr Greenhouse warned it was crucial for people to have regular check-ups and to wear condoms, even during oral sex.
Steve Jones, Regional Manager for Terrence Higgins Trust in the West of England, said: "The more partners you have, the potential for the spread of any infection. We encourage people to get tested frequently if they have put themselves at risk.
"Certainly men who have sex with men do seem to have a greater burden of STDs. Possibly this is because men who have sex with men do tend to change their sexual partners more frequently than the heterosexual community.
"However men who have sex with men are more likely to be screened for infections more frequently – generally the infections are identified a lot sooner.
"Social networks also makes finding sexual partners a lot easier and that, I'd say, is for all communities."
Cases of syphilis recorded in the Bristol rose by more than a third, from 15 in 2012 to 22 last year.
Public Health England's figures also showed a seven per cent rise in cases of genital warts from 636 in 2012 to 694 last year.
Anyone wishing to arrange an appointment at the Bristol clinic should call 0117 342 6900. Weston-super-Mare residents should call 01934 881234.