It’s the first report of a gonorrhea strain that doesn’t respond to the combination of antibiotics that experts recommend.

A man in the UK has been infected with a strain of gonorrhea bacteria that is resistant to multiple antibiotics.

The man had a regular female partner in the UK and had sexual contact with a woman in southeast Asia a month before he developed gonorrhea symptoms, according to the Health Protection Report from Public Health England.

Doctors treated him with the antibiotic ceftriaxone, and then another antibiotic, spectinomycin. The treatment failed, as his throat swabs were still positive for the bacteria, called Neisseria gonorrhoeae.

The man is now being treated with a third drug, called ertapenem, and tests suggest it might work. But tests also showed the bacteria were definitely resistant to azithromycin and ceftriaxone, the two drugs the US Centers for Disease Control and Prevention recommend for treating gonorrhea.

This is the world’s first known case of N. gonorrhoeae that is resistant to azithromycin and ceftriaxone. The BBC called it “super-gonorrhea.”

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The idea of a nearly untreatable gonorrhea has been a thing for some time.

The World Health Organization issued a report on drug-resistant gonorrhea in July that looked at 77 countries. It found that 81% of the countries reported azithromycin resistance and 66% reported decreased susceptibility to ceftriaxone.

And in 2016, Alan Katz and colleagues at the University of Hawaii published a study about a cluster of seven cases in Oahu, Hawaii, that were resistant to azithromycin and ceftriaxone, which “may bring the threat of treatment failure in the United States with the current recommended dual therapy one step closer,” they wrote.

This new case is “very concerning,” said Yonatan H. Grad, an assistant professor of immunology and infectious diseases at Harvard. However, it’s not yet clear if the man’s gonorrhea is incurable because he’s still being treated.

This case was probably “inevitable,” Grad told BuzzFeed News by email, because people have been tracking the emergence of highly resistant strains for some time.

“This does not bode well,” he said. “We will see more cases of difficult-to-treat gonorrhea that may require us to use non-standard treatment approaches.”

Here are the places in the US that are fighting drug-resistant gonorrhea:

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Here’s how you can avoid getting gonorrhea:

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Gonorrhea is a sexually transmitted infection, or STI. Anyone who is sexually active can get it, and it’s pretty common. In the US, there are about 820,000 new infections each year, and about 570,000 of them are in people 15 to 24 years of age. The bacteria can infect your genitals, rectum, and throat, according to the CDC.

Not having sex can prevent an infection, but using condoms correctly and limiting sexual partners can also help. Here’s a tutorial on how to use a male condom, if you don’t know how to use one (or if you think you know, but maybe want to double check).

People have known about gonorrhea since medieval times and have sometimes called it “the clap,” although the germ wasn’t identified until 1879.

Gonorrhea symptoms can sometimes be tricky and difficult to detect. Men can have a burning sensation when they urinate, a penile discharge, or less often, swollen testicles. Women can have no symptoms at all, or pain and burning while urinating, vaginal discharge, or vaginal bleeding between periods. A rectal infection can include itching, discharge, pain on defecation, bleeding, and soreness.