In August 2003 a prepubescent 8 year old girl presented with a sudden onset history of a non-irritating, odourless heavy green vaginal discharge which had developed overnight. She had arrived back in Sydney approximately 24 hours earlier by an international air flight following an overseas holiday with her mother and two adolescent siblings. The family had spent 72 hours in transit flying from Rome to Sydney via Moscow.

The child was taken initially to her family doctor and a heavy growth of Neisseriagonorrhoeae was isolated. The organism was resistant to both penicillin and ciprofloxacin. One week later, following an initial course of antibiotics, the …