New Delhi: If you thought gonorrhoea -- the most antibiotic-resistant of all the sexually transmitted infections -- can spread through only oral, anal or vaginal sex with someone with the disease, hold on. New research suggests mouth kissing can also be a risk factor in spread of the infection and a good-quality anti-bacterial mouthwash can help.

The global sexual health community "needs to recognise that gonorrhoea is on the rise and that there should be an increased awareness of the risks of kissing as a route of transmission", said one of the researchers Christopher Fairley, Professor at Monash University in Australia.

"Understanding how it is transmitted is the key to understanding how to control it -- if transmission by kissing is a key route of transmission then it is important to investigate new methods of control, such as anti-bacterial mouthwash," Fairley added.

According to Dr B.M. Doda, senior physician at Walia Nursing and Maternity Home in New Delhi, kissing can spread gonorrhoea.

'I agree with the study that kissing can also cause gonorrhoea though the chances are less. Saliva can also help spread the disease," Dr Doda told IANS.

Dr Joydeep Ghosh who is Consultant (Internal Medicine), Fortis Anandapur Kolkata, said: "I have seen people (mostly heterosexual and bi-sexual males) who never had sex for months had oral gonorrhoea because of kissing".

According to the the World Health Organization (WHO), each year, an estimated 78 million people are infected with gonorrhoea, which is caused by the bacterium Neisseria gonorrhoeae.

Gonorrhoea can infect the genitals, rectum and throat. There is a global rise in gonorrhoea rates and, until now, no one has understood why.

The conventional wisdom has been that the disease spreads among people who have oral, anal or vaginal sex with someone with the disease.

The new research, published in The Lancet Infectious Diseases, indicates that a significant -- and previously unrecognised -- route of transmission of the bacterial infection is kissing.

A study, published earlier this year in the journal Sexually Transmitted Infections, analysed more than 3,600 men who have sex with men over a 12-month period from March 2016.

By mapping those who only kissed partners, compared to having sex with partners, the same Fairley team were able to determine that the transmission of the disease is high in people who kiss only, and was higher in those who have sex with kissing compared to those who have sex without kissing.

According to Dr Rahul Sharma, Consultant, Dermatology at Nayati Medicity, Mathura, kissing can increase the chances of gonorrhoea in those who indulge in oral sex.

"Recently, we have seen cases of pharyngeal gonorrhoea on rise. We suspect oral gonorrhoea when we get history of oral sex and other causes of pharyngitis are ruled out. History and type of sexual exposure is important," said Sharma.