Chlamydia
is a common sexually transmitted disease (STD) caused by infection with Chlamydia trachomatis. It can cause cervicitis in women and urethritis and
proctitis in both men and women. Chlamydial infections in women can lead to
serious consequences including pelvic inflammatory disease (PID), tubal factor
infertility, ectopic pregnancy, and chronic pelvic pain. Lymphogranuloma
venereum (LGV), another type of STD caused by different serovars of the same
bacterium, occurs commonly in the developing world, and has more recently
emerged as a cause of outbreaks of proctitis among men who have sex with men (MSM)
worldwide.
Chlamydia
is the most frequently reported bacterial sexually transmitted infection in the
United States. In 2010, 1.4 million cases of chlamydia were reported to the
U.S.CDC from 50 states and the District of Columbia, but an estimated 2.86
million infections occur annually. Many cases are not reported because most
people with chlamydia do not have symptoms and do not seek testing. Chlamydia
is most common among young people. It is estimated that one in 15 sexually
active females aged 14-19 years has chlamydia.
People
at risk for chlamydia
Any
sexually active person can be infected with chlamydia. Anyone with genital
symptoms such as discharge, burning during urination, unusual sores, or rash
should refrain from having sex until they are able to see a health care
provider about their symptoms.
Also,
anyone with an oral, anal or vaginal sex partner who has been recently
diagnosed with an STD should see a health care provider for evaluation.
Because
chlamydia is usually asymptomatic, screening is necessary to identify most
infections. Screening programs have been demonstrated to reduce rates of
adverse sequelae in women. CDC recommends yearly chlamydia screening of all
sexually active women age 25 or younger and older women with risk factors for
chlamydial infections (e.g., women who have a new or more than one sex
partner). Pregnant women should be screened during their first prenatal care
visit. Pregnant women younger than 25 or at increased risk for chlamydia (e.g.,
women who have a new or more than one sex partner) should be screened again in
their third trimester. Any woman who is sexually active should discuss her risk
factors with a health care provider who can then determine if more frequent
screening is necessary.
Routine
screening is not recommended for men. However, the screening of sexually active
young men should be considered in clinical settings with a high prevalence of
chlamydia (e.g., adolescent clinics, correctional facilities, and STD clinics)
when resources permit and do not hinder screening efforts in women.
Men
who have sex with men (MSM) who have receptive anal sex should be screened for
chlamydia each year. MSM who have multiple and/or anonymous sex partners should
be screened more frequently (e.g., at three to six-month intervals).
HIV-infected
sexually active women who are age 25 or younger or have other risk factors, and
all HIV-infected patients who report having receptive anal sex should be
screened for chlamydia at their first HIV care visit and then at least annually.
A patient’s health care provider might determine more frequent screening is
necessary, based on the patient’s risk factors.
Symptoms
Chlamydia
is known as a “silent” infection because most infected people have no symptoms.
If symptoms do occur, they may not appear until several weeks after exposure.
Even when it causes no symptoms, chlamydia can damage a woman’s reproductive
organs.
In
women, the bacteria first infect the cervix (structure that connects the vagina
or birth canal to the uterus or womb) and/or the urethra (urine canal). Some
infected women have an abnormal vaginal discharge or a burning sensation when
urinating. Untreated infections can spread upward to the uterus and fallopian
tubes (tubes that carry fertilized eggs from the ovaries to the uterus),
causing pelvic inflammatory disease (PID). PID can be silent or can cause
symptoms such as abdominal and pelvic pain. Even if PID causes no symptoms
initially, it can lead to infertility (not being able to get pregnant) and other
complications later on.
Some
infected men have discharge from their penis or a burning sensation when
urinating. Pain and swelling in one or both testicles (known as “epididymitis”)
may occur but is less common.
Chlamydia can infect the rectum in men and women, either through receptive anal sex, or possibly via spread from the cervix and vagina. While these infections often cause no symptoms, they can cause rectal pain, discharge, and/or bleeding (known as “proctitis”).
Complications due to Chlamydia Infection
The
initial damage that chlamydia causes often goes unnoticed. However, chlamydial
infections can lead to serious health problems.
In women, Untreated
infection can spread upward to the uterus and fallopian tubes (tubes that carry
fertilized eggs from the ovaries to the uterus), causing pelvic inflammatory
disease (PID). PID can be silent or can cause symptoms such as abdominal and
pelvic pain. Both symptomatic and silent PID can cause permanent damage to a
woman’s reproductive tract and lead to long-term pelvic pain, inability to get
pregnant and potentially deadly ectopic pregnancy (pregnancy outside the
uterus).
Complications
are rare in men. Infection sometimes spreads to the tube that carries sperm
from the testis, causing pain, fever, but, rarely, preventing a man from being
able to father children.
Chlamydia in pregnant woman
In
pregnant women, untreated chlamydia has been associated with pre-term delivery,
and can spread to the new born, causing an eye infection or pneumonia.
Screening and treatment of chlamydia during pregnancy is the best way to
prevent these complications. All pregnant women should be screened for
chlamydia at their first prenatal visit.
Diagnosis
There are
laboratory tests to diagnose chlamydia. Specimens commonly used for testing
include a cotton swab of the vagina (collected by the woman herself or her
health care provider) or a urine sample.
Chlamydia Treatment
Penicillin
is not effective against chlamydia.
Chlamydia can be easily treated and cured with antibiotics. HIV-positive persons with
chlamydia should receive the same treatment as those who are HIV-negative.
Persons
with chlamydia should abstain from having sex for seven days after single dose
antibiotics, or until completion of a seven-day course of antibiotics, to
prevent spreading the infection to partners.
Repeat
infection with chlamydia is common. Persons whose sex partners have not been
appropriately treated are at high risk for re-infection. Having multiple
chlamydial infections increases a woman's risk of serious reproductive health
complications, including pelvic inflammatory disease and ectopic pregnancy.
Women and men with chlamydia should be retested about three months after
treatment of an initial infection, regardless of whether they believe that
their sex partners were successfully treated.
Infants
infected with chlamydia may develop conjunctivitis (infection of the membrane
lining the eyelids) and/or pneumonia. Chlamydial infection in infants can be
treated with antibiotics.
Prevention Strategies
Not having
sex is the best protection against chlamydia and other STDs. Having sex with
only one uninfected partner who only has sex with you is also safe. Latex male condoms, when used consistently and correctly, can reduce the risk of getting
or giving chlamydia. The surest way to avoid chlamydia is to abstain from
vaginal, anal and oral sex or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
To submit your abstracts at the conference STD 2018: http://bit.ly/stdabst2018
Source: http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/chlamydia
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