CHLAMYDIA

What is Chlamydia?

Chlamydia is the most prevalent STI in the United States, with 657,097 cases reported in 1999 of which 80% were women. Women are more than 4 times as likely to be infected with chlamydia than men (404.5/100,000 women vs. 94.7/100,000 men) (1).

Chlamydia is a common sexually transmitted infection (STI) caused by the bacterium, Chlamydia trachomatis, which can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur “silently” before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man (9).

How does one contract chlamydia and how is it diagnosed?

Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth

Laboratory tests are used to diagnose chlamydia. Urine and other tests require that a specimen be collected from the cervix.

What are the signs and symptoms of chlamydia?

Chlamydia is known as a "silent" disease because its early symptoms are so mild. About three quarters of infected women have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure ( 2 ).

In women, the bacteria infects the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes (tubes that carry eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum ( 9 ).

Men or women who have anal intercourse may acquire a chlamydial infection in the rectum, which can cause pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner ( 2 ).

What are the complications and how will it affect a pregnancy?

If left untreated, chlamydia can mature to serious reproductive and other health problems with both short-term and long-term consequences and the damage that chlamydia causes is often “silent" ( 2 ).

Untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in approximately 40 percent of women with chlamydia which is left untreated. PID can cause permanent damage to the fallopian tubes, uterus, and its surroundings. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed ( 3 ).

In pregnant women, there is evidence that untreated chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns ( 9 ).

What are the treatments and prevention methods for chlamydia?

Chlamydia can be treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative ( 3 ).

All sex partners should be tested, and treated. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment. Re-infection is a possibility if not treated correctly.

Women whose sex partners have not been treated are at high risk for re-infection. Having multiple infections increases a woman's risk of serious reproductive health complications, including infertility ( 2 ).

The best way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact. Also, being in a long-term monogamous relationship, that is, only have sex with one person who only has sex with you.

Latex male condoms, when used correctly, can reduce the risk of transmission of chlamydia. Chlamydia screening is recommended annually for all sexually active women 25 years of age and younger. An annual screening test also is recommended for older women with risk factors for chlamydia (a new sex partner or multiple sex partners). All pregnant women should have a screening test for chlamydia ( 2 ).

Any genital symptoms such as discharge or burning during urination or an unusual sore or rash should be a signal to stop having sex and to consult a health care provider immediately. If a person has been treated for chlamydia (or any other STI), he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from chlamydia and will also reduce the person's risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for chlamydia ( 8 ).