Introduction
Chlamydial
("kla-MID-ee-uhl") infection is a curable sexually transmitted
disease (STD), which is caused by a bacterium called Chlamydia trachomatis.
However, testing positive for chlamydia means that you
are 300% - 500% more susceptible to HIV, if exposed.
[1]
Chlamydial infection is one of the most widespread bacterial STDs in the United
States. The U.S. Centers for Disease Control and Prevention (CDC) estimates
that more than 4 million people are infected each year.
[2]
-
As many as 1 in 10 adolescent females tested for chlamydia is infected.
[3]
- 15-
to 19-year-olds represents 46% of infections. [4]
- 20-
to 24-year-olds represents another 33%.
[5]
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How can I get Chlamydial Infection?[6]
During
oral, vaginal, or anal sex with an infected partner. You can get infected even
if you don't exchange body fluids during sexual contact.
Hand-to-eye
contact.
Newborn
babies can get infected when they pass through the mother's infected birth
canal.
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What Are the Symptoms?[7]
Most women rarely experience any symptoms. If symptoms do occur, they will usually appear between 7 and 21 days after exposure.
Some symptoms may include:
- Mucus or pus-like vaginal discharge
- A burning sensation while urinating
- Lower abdominal pain
- Lower back pain
- Fever
- Nausea
- Pain during sexual intercourse
- Bleeding between menstrual periods
It is important to be aware of these symptoms, so chlamydia does not go untreated. Since many symptoms are so mild and rare, most often the STI is not detected until complications begin to occur.?
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How Does the Doctor Diagnose Chlamydial Infection?[8]
Chlamydial infection is easily
confused with gonorrhea
because the symptoms of both diseases are similar and the diseases can occur
together, though rarely.
The most reliable way to find out
whether the infection is chlamydial is through laboratory tests. Usually, a
doctor or other health care worker will send a sample of pus from the vagina or
penis to a laboratory that will first culture and grow the bacteria and then
test the cultures for chlamydia. This method, however, is expensive and
technically difficult. Results can take up to 3 days.
Another method is the direct
fluorescent antibody test (DFA). This oldest alternative to culture uses a
scientific method called staining to make chlamydia easier to spot under a
microscope. DFA can give quicker results than culture and can be performed on
specimens taken from the eye, cervix or penis.
Enzyme immunoassays come in some
forms that allow use in small, unsophisticated laboratories that don't have
special lab equipment. Because testing can be done where the specimen is
collected, results are more rapid than with the traditional culture method,
access to testing is increased, and costs can be lower.
Tests to detect the genes of C.
trachomatis keep
in italics in urine, as well as genital, samples have been developed and
approved in the last few years. These tests can accurately identify even very
small numbers of genes in a specimen. These tests can be expensive, but are
becoming more popular among public and other labs because of their accuracy and
the relative ease of collecting urine samples. Results from the urine test are
available within 24 hours.
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How is Chlamydial Infection Treated?
If you are infected with C.
trachomatis, your doctor or other health
care worker will probably give you a prescription for an antibiotic:
- Azithromycin
(taken for one day only)
- Doxycycline
(taken for seven days) to treat people with chlamydial infection.
- Erythromycin
- Ofloxacin
Doctors may treat pregnant women
with azithromycin or erythromycin, or sometimes, with amoxicillin. Penicillin,
which doctors often use to treat some other STDs, won't cure chlamydial
infections.
If you have chlamydial infection:
Take all of the prescribed
medicine, even after symptoms disappear! If the symptoms do not disappear
within one to two weeks after finishing the medicine, go to your doctor or
clinic again. It is very important to tell your sex partners that you have
chlamydial infection so that they can be tested and treated.
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What Can Happen if the Infection is Not Treated?
The infection may move inside the
body if it is not treated. There, it can cause pelvic inflammatory disease
(PID) epidydimitis, two very serious
illnesses.
In men, untreated chlamydial
infections may lead to pain or swelling in the scrotal area, which is a sign of
inflammation of a part of the male reproductive system located near the
testicles known as the epididymis. Left untreated, these complications can
prevent people from having children.
Each year up to 1 million women in
the United States develop PID, a serious infection of the reproductive organs.
As many as half of all cases of PID may be due to chlamydial infection, and
many of these don't have symptoms. PID can cause scarring of
the fallopian tubes which can block the tubes and prevent
fertilization from taking place. Researchers estimate that 100,000 women each
year become infertile because of PID.
In other cases, scarring may
interfere with the passage of the fertilized egg to the uterus during
pregnancy. When this happens, the egg may attach itself to the fallopian tube.
This is called ectopic or tubal
pregnancy. This very serious condition results in a miscarriage and can cause
death of the mother.
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Can Chlamydial Infection Affect a Newborn Baby?
A baby who is exposed to C.
trachomatis in the birth canal during
delivery may develop an eye infection or pneumonia. Symptoms of conjunctivitis
or "pink eye," which include discharge and swollen eyelids, usually
develop within the first 10 days of life.
Symptoms of pneumonia, including a
cough that gets steadily worse, most often develop within three to six weeks of
birth. Doctors can treat both conditions successfully with antibiotics. Because
of these risks to the newborn, many doctors recommend that all pregnant women
get tested for chlamydial infection.
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How Can I Prevent Getting Chlamydial Infection?
Abstain from sexual activity.
Using male latex condoms correctly every time you have sex.
If you are infected but have no
symptoms, you may pass the bacteria to your sex partners without knowing it.
Therefore, many doctors recommend that anyone who has more than one sex
partner, especially women under 25 years of age, be tested for chlamydial
infection regularly, even if they don't have symptoms. (See
http://www.fda.gov/fdac/features/1999/499_std.html#tested
)
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Current Research
Widespread chlamydia screening
among women can get results, as was demonstrated in a recent study supported by
NIH. Researchers at Seattle's Group Health Cooperative of Puget Sound and the
University of Washington found that symptomless women who were screened and
treated for chlamydial infection were almost 60 percent less likely than
unscreened women to develop pelvic inflammatory disease.
With such effective tools for
screening and treatment, why has it proved so difficult to stop the spread of
this microorganism? The answer, experts agree, is that not enough at-risk young
people are getting tested.
"There are about a million
reasons people don't get tested," says Diane Mitchell, M.D., an
obstetrician-gynecologist and medical reviewer with the Food and Drug
Administration. "They might feel uncomfortable, or not have insurance, or
just not know they should be tested for chlamydia."
Also, doctors often fail to discuss
the issue of sexually transmitted diseases with their young patients, according
to Gale Burstein, M.D., a chlamydia researcher at Johns Hopkins
University.? "A sexually active
adolescent woman is more likely to test positive for chlamydia than for
tuberculosis, yet TB tests are done much more routinely".
Beyond encouraging more young
people to get routinely screened for chlamydia, experts are searching for other
avenues to control this sexually transmitted disease. Scientists are looking
for better ways to diagnose, treat, and prevent chlamydial infections. NIAID
supported scientists at
Stanford University and the University of California at San Francisco recently
completed sequencing the genome for C. trachomatis. The sequence represents an encyclopedia of
information about the organism. This accomplishment will give scientists
important information as they try to develop new antibiotics as well as a safe
and effective vaccine.
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References
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