Chlamydia is not a flower. This was an educational campaign slogan used to raise awareness of the most frequently reported infectious disease in the US. Not many years ago, chlamydia was not that well known. Now, with over 4,000,000 new infections each year, it is all-too-familiar among sexually active adolescents and young adults. In 2002, there were 1390 cases of Chlamydia in Westchester County. In 2003, there were 1569 cases.

Untreated chlamydial infection is a leading cause of pelvic inflammatory disease (PID) in women and can lead to infertility. It can be transmitted from an infected mother to the infant during birth, resulting in neonatal eye infection or pneumonia. The cost for treatment of chlamydia and resulting complications in the US is estimated at over $2 billion per year.

What is it?

Chlamydial infection is a sexually transmitted infection caused by a bacterium, Chlamydia trachomatis.
 

Symptoms

Symptoms develop from 1 – 3 weeks after infection, and may include a milky discharge from the urethra, pain or swelling in the testicles (in men), cervical discharge or bleeding (in women), burning or itching on urination, or inflammation of the rectum.

70 - 90 % of women and 40 - 50% of men do NOT have any noticeable symptoms. This is a major reason for the high rates of infection. Because it is often asymptomatic and the consequences of untreated infection are serious, sexually active adolescents and women under 24 should be routinely screened for chlamydial infection.

PID results when untreated infections in women such as chlamydia or gonorrhea spread to the uterus, fallopian tubes, and ovaries. PID is a serious health problem that can result in infertility, chronic pelvic pain, or tubal pregnancy (pregnancy outside the uterus). Symptoms of PID may include pain in the lower abdomen or back, fever, spotting or bleeding between menstrual periods, pain during sex, and increased vaginal discharge. Many women do not have symptoms when they have a chlamydial infection.
 

In men, untreated chlamydial infection can spread to the epididymis, the body structure where sperm is stored, causing pain and swelling. This infection, called epididymitis, can lead to infertility.
 

These are serious infections and anyone with possible symptoms should seek treatment immediately.
 

Transmission

Chlamydia is transmitted through unprotected vaginal and anal sex with an infected partner.

Diagnosis

Only a health care provider can diagnose chlamydia. Laboratory tests for chlamydia are easily performed and involve the collection of fluid from the cervix, urethra, and/or rectum. Chlamydia can now also be diagnosed through a urine test, eliminating one barrier to testing for men—the urethral swab, and permits testing when a full examination may not otherwise be practical.

Treatment

Most chlamydial infection is effectively treated with antibiotics in a single dose or 7 day treatment.

PID and epididymitis are more complicated infections and may take longer to treat. People should abstain from sexual contact for 7 days after treatment is completed. Recent sexual contacts should be notified and treated; and, to avoid reinfection, there should be no sexual contact until all partners have completed treatment. Because chlamydia and gonorrhea infection frequently occur together, patients with gonorrhea are usually treated for chlamydia also.

Prevention

• Abstinence from sexual activity is the surest way to avoid acquiring or transmitting chlamydia.
• The next surest way is to limit sexual contact to one uninfected partner who only has sex with you.

• For those choosing to be sexually active, condoms should be used correctly and consistently to minimize transmission.
• Avoid sexual contact if suspicious symptoms are present. If you suspect that you have chlamydia (or any sexually transmitted disease), seek immediate care at a local STD clinic, hospital, or medical practitioner.
• Before having sex, talk with your partner(s) about chlamydia and other sexually transmitted diseases. Negotiate a risk reduction strategy with them that feels comfortable to both of you. If the STD status for you or your partner is unknown, go together to get screened at a local STD clinic, hospital, or medical practitioner.
• If you have chlamydia (or any sexually transmitted disease), notify all sex partners so that they can also seek and obtain treatment.

People with chlamydia are more susceptible to HIV infection than those without chlamydia. In addition, people who have concurrent infections of chlamydia and HIV appear more likely to transmit HIV to their sex partners than HIV infected people without chlamydia.

Fact sheet on Chlamydia from the Centers for Disease Control

Information courtesy of Seattle and King County Public Health
at (http://www.metrokc.gov/health/)

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