Chlamydia Infection

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Chlamydia Infection, How it is Transmitted, Symptoms and Treatment.

Chlamydia Infection
Among all sexually transmitted infections, chlamydia remains the most frequently reported bacterial STD in the United States, affecting approximately 4 million Americans each year, with an overall prevalence rate of 5%. Chlamydia may be considered a silent epidemic. In 1995, the World Health Organization or WHO estimated 89 million cases of Chlamydia trachomatis infections worldwide. Over the past 10 years, cases of chlamydia have risen by almost 250%. Though it affects both men and women and occurs in all age groups, it is most prevalent in teenagers. At high risk group includes sexually active adolescent girls with a higher rate of prevalence and an incidence of 10%.

Causative Agent of Chlamydial Infection
Chlamydia is caused by Chlamydia trachomatis, a gram-negative bacterium that is not visibly seen by the naked eye. Patients with any STD are usually at increased risk of co – infection with another STD. It has been found that co - infection of chlamydia and gonorrhea is most common. It is approximated that 40% of women and 20% of men with chlamydial infection are co - infected with gonorrhea.

How is Chlamydia transmitted?
C. trachomatis is usually transmitted through unprotected vaginal or anal sexual intercourse or through oral sex. It mainly invades and infects the mucus membranes of the cervix, vagina, mouth, throat, anus and urethra. Chlamydial infection is also commonly seen in newborns born vaginally to infected mothers. Almost 60% of neonates develop the infection if no appropriate interventions are utilized.

The risk for chlamydial infection increases with multiple sexual partners, recent new sexual partner, history of an existing STD, previous infection or sexual promiscuity.

Signs and Symptoms of Chlamydial Infection
The severity of the signs and symptoms related to chlamydial infection may vary from mild to severe. The types of symptoms arising from this STD may also vary, depending on the gender of the afflicted individual.

Chlamydia is also known as a silent disease because almost 75 to 80% of infected women and approximately 50% of infected men have no signs or symptoms. And so, most of the time, people with the disease may not be aware that they have chlamydia. This lack of awareness may explain the increased prevalence of this STD in the general population. People continue having unprotected sex and unknowingly transmit the infection to their sexual partners.

Almost all patients with symptoms, regardless of the individual’s gender, complain of dysuria, or painful urination. Yellow mucopurulent discharge from the urethra, is also frequently observed. The symptoms typically arise one to three weeks after the exposure to the bacterium. Patients may also have a history of sexually transmitted infection.

Chlamydia symptoms found in women
The most common site of chlamydial infection in women is the cervix. Based on research, only 50% of women with cervical chlamydia or cervicitis manifest signs and symptoms associated to the infection. Women who have symptoms report abnormal mucopurulent vaginal discharges. Intermenstrual bleeding, postcoital bleeding, or bleeding after sex, and abdominal pain have been noted. Painful sexual intercourse, burning sensation during urination and fever are also some of its symptoms. Pelvic pain or lower abdominal pain can be an early indicator of pelvic inflammatory disease or PID, one of the leading causes of infertility in women.

Chlamydial infection in men
Only 50% of infected males demonstrate signs or symptoms of chlamydia. Most men develop urethritis, or inflammation of the urine canal, though it is only detected 30% of the time. Urethritis is marked by scant, watery discharge from the urethra. It is manifested by difficult or painful and burning urination. In lesser number of cases, men may also develop epididymitis, or inflammation of the sperm ducts. Epididymis functions as the storage, maturation and transport of the sperm. This infection is manifested by fever, unilateral testicular pain and swelling of the scrotum. Chlamydia could also spread to the prostate gland, resulting in burning or painful urination, frequent urination, pain in the abdomen, groin, lower back, area between the penis and rectum, testes and penis, urgent need to urinate and painful ejaculations.

Chlamydial proctitis mainly involves the infection of the anus and rectum. It occurs mainly in men who engage in anal intercourse with other men. Symptoms include anal or rectal pain, anal discharges, persistent urge to move the bowels and constipation.

Chlamydia and Pelvic Inflammatory Disease
Chlamydial infections are the leading cause of infertility in women. Chlamydia strikes the upper female genital tract, including the fallopian tubes, endometrium or lining of the uterus and pelvic peritoneum or the lining of the pelvis, which increase the risk for pelvic inflammatory disease or PID. Chlamydial infections are responsible for half of the cases of PID in the United States. Untreated or inappropriately managed or prolonged chlamydia infections result in PID. The scar tissue formation prevents the normal ovulation and could block the passage of the egg through the fallopian tube. These abnormalities can lead to infertility.

Women with PID are also at increased risk for ectopic pregnancies. Fallopian tube scarring makes it difficult for the fertilized egg to move towards the uterus, causing the embryo to implant within the fallopian tube.

Other Complications
Other long-term problems brought about by chlamydial infections include chronic pelvic pain and perihepatitis, or inflammation of the peritoneal capsule of the liver and its nearby tissues. Women with chlamydia are also at increased risk of developing veneral warts.

Treatment
The treatment of chlamydial infections is the same for all sexes. For uncomplicated cases of urethritis, cervicitis and proctitis, clinicians usually prescribe a single dose of oral azithromycin, a macrolide antibiotic. This one-time administration of drug ensures that the treatment is completed and that the bacteria have been completely eradicated from the system. Doxycycline, a tetracycline antibiotic, is also prescribed. The drug treatment is given for seven days, administering 100 mg of doxycycline twice daily. Keep in mind that this antibiotic should not be administered to pregnant women or to those who think they are pregnant and to lactating mothers. Doxycycline can cross the placenta and increases the risk for toxic effects on the development of bones and teeth in fetus.

Chlamydia and gonorrhea frequently coexist. To fully recover from this STD, some clinicians prescribe treatment drugs for both infections at once.

Sexual Partner Treatment
Current and recent sexual partners of infected individuals should also be treated. There is a big possibility that that he/she might also be infected in spite of the absence of chlamydia symptoms. This procedure is also important since the untreated partner can reinfect the patient. It is recommended to notify your sexual partner about your diagnosis and inform him/her that a clinic visit and a course of treatments are necessary. At present, some clinics have a policy of giving two prescriptions, one for the patient and the other for the partner.

Sexual contact is avoided for one week after the couple has been completely treated, the symptoms have been resolved and the bacteria have been completely eliminated.

Prevention
The best way to prevent chlamydia is to avoid sexual intercourse. If you choose to engage in sex, make sure that you are protected. Use a latex condom in every sexual act and maintain a monogamous relationship. It is also best to determine the medical and sexual history of your partner.

Read About other Women's Health Concerns
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Read About Genital Warts caused by HPV Infection