Chlamydia

What causes it?

  • bacteria called chlamydia trachomatis

How do you get it?

  • during vaginal or anal intercourse with an infected partner
  • a pregnant woman can pass the infection to her baby during birth which can cause an eye infection or pneumonia in the newborn

How long does it take for symptoms to appear?

  • usually 2 to 6 weeks but can be longer

Symptoms

Females might have:

  • no symptoms at all (up to 70% of women don’t have any symptoms)
  • change in colour, amount or odour of vaginal discharge
  • irregular vaginal bleeding or spotting
  • pain during sexual intercourse
  • abdominal pain

Males might have:

  • no symptoms at all (up to 50% of men don’t have any symptoms)
  • pain during urination
  • clear mucus-like discharge from the penis
  • slight irritation or itch at the tip of the penis

Long term effects

Female

  • if it spreads to the uterus, fallopian tubes and ovaries, it can cause pelvic inflammatory disease (PID)
  • tubal pregnancy
  • sterility

Male

  • if it spreads to the testicles, the scrotum might become swollen and painful
  • sterility
  • urinary tract complications

Both

  • if it spreads to the blood, it might cause more severe illness, for example arthritis

Diagnosis

  • physical examination by a doctor and lab tests (smears and cultures)

Treatment

  • take prescribed antibiotics
  • follow-up testing if necessary

Special considerations

  • antibiotic ointment is placed in the eyes of all babies at birth to prevent infection

For more information, see

Student Sexuality Information Services (SSIS)

 

 

Chlamydia in the United States

What is Chlamydia? 

Chlamydia is a sexually transmitted disease (STD) that is caused by the bacterium Chlamydia trachomatis. Because approximately 75% of women and 50% of men have no symptoms, most people infected with chlamydia are not aware of their infections and therefore may not seek health care.

When diagnosed, chlamydia can be easily treated and cured. Untreated, chlamydia can cause severe, costly reproductive and other health problems which include both short- and long-term consequences, including pelvic inflammatory disease (PID), which is the critical link to infertility, and potentially fatal tubal pregnancy.

Up to 40% of women with untreated chlamydia will develop PID. Undiagnosed PID caused by chlamydia is common. Of those with PID, 20% will become infertile; 18% will experience debilitating, chronic pelvic pain; and 9% will have a life-threatening tubal pregnancy. Tubal pregnancy is the leading cause of first-trimester, pregnancy-related deaths in American women.

Chlamydia may also result in adverse outcomes of pregnancy, including neonatal conjunctivitis and pneumonia. In addition, recent research has shown that women infected with chlamydia have a 3 – 5 fold increased risk of acquiring HIV, if exposed.

Chlamydia is also common among young men, who are seldom offered screening. Untreated chlamydia in men typically causes urethral infection, but may also result in complications such as swollen and tender testicles.

What is the magnitude of the problem?

Chlamydia is the most frequently reported infectious disease in the United States. Though 526,653 cases were reported in 1997, an estimated 3 million cases occur annually. Severe under reporting is largely a result of substantial numbers of asymptomatic persons whose infections are not identified because screening is not available. Highlights of reported data are as follows:

  • From 1984 through 1997, reported rates(1) of chlamydia increased from 3.2 to 207.0 cases per 100,000 population. This trend primarily reflects increased screening, recognition of asymptomatic infection (mainly in women), and improved reporting capacity rather than a true increase in disease incidence.

  • In 1997, the reported rate of chlamydia for women (335.8) substantially exceeded the rate for men (70.4), due mainly to increased detection of asymptomatic infection in women through screening. Low rates of reported chlamydia among men suggest that many of the partners of women with chlamydia are not screened or treated.

  • As in previous years, 1997 rates of chlamydia were highest in the West and the Midwest, where substantial resources have been committed for organized screening programs.

How are adolescents and young women affected?

  • As many as 1 in 10 adolescent girls tested for chlamydia is infected.

  • Based on reports to CDC provided by states that collect age-specific data, teenage girls have the highest rates of chlamydial infection. In these states, 15- to 19-year-old girls represent 46% of infections and 20- to 24-year-old women represent another 33%. These high percentages are consistent with high rates of other STDs among teenagers.

  • Among women entering the Job Corps in 1997, chlamydia rates ranged from 4 – 14% by state (20,000 entrants are screened annually). Chlamydial infection is widespread geographically and highly prevalent among these economically disadvantaged young women between 16 and 24 years old.

What does chlamydia cost?

The annual cost of chlamydia and its consequences in the United States is more than $2 billion. The CDC estimates screening and treatment programs can be conducted at an annual cost of $175 million. Every dollar spent on screening and treatment saves $12 in complications that result from untreated chlamydia.

What is being done to address the problem?

In 1993, Congress appropriated funds to begin a national STD-related infertility prevention program. Through a cooperative effort between CDC and the Office of Population Affairs, the program involves strong collaboration among family planning, STD and primary health care programs, and public health laboratories. Significant progress has been made where screening programs have been fully implemented.

  • A 65% decline in infection was demonstrated in family planning clinics in Federal Region X (Alaska, Idaho, Oregon, and Washington) in the first 8 years of screening, from 1988 to 1995. These declines have occurred across all age groups since testing began in 1988, although adolescents continue to have the highest rates of disease.

  • A 31% decline in infection was indicated for females under age 20 during the first 2-1/2 years of initial large-scale screening in Region III (Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia), from 7.8% in 1994 to 5.4% during January-June 1996.

  • A 16% decline in infection was indicated for females under age 20 during the first 2-1/2 years of initial large-scale screening in Region VIII (Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming), from 5.5% in 1994 to 4.6% during January-June 1996.

  • Strong evidence is now available that chlamydia screening and treatment not only reduces the prevalence of lower genital tract infection, but also decreases the incidence of costly complications, such as PID. A randomized trial of chlamydia screening and treatment in a health maintenance organization demonstrated a 56% reduction in the incidence of PID in the screened group in the 12 months following the trial.

Due to resource constraints, the program continues only as demonstration projects in most parts of the country. CDC estimates that nearly 75% of women at risk reside in 30 states that are only just beginning to screen for chlamydia. For example, in California, Florida, Georgia, Illinois, New York, and Texas, more than 200,000 women in each state who attend publicly funded family planning and STD clinics currently do not have access to screening and treatment.

Since these programs have focused on prevention efforts in women, many men with chlamydia are not diagnosed and treated, thus continuing the cycle of infection.

CDC has developed recommendations for the prevention and management of chlamydia for all providers of health care. These recommendations call for screening of all sexually active females under 20 years of age at least annually, and annual screening of women ages 20 and older with one or more risk factors for chlamydia (i.e., new or multiple sex partners and lack of barrier contraception). All women with infection of the cervix and all pregnant women should be tested.

What still needs to be done?

Programs to provide testing for infection through screening and subsequent treatment are needed nationwide. A successful program must include comprehensive screening and treatment not only for women but also for men. Recent research advances have made available extremely accurate urine tests which make testing of males more feasible and less uncomfortable than older tests. In addition, single-dose antibiotic therapy promises to substantially enhance the likelihood of successful treatment — especially in adolescents — as compared to commonly used 7-day oral medication.

1. Rates are per 100,000 population. 

 

 

Chlamydial Infection

Article courtesy of the NIAID:

What is Chlamydial Infection?

Chlamydial ("kla-MID-ee-uhl") infection is a curable sexually transmitted disease (STD), which is caused by a bacterium called Chlamydia trachomatis. You can get genital chlamydial infection during oral, vaginal, or anal sexual contact with an infected partner. It can cause serious problems in men and women as well as in newborn babies of infected mothers.

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. Health economists estimate that chlamydial infections and the other problems they cause cost Americans more than $2 billion a year.

What Are the Symptoms of This STD?

Because chlamydial infection does not make most people sick, you can have it and not know it. Those who do have symptoms may have an abnormal discharge (mucus or pus) from the vagina or penis or pain while urinating. These early symptoms may be very mild. Symptoms usually appear within one to three weeks after being infected. Because the symptoms may be mild or not exist at all, you might not seek care and get treated.

The infection may move inside the body if it is not treated. There, it can cause pelvic inflammatory disease (PID) in women and epidydimitis in men, two very serious illnesses.

C. trachomatis can cause inflamed rectum and inflammation of the lining of the eye ("pink eye"). The bacteria also can infect the throat from oral sexual contact with an infected partner.

How Does the Doctor Diagnose Chlamydial Infection?

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 ways to find out whether the infection is chlamydial are 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 look for the bacteria.

The urine test does not require a pelvic exam or swabbing of the penis. Results from the urine test are available within 24 hours.

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 such as azithromycin (taken for one day only) or doxycycline (taken for seven days) to treat people with chlamydial infection. Or, you might get a prescription for another antibiotic such as erythromycin or 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.

What Can Happen if the Infection is Not Treated?

In women, untreated chlamydial infections can lead to PID. 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.

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 and congestion, 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.

How Can I Prevent Getting Chlamydial Infection?

You can reduce your chances of getting chlamydia or of giving it to your partner by using male latex condoms correctly every time you have sexual intercourse.

If you are infected but have no symptoms, you may pass the bacteria to your sex partners without knowing it. Therefore, any 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.

What Research is Going On?

Scientists are looking for better ways to diagnose, treat, and prevent chlamydial infections. NIAID-supported scientists 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 a safe and effective vaccine. Developing topical microbicides (preparations that can be inserted into the vagina to prevent infection) that are effective and easy for women to use is also a major research focus.

 

 

Chlamydia
Chlamydia is the number one bacterial sexually transmitted disease (STD) in the United States today. Four million new cases of chlamydia occur each year. It’s particularly common among teens and young adults. Pelvic inflammatory disease (PID), which can be caused by chlamydia, is a leading cause of infertility when left untreated.

Symptoms
Chlamydia is known as the "silent epidemic" because three quarters of the women and half of the men with the disease have no symptoms. Possible symptoms include discharge from the penis or vagina and a burning sensation when urinating. Additional symptoms for women include lower abdominal pain or pain during intercourse and bleeding between menstrual periods. Men may experience burning and itching around the opening of the penis and/or pain and swelling in the testicles.

Testing
There are two kinds of test for chlamydia. One involves collecting a small amount of fluid from an infected site (cervix or penis) with a cotton swab. These tests are universally available. New tests, which use only urine samples, will be available soon and will make testing much easier and less painful.

Treatment
There has been major progress in the treatment of chlamydia with antibiotics over the past few years. A single dose of azithromycin (click here for full prescribing information; download the latest version of Adobe Acrobat Reader free) or a week of doxycycline (twice daily) are the most commonly used treatments. (For the U.S. only) Common side effects of these treatments include diarrhea (7%), nausea (5%), abdominal pain (5%), and vomiting (2%).

Prevention
You can get and spread chlamydia through unprotected vaginal and anal sex. Preventing chlamydia means approaching sexual relationships responsibly: limit the number of your sex partners, use condoms, and if you think you are infected, avoid any sexual contact and visit a local STD clinic, hospital, or your doctor. Be sure your partner is treated to avoid becoming reinfected.

Genital Chlamydia

Chlamydia infections are caused by the bacterium Chlamydia trachomatis. Clinically, genital chlamydia may present in males as a urethritis and in females as a mucopurulent cervicitis(1). In women (and perhaps men), 50% to 70% of chlamydia infections are often clinically silent. Unrecognized and untreated infections can remain with the host for months and can be transmitted to sex partners(2). For females, complications resulting from untreated or under-treated chlamydia can be severe: ectopic pregnancy (30%)(3), pelvic inflammatory disease (25%-65% )(4) and infertility. Vertical transmission of chlamydia is the primary pathogen responsible for infant infectious conjunctivitis (40%) and infant pneumonia (73%)(5). The morbidity of chlamydia and its associated costs make chlamydia infections an important public health issue. Genital chlamydia has been the most commonly reported sexually transmitted disease in Canada since becoming a notifiable disease in 1990.

In 1991, data were collected from nine provinces/territories only, with a total reported number of 39,003 cases. If the same rate were assumed for the missing provinces/territories, the number of cases would have been 51,264 for 1991. There were 37,551 reported cases in 1995, which indicates a 26.8% drop in the number of cases reported nationally over the last 5 years, using the estimated figures of 1991. The incidence rate based on actual reported cases dropped by 30.3%, from 182.2 cases per 100,000 population in 1991 to 127 cases per 100,000 in 1995 (Figure 3).

Females represented 75.8% of genital chlamydia cases reported in 1995. The under-representation of males is most likely due to the high proportion of asymptomatic cases (for which medical intervention was not sought) and the lack of screening opportunities compared with those for women.

In 1995, 70.3% of all reported cases were between the ages of 15 and 24 years (Annex 2). Females in the 15-19-year age group had the highest reported rate, of 1,109.1 cases per 100,000, which was almost 9 times the national rate. The highest reported rate for males was 335.6 cases per 100,000 in the 20-24-year age group, 2.6 times the national rate (Figure 4).

Regionally, the Northwest Territories (NWT) reported a rate of infection of 1,388.5 cases per 100,000 population, an incidence 11 times higher than the national rate (127/100,000). The NWT was followed by the Yukon (518.0/100,000) and Manitoba (264.4/100,000). Newfoundland had a low rate of 47.5 cases per 100,000 population (Figure 5).

Over the past several years, there have been substantial advances in the diagnostic technology of sexually transmitted diseases – for example, DNA amplification methods, such as polymerase chain reaction (PCR) and ligase chain reaction (LCR). These tests have the advantage over the current culture methods in that non-invasive samples (e.g., urine) can be used. As well, the tests have proven to be more sensitive at detecting low-level infections than the current methods(6,7) without compromising specificity(8). Furthermore, the PCR tests may define a group of patients whose infection with C. trachomatis could have been missed by conventional assay methods – as for groups of men aged 24 years and over(9).

 

 

 

What is chlamydia?
Chlamydia (klah-MIH-dee-ah) is the most common sexually transmitted bacterial infection in the U.S. Its full name is chlamydia trachomatis (trah-ko-MAH-tis). It is a kind of bacteria that can infect the penis, vagina, cervix, anus, urethra, or eye.

Chlamydia is the name of several types of bacteria. Chlamydia trachoma, for example, has been a major cause of blindness for centuries. Chlamydia trachomatis is sexually transmitted. One strain occurs primarily in the tropics and causes lymphogranuloma venereum � symptoms include skin lesions and swelling of certain glands in the genital area. The other, we simply call "chlamydia," a very common infection in the U.S.

What are the symptoms of chlamydia?
Usually, chlamydia has no symptoms. Up to 85 percent of women and 40 percent of men with chlamydia have no symptoms. Most people are not aware that they have the infection.

When symptoms do occur, they may begin in as little as 5-10 days after infection.

When women have symptoms, they may experience:

  • bleeding between menstrual periods
  • vaginal bleeding after intercourse
  • abdominal pain
  • painful intercourse
  • low-grade fever
  • painful urination
  • the urge to urinate more than usual
  • cervical inflammation
  • abnormal vaginal discharge
  • mucopurulent cervicitis (MPC) � a yellowish discharge from the cervix that may have a foul odor

When men have symptoms, they may experience:

  • pus or watery or milky discharge from the penis
  • pain or burning feeling while urinating
  • swollen or tender testicles

These symptoms are like the symptoms of gonorrhea. They are called nongonococcal urethritis (NGU). Men often don’t take these symptoms seriously because the symptoms may appear only early in the day and can be very mild.

In women and men, chlamydia may cause the rectum to itch and bleed. It can also result in a discharge and diarrhea. If it infects the eyes, chlamydia may cause redness, itching, and a discharge.

How is chlamydia spread?
Chlamydia is spread by vaginal and anal intercourse. It can also spread from a woman to her fetus during birth.

How many people have chlamydia?
Three million American women and men become infected with chlamydia every year. Chlamydia is:

  • four times as common as gonorrhea
  • more than 30 times as common as syphilis
  • most common among women and men under 25

For every person with herpes, there are six with chlamydia.

Is chlamydia dangerous?
Chlamydia is a serious health threat, especially for women.
In women, the infection usually begins on the cervix. It can spread to the fallopian tubes or ovaries. It may cause PID, pelvic inflammatory disease. Chlamydia results in 250,000 to 500,000 cases of PID every year in the U.S.

PID can scar and block the fallopian tubes. That can make a woman sterile and unable to get pregnant. Fertilized eggs may not reach the uterus because tubes are blocked. If they develop in the tubes, this is called an ectopic pregnancy. A woman may die if a pregnancy develops outside her uterus. She usually needs emergency surgery. Women with PID of the fallopian tubes are 7-10 times more likely than other women to have ectopic pregnancies.

The symptoms of PID include:

  • longer and/or heavier periods
  • more cramping during periods
  • abnormal mucus discharges
  • pain in lower abdomen
  • tiredness, weakness
  • fever
  • vomiting
  • pain during vaginal intercourse
  • pain during pelvic exam

Chlamydia also makes men sterile. It can spread from the urethra to the testicles. Then it can result in a condition called epididymitis. Epididymitis can cause sterility. Chlamydia causes more than 250,000 cases of acute epididymitis in the U.S. every year. Symptoms include fever as well as swelling and extreme pain in the scrotum.

Chlamydia may cause Reiter’s syndrome � usually in young men. Symptoms usually appear in this order:

  • urethritis
  • lesions that form hard crusts on the penis
  • ulcers in the mouth or throat
  • conjunctivitis
  • arthritis

Arthritis becomes a disability for about one out of three men who develop Reiter’s syndrome.

Reiter’s Syndrome

Chlamydia does not only affect women. It also poses serious health risks for men.

Of the estimated one and a half million men in the U.S. who get chlamydia each year one percent � 15,000 � may develop Reiter’s syndrome. Perhaps one-third of these men � 5,000 � will become permanently disabled each year ome women may be affected by Reiter’s syndrome.

How does chlamydia affect pregnancy?
Between 20 and 50 percent of children born to women with chlamydia will be infected. Every year more than 180,000 babies are born with eye infections or pneumonia. Chlamydia is the leading cause of neonatal conjunctivitis � an eye infection that can cause blindness. Symptoms usually begin within four weeks of birth.

These children can also develop chlamydia pneumonia, a kind of pneumonia that can be fatal. This infection is harder to treat in infants than adults.

Chlamydia also may cause heavy bleeding before delivery. It might cause membranes to break early, resulting in premature delivery. It also may be connected to miscarriage, stillbirth, or low birthweight.

Fortunately, treatment of chlamydia is successful in nine out of ten pregnant women.

How is chlamydia diagnosed?

  • examination of the cervix and cervical discharge
  • laboratory tests of cells from the penis, cervix, urethra, or anus
  • examination of urine samples

Pap tests sometimes suggest that chlamydia tests are needed. They should not be relied upon as a check for chlamydia.

Gonorrhea and chlamydia may have similar symptoms. It is important to tell them apart. Certain medications can kill gonorrhea but don’t work for chlamydia. Other sexually transmitted infections may hide the symptoms of chlamydia.

Is there a cure for chlamydia?
Yes. Chlamydia is easy to treat. Both partners must be treated at the same time. Antibiotics kill chlamydia bacteria. Doxycycline or azithromycin are the preferred treatments. Azithromycin is taken in one dose. Although doxycycline costs less, it must be taken for seven days.

Ofloxacin, erythromycin, and erythromycin ethylsuccinate are also prescribed to cure chlamydia. Erythromycin is often prescribed for pregnant women and other people who cannot take tetracycline. It is also used to treat infants with eye infections or pneumonia caused by chlamydia. Your clinician can help you decide which is the best treatment.

PID is usually treated with medicine. Surgery may be needed as well. But sterility caused by chlamydia is often permanent.

If you are treated for chlamydia, or any other sexually transmitted infection, remember:

  • Take all the prescribed medicine. Even if the symptoms go away, the infection may still be in your body.
  • Schedule follow-up visits to make sure you’ve been cured before you have sex again.
  • Make sure your partner is treated at the same time so you don’t reinfect each other.
  • Do not share your medicine with anyone.

Who is most likely to get chlamydia?

  • people who have a number of different sex partners
  • people whose sex partners have a number of different sex partners
  • people who don’t use condoms
  • people with a history of other sexually transmitted infections
  • sexually abused children

Young adults have the highest rates of chlamydia.

How can people with chlamydia avoid spreading it?

  • Inform sex partners of the infection.
  • Have no sex until treatment is complete.
  • Be sure sex partners are screened and treated at the same time.
  • Use female or male condoms every time.

Anyone with a sex partner who has NGU, MPC, or acute PID should be checked for chlamydia and other sexually transmitted infections. Since chlamydia infection often has no symptoms, women at risk should ask to be checked for sexually transmitted infections every 6-12 months.

Any woman who thinks that she or her partner has chlamydia should tell her clinician immediately. This is especially important for pregnant women.

How can I avoid getting chlamydia?

  • Use a female or male condom every time.
  • Have routine checkups for sexually transmitted infections.
  • Abstain from sexual intercourse.

Does using birth control increase my risk of getting chlamydia?
There is some evidence that hormones in the birth control pill may change the cervix in ways that make it more open to chlamydia infections. However, women who take the Pill have a lower risk of developing PID from chlamydia than women who don’t. Nonetheless, women on the Pill should also use a condom with partners who may have sexually transmitted infections.

Only female and male condoms offer good protection. Spermicides used with diaphragms, cervical caps, contraceptive foams, gels, and suppositories may offer some protection.

Women who contract chlamydia while using the IUD are at higher risk of developing PID. That is why only women in stable, monogamous relationships are advised to use the IUD.

Where can I get tested and treated for chlamydia?
Planned Parenthood or other health centers, doctors, and health departments offer testing, treatment, and counseling.

 


What is it?

Chlamydia is one of the most common sexually transmitted diseases (STDs). It is caused by a kind of bacteria.

How is it spread?

Chlamydia is spread through unprotected oral, vaginal, or anal sex with an infected person. Sometimes, chlamydia can be spread to the eyes by the hands or through direct contact with the infected fluids. It can also be passed from an infected mother to her baby during birth. A

person remains infectious until he or she is properly treated.

What are the symptoms?

Approximately 80% of women and 50% of men infected with chlamydia have no symptoms. They can unknowingly pass the infection to their sexual partner(s).

Women may have itching or more discharge from the vagina. They may also have bleeding during or after sexual intercourse, pain in the lower abdomen or pain when passing urine.

Men may have discharge and itching around the urethra. The urethra is the opening in the penis. They may also have burning when they pass urine, or pain and swelling in the testicles.

How is it diagnosed?

The doctor can test women for chlamydia by taking a swab from the cervix. The cervix is the opening to the womb or uterus. In men, a swab is taken from the urethra. Men should not pass urine 2 hours before the test. Some clinics may use a urine test for chlamydia. It is hard to detect chlamydia in the throat or rectum.

What are the complications?

Untreated chlamydia in women may lead to a condition called pelvic inflammatory disease. Pelvic inflammatory disease is also know as PID. It is a serious infection of the lining of the womb or uterus, the fallopian tubes and ovaries. Sometimes the fallopian tubes of a woman with PID are blocked by scar tissue and her eggs cannot pass through. When this happens, she may not be able to get pregnant. If the fallopian tubes are only partly blocked so the sperm can pass through, she may have a pregnancy inside the fallopian tube. This is called an ectopic pregnancy. Women with untreated chlamydia may also have miscarriages.

Men with untreated chlamydia may become sterile when the tubes carrying the sperm are blocked by scar tissue. They may have swelling and pain in their testicles. This is a condition called epididymitis. Some men may also develop arthritis. Infants who are born to mothers with untreated chlamydia may become ill with pneumonia or eye infections.

How is it treated?

Chlamydia is treated with antibiotic pills. Some of the commonly used antibiotics include Doxycycline, Erythromycin, and Azithromycin. It is important that you complete the treatment as directed by your doctor or clinic. Even if your symptoms have disappeared, you must finish all the pills to make sure that you are cured.

If you have PID or epididymitis, you may need to go into a hospital and be treated with intravenous antibiotics.

What about sexual partners?

All sexual partners within the past 3 months should be examined and treated. If you have not had sex in the past three months, your last sexual partner should be examined and treated. Tell your partner(s) that having no symptoms does not mean there is no infection. Your public nurse can help you notify your partner(s). Your name will be kept confidential.

Is follow-up important?

It is a good idea to have a follow-up test 4 weeks after you have compleated the treatment to make sure that you are cured.

Remember:

  • Take all your medication as prescribed by your doctor or clinic.

  • Avoid sex while you and your sexual partner(s) are being treated. You can get

  • reinfected every time you have sex with an untreated or infected partner.

  • Use condoms to lower the chance of STDs and to prevent pregnancy.

  • It is possible to have more than one infection at a time, so it is important to be tested for other STDs.

 Reprinted with permission of Toronto Public Health

 

 

What is Chlamydia?


In the western world, Chlamydia trachomatis is a bacterium which causes a sexually-transmitted infection.


A slightly different type of chlamydia can also cause trachoma, which is an eye disease found commonly in the Tropics but this is NOT a sexually transmitted infection.


Chlamydia is a very common disease, which, because of its complications, should be taken very seriously. In women, the commonest site for infection is the cervix, or neck of the womb. It can also affect the urethra, which is the tube which carries urine from the bladder to the outside world. Other sites for chlamydial infection in both men and women include the tissues around the rectum and also the eyes. The most worrying effect of a chlamydial infection in women is that of potential fertility problems, due to inflammation of the Fallopian tubes or cervix.


The disease is particularly common among young people.


How do you get Chlamydia?


  • Chlamydia is primarily transmitted through sexual intercourse.


  • Mothers with chlamydia can infect their children during delivery. There are usually no symptoms at birth, but some 7-14 days after delivery the infection starts to show itself and may result in pneumonia in the baby when 2-3 weeks old.


  • If symptoms occur, they will show one to three weeks after the time of infection.


 

What are the symptoms of Chlamydia?


In men


  • Stinging feeling during urination, due to inflammation of the urethra. This can be quite a mild symptom and may only last for a few days so can be easily missed


  • Discharge from the penis and possible itchiness around the opening.


  • Pain or tenderness in the testicles.


In women


  • Stinging feeling during urination.


  • Unusual vaginal discharge.


  • Pain in the lower abdomen due to inflammation of the Fallopian tubes (see Pelvic Inflammatory Disease).


  • Pain during sex, which may be superficial (as the penis goes in) or deep (when penis is deep inside vagina)


  • in some cases, bleeding between periods.


In infants


  • Premature birth.


  • Pneumonia (rare).


In adults, Chlamydia may also infect the rectum, with an inflammation of the tissues around that area (proctitis). This can cause a clear, sticky discharge of mucus from the rectum and pain on opening the bowels as well as diarrhoea, although this is not a common symptom. Chlamydia can also cause eye infections (conjunctivitis). This, however, should not be confused with the tropical eye disease mentioned in the introduction. Trachoma (the eye disease that causes blindness) is caused by a slightly different type of Chlamydia to the one which is spread sexually.


 

How does the doctor diagnose Chlamydia?


One of the most common ways of testing for Chlamydia is for the GP to collect a cell sample from the infected area (cervix or penis) with a cotton swab, which is sent to a laboratory for evaluation and results. However, because of the importance in diagnosing chlamydial infections and the practical difficulties in doing this in the GP surgery, many GPs will advise that you are seen in a specialist genito-urinary clinic so that a firm diagnosis can be made and treatment started as soon as possible. It is important to take any antibiotics given and to also get your partner treated. Some clinics advise re-testing some weeks after treatment, to make sure that the chlamydia has been cleared but re-testing may be delayed for up to six months, when any possible re-infection will be picked up, or may be advised with a change of partner.


Chlamydial infection can be confused with gonorrhoea because the symptoms of both diseases are similar. Sometimes they occur together; however, the treatment is different so an accurate diagnosis is important. If you think you are at risk of infection, by either having a new partner, or several partners at the same time, and have any of the symptoms mentioned, then you should avoid any further sexual contact and make an appointment as soon as possible with your local genito-urinary clinic (most will see people on the day of booking or at a ‘walk-in’ clinic). Remember that the symptoms of chlamydial infection can be mild or easy to miss so if there is any suggestion at all of infection, it is always best for you and your partner or partners to get things checked out. Even though you feel healthy, if you are sexually active you may still need to be tested periodically.


How is Chlamydia treated?


Chlamydia is easily treatable with a course of antibiotic medication, usually erythromycin or tetracycline tablets. If a Chlamydia infection is present, the patient’s partner(s) will also need to be treated so that the infection does not recur.


Future prospects?


When treated early, there are usually no long-term consequences of Chlamydia although this cannot be guaranteed. Serious complications can result, however, when left untreated.


Long-term complications in men


  • Epididymitis – an inflammation of the epididymis, which is the tube which carries the sperm from the testicles. In very rare cases, where both epididymal tubes have been affected, this infection can cause sterility.


  • Reiter’s syndrome – an autoimmune condition where sufferers have conjunctivitis or an eye problem known as ‘uveitis’, inflammation of several joints (polyarthritis) and rarely, a rash on the palms of the hands and soles of the feet.


  • Fertility problems – past chlamydial infections can affect fertility but without necessarily causing definite sterility.


Long-term complications in women


  • Pelvic Inflammatory Disease (PID) – an ascending infection that spreads from the vagina and cervix to the uterus and Fallopian tubes. PID can lead to sterility.


  • Perihepatitis – an infection around the liver.


  • Reiter’s syndrome – see above.


There are no guarantees that treatment of chlamydia will prevent further problems occurring particularly when it comes to fertility. The chance of becoming infected with Chlamydia can be reduced by avoiding risky sexual behaviour. Limiting the number of sexual partners and using condoms during sexual intercourse greatly reduces the chance of become infected.