WHAT IS IT?
VOL: 100, ISSUE: 28, PAGE NO: 31
WHAT IS IT?
- Chlamydia is a sexually transmitted infection (STI).
- It is caused by the intracellular bacterium Chlamydia trachomatis.
- It is one of the most common STIs and the most likely identifiable cause of non-specific urethritis in men.
- It can affect the eyes, throat, and lungs.
- If chlamydia is left untreated, complications may occur.
- It may be carried asymptomatically for months or years. Diagnosis does not necessarily imply recent infection.
- It is the UK’s most common treatable STI.
- It affects one in twelve sexually active women aged 16-24.
- Infection occurs during vaginal, oral or anal sex, or other genital contact with a partner who has chlamydia.
- Newborn babies can acquire the infection during birth.
- A conjunctive infection can follow if discharge is transferred on hands.
Factors linked with a higher risk of infection include:
- Under 25 years of age;
- A new sexual partner;
- Lack of barrier contraception such as having intercourse without condoms;
- Use of oral contraceptive;
- Women having a termination of a pregnancy.
- Chlamydia is often asymptomatic.
- If symptoms occur, they usually start one to three weeks after the infection is acquired.
- Symptoms may stop despite the continued presence of infection.
- Chlamydia can be passed on even when there are no symptoms.
COMMON FEMALE SYMPTOMS
Women may experience the following:
- Abnormal vaginal discharge;
- Painful intercourse;
- Painful urination;
- Occurrence of bleeding between menstrual periods;
- Bartholin glands (producer of sexual lubrication mucus) become inflamed and cysts may form;
- Pain in lower back and pelvic area.
COMMON MALE SYMPTOMS
Men may experience the following:
- Yellow urethral discharge;
- Tender and swollen testicles;
- Inflamed joints and eyes.
- Traditionally, diagnosis has been made from male urethral or female cervical swabs.
- DNA amplification tests, such as ligase chain reaction (LCR) and polymerase chain reaction (PCR), have led to less invasive investigations, such as urine testing.
- Antibiotics (100mg doxycycline, administered orally twice a day for seven days; or 1g azithromycin in a single oral dose).
- If the patient is asymptomatic, it is important to emphasise the importance of compliance with treatment as the infection may spread and cause complications.
- Strategies to prevent reinfection, such as practising ‘safer sex’, should be discussed.
- Sexual partners need to be assessed and treated, even if they are asymptomatic.
- Patients should be told to avoid sex until their treatment and that of their partner(s) is complete.
- Ectopic pregnancies.
- Pelvic inflammatory disease (PID).
- Female or male infertility.
- Epididymo-orchitis (inflammation of the testis and epididymis).
- Chronic pelvic pain.
- Fitz-Hugh-Curtis syndrome (perihepatitis).
- Sexually acquired reactive arthritis (SARA).
WHY IS IT SO COMMON?
Possible reasons include:
- STI education is not school-based;
- No high-profile public sexually transmitted disease or infection education campaigns;
- No national screening programme.
PHLS factsheet on chlamydia: www.hpa.org.uk/infections/topics_az/hiv_and_sti/sti-chlamydia/general.htm