Chlamydia is one of the common sexually transmitted disease, most prevalent in young women aged between 14 to 25. In the US this is the most commonly diagnosed sexually transmitted disease (STD). The infection takes place due to the presence of bacteria Chlamydia trachomatis. These bacteria usually infiltrate columnar epithelial cells of urethra, cervix or rectum. Worldwide, chlamydia is the largest source of curable sexually transmitted disease accounting for 61 million infected individuals annually (as of 2015). According to 2017 report, in the US alone 1,708,569 individual was identified with chlamydia infection which can sum up annually to 2.86 million infected individuals.
Why we get Chlamydia?
Being one of the major sexually transmitted disease, the main route of bacterial entry is through sexual contacts. Mostly sexual interaction through the vagina, anal or oral route can spread the infection. Additionally, new-born babies get infected from deceased mother during the passage through the birth canal. This prenatal transfer can generate conjunctivitis or pneumonia to new-borns. However, casual contacts like hugging, kissing or food sharing do not play any role to spread the bacteria.
How common is Chlamydia
Being a common sexually transferred syndrome, one individual out of twenty people becomes infected with chlamydia especially young women in the age group of 14-24 having a several or new sex partner. It is often referred to as the silent killer as a lot of time Chlamydia do not show any symptoms. A higher number of men and women (75% of women and 50% of men) are known to carry these particular bacteria without having any visible symptoms.
Am I infected?
When Chlamydia shows symptoms it generally appears within 2 months or 60 days after the sexual interaction with the infected person. In a majority of instances, symptoms are seen within 1-3 weeks. However, the symptoms vary between male and female. Infected women will show symptoms such as-
- Vaginal discharge, yellowish white in colour due to an infection in the cervix area.
- Small bleeding or spotting in-between normal menstruation cycle.
- A burning sensation during urination.
- Unusual discharge at the time of urination.
While infected men will show symptoms like-
- Secretion of pus from the penis.
- Itching or irritation in the genital area whether urinating or not, but no burning sensation.
Additionally, chlamydia can also generate eye infection with the itchy red eye with or without discharge. Rarely the infection also spread to throats. In situations where there are visible symptoms, a visit to clinician will follow a bacterial swab test where samples are examined from the infected site such as rectum, cervix or urethra. Alternatively, blood test, NAAT/ nucleic acid amplification test or cell culture-based methods are used to identify the presence of Chlamydia bacteria. NAAT is highly sensitive and can perform on a sample collected by swab test or urine. Although NAAT is a highly sensitive method for the detection purpose, use of rectal or pharyngeal swab is not approved by FDA
But as most of the time the infection is asymptotic, thus a regular visit to a clinician is the best option for a sexually active person for possible chlamydia screening.
Mostly the chlamydia infection is treated with the use of antibiotics like Azithromycin in single dose or Doxycycline for a week. To prevent further infection, sexual activity abstains during the antibody treatment. Antibiotics generally give cure from the bacterial infection, however, any permanent damage occurred during infection cannot be repaired with medication. If antibiotics fail to inhibit the bacterial spread or the symptoms continued then a repeated visit to the clinician is recommended. The recurrent occurrence of Chlamydia is a very common phenomenon as an individual without proper treatment can sustain the infection and spreads to partners. Both women and men thus advised to follow the screening check-up in every 3 months interval irrespective of the treatment scenario of their partners.
What should partners do?
When an individual gets diagnosed with chlamydia infection and follows treatment regimen, corresponding partners should be informed. Thus partners can also follow a health check-up and medication if necessary. This is a useful approach to reduce the rate of infection spreading as well as the chance of reinfection. Once diagnosed the partners should not participate in active sex during the medication period until the symptoms get resolved. In some US states, a further expedited partner therapy or EPT approach is followed. In this program, extra medicines and prescriptions are provided to the infected individuals for sharing with their respective partners. EPT instead of standard treatment provided better infection management and reduced recurrence rates.
The general mode of prevention
To reduce the risk of Chlamydia infection few preventive measured can be followed, such as-
- Use of latex based condoms for male and polyurethane condoms for females. As this will help to reduce the chance of infection but not complete eradication.
- A limited number of sex partners, as multiple numbers of partners, increased the chance of infection.
- Go through regular check-ups if there are multiple partners and sexual activity.
Male Chlamydia support and male awareness
While mostly talking about women health in relation to STD like Chlamydia, integration of the male individual into such services is also necessary to maintain women productivity. Male mostly unaware of their infection status is one of the main sources of female reinfection. Thus a male integration approach is beneficiary in terms of reduced cost for persistent infection or reinfection in females and also provides awareness among male counterpart. Introduction of the male partner to Chlamydia screening or identification program can be initiated by local health care provider which includes a contact to the male partners, and when required provide a testing opportunity for Chlamydia identification. Male as a partner required to be aware of Chlamydia infection and provide support in Chlamydia prevention for their female partners. Male awareness is important both for Chlamydia awareness as well as bears equal responsibility for getting screened and tested for pathogen identification.