Chlamydia Infection – Causes, Treatment, and Prevention.

Definition

Chlamydia is a common sexually transmitted disease. Chlamydial infection, caused by Chlamydia trachomatis, it can infect both men and women. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat.

Microscopic image of Chlamydia trachomatis in a cell

Life cycle of Chlamydia trachomatis

History

Chlamydia trachomatis was first discovered in 1907 by Stanislaus von Prowazek in Berlin.  The genus part of the name, Chlalmydia, comes from the Greek word chlamys, which means cloak and the species part of the name, trachomatis is also Greek and means rough or harsh.  This name is perfectly associated with the actions of this disease.

Epidemiology in world wide

The World Health Organization (WHO) estimates that in 2012, 131 million new cases occurred among adults and adolescents aged 15–49 years worldwide, with a global incidence rate of 38 per 1000 females and 33 cases of chlamydia result in an overall prevalence of 4.2% for females and 2.7% for males, with the highest prevalence in the WHO Region of the Americas and the WHO Western Pacific Region.  In many countries, the incidence of chlamydia is highest among adolescent girls aged 15–19 years, followed by young women aged 20-24 years.

What causes chlamydia?

• It’s caused by bacteria (tiny, living cells) called Chlamydia trachomatis.
• They can live in the uterus (womb), vagina and cervix (entrance to the womb), the urethra (tube where urine comes out), the rectum (back passage), and sometimes the throat and eyes.
• Anyone who’s sexually active can get it and pass it on. You don’t need to have lots of sexual partners.

Transmission of Chlamydia trachomatis

Chlamydia is usually passed from one person to another through sexual contact. You can get the infection if you come into contact with the semen (cum or pre-cum) or vaginal fluids of someone who has chlamydia. Chlamydia is most commonly spread through:

• Unprotected (without a condom) vaginal or anal sex
• Sharing sex toys that aren’t washed or covered with a new condom each time they’re used. It can be spread by giving or receiving oral sex (going down, giving head) with someone who has chlamydia. The risk can be lowered by using a condom or dam (latex or soft Plastic Square) to cover the genitals.
• If infected semen or vaginal fluid comes into contact with the eye (for example if it’s transferred from the genitals to the eye by the fingers) it can cause conjunctivitis (infection or irritation of the eye).
• Chlamydia can be passed from a pregnant woman to her baby.
• You can’t get chlamydia from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery

Symptoms and signs

More than two in three women and one in two men with chlamydia won’t have any obvious signs or symptoms, or will have symptoms so mild they’re not noticed. Signs and symptoms can show up 1–3 weeks after coming into contact with chlamydia, many months later, or not until the infection spreads to other parts of your body. You might notice:

Women

• Bleeding between periods and/or heavier periods (including women who are using hormonal contraception)
• Bleeding after sex
• Pain and/or bleeding when you have sex
• Lower abdominal pain (pelvic pain)
• An unusual vaginal discharge
• Pain when passing urine
• If the infection spreads, you might get lower abdominal pain, pain during sex, nausea, or fever.

Men

• A white/cloudy or watery discharge from the tip of the penis
• Pain when passing urine
• Pain in the testicles

Men and women

• There are rarely any symptoms if the infection is in the rectum (back passage) but it may cause discomfort and discharge.
• Infection in the eyes can cause pain, swelling, irritation and/or discharge.
• Infection in the throat is uncommon and usually has no symptoms

Risk factors that leads to chlamydia infection

You are most at risk if:

• Having sex without a condom, or sex with a condom that has ripped or come off
• Had more than one sexual partner in the last 12 months
• You or your partner(s) have another STI (many other STIs also have no other symptoms)
• You are under 25.

Complications associated with this infection

Women

• In women, an untreated infection can spread to your uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can cause permanent damage to your reproductive system. This can lead to long-term pelvic pain, infertility, and ectopic pregnancy.
• Women who have had chlamydia infections more than once are at higher risk of serious reproductive health complications.

Men

• Men often don’t have health problems from chlamydia. Sometimes it can infect the epididymis (the tube that carries sperm). This can cause pain, fever, and, rarely, infertility.

Both men and women can develop reactive arthritis because of a chlamydia infection. Reactive arthritis is a type of arthritis that happens as a “reaction” to an infection in the body. Babies born to infected mothers can get eye infections and pneumonia from chlamydia. It may also make it more likely for your baby to be born too early. Untreated chlamydia may also increase your chances of getting or giving HIV/AIDS.

Diagnosing of Chlamydia infection in men and women

Screening and diagnosis of chlamydia is relatively simple. Tests include:

• A urine test. A sample of your urine analyzed in the laboratory may indicate the presence of this infection.
• A swab. For women, your doctor takes a swab of the discharge from your cervix for culture or antigen testing for chlamydia. This can be done during a routine Pap test. Some women prefer to swab their vaginas themselves, which has been shown to be as diagnostic as doctor-obtained swabs.
• For men, your doctor inserts a slim swab into the end of your penis to get a sample from the urethra. In some cases, your doctor may swab the anus.
• Nucleic acid amplification tests (NAATs) are the most sensitive tests for detecting chlamydia and gonococcal infections. NAATs can be performed on endocervical, urethral, vaginal, pharyngeal, rectal, or urine samples (first-void is preferred). The accuracy of NAATs on urine samples has been found to be nearly identical to that of samples obtained directly from the cervix or urethra.

Treating of Chlamydia infection

• Chlamydia can be easily cured with antibiotic therapy. Antibiotics may be given as a single dose or a 7-day course.
• Women should abstain from sexual intercourse during the 7-day course of antibiotics or for 7 days after the single dose treatment to avoid spreading the infection to others.
• Azithromycin and doxycycline are antibiotics commonly used to treat chlamydia infection, but other antibiotics may be successfully used as well.
• Pregnant women may be safely treated for chlamydia infection with antibiotics (for example, azithromycin, amoxicillin, and erythromycin ethylsuccinate, but not doxycycline).
• Sex partners of a person diagnosed with chlamydia should also be tested and treated if necessary, to avoid reinfection and further spread.

How to prevent chlamydia?

These steps will also help protect you from getting or passing on an infection without knowing it.

• Use condoms (male or female) every time you have vaginal or anal sex
• If you have oral sex (going down, giving head), use a condom to cover the penis, or a latex or polyurethane (soft plastic) square to cover the female genitals or male or female anus
• If you’re a woman and rub your vulva against a female partner’s vulva one of you should cover the genitals with a latex or polyurethane square
• If you’re not sure how to use condoms correctly
• Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.