It is the most commonly reported STD and two to three times more common than gonorrhea yet many people, both men and women, do not know that they have chlamydia. In fact as many as 8 out of 10 women and 5 out of 10 men may have no symptoms of chlamydia despite being infected. It can still be spread to partners and even newborns during childbirth, and chlamydia can cause infections of surrounding organs or even of the lungs and eyes in babies.
What is chlamydia?
Chlamydia is an infection caused a type of bacteria known as Chlamydia trachomatis. It affects both men and women but is more likely to lead to more severe complications among women and newborn babies who may contract it during birth. Chlamydia infection is one of the leading causes of infertility among women. Antibiotics can very effectively treat the infection.
Due to the nature of the disease, partners of a person with a chlamydia infection should also be treated or it can result in re-infection. Unlike with certain other infections, having chlamydia does not result in future immunity and a person can contract the infection several times in life. Ideally the infection should be prevented by ensuring early treatment and the use of barrier protection.
Causes of Chlamydia
Chlamydia trachomatis is one species of the Chlamydiae family of bacteria. There are about 18 different strains (serovars) of the Chlamydia trachomatis species. Some tend to cause genital tract infections as is seen in chlamydia, uncommon infections like lymphogranuloma venereum (LGV) and severe eye infections that can lead to blindness.
The chlamydia bacteria infects the squamocolumnar cells lining the female genital tract and due to changes in early adulthood, adolescent females who are sexually active are at particular risk. The bacterium then triggers inflammation and this continues even after it enters the target cells. Although as many as 40% of adults with chlamydia also have gonorrhea, this is a separate sexually transmitted infection.
How is chlamydia spread?
Chlamydia is mainly spread through sexual contact. This includes vaginal, oral and anal sex. It can also be spread to newborns as the baby passes through the birth canal if the mother has the infections. Chlamydia cannot be transmitted through non-sexual contact like shaking hands. The spread of chlamydia can significantly reduced by the use of condoms.
Any sexual active person can contract chlamydia if their partner has the infection. However, it is more common among people under the age of 24 years. The risk is also greater among people who have multiple sexual partners and do not use barrier protection like condoms. Even skipping condom use just once can lead to chlamydia infection. People with a history of sexually transmitted infections are naturally at higher risk.
Signs and Symptoms
The incubation period for chlamydia infection varies from 1 to 3 weeks. This means that the bacteria can be in the body for this period of time before the first symptoms arise. However, many men and women with chlamydia have no symptoms for much longer periods of time and the infection can be missed while it is passed on to other partners. Often when the symptoms are present it is mild and frequently mistaken for a urinary tract infection.
The signs and symptoms include:
- Painful urination (dysuria)
- Yellow urethral discharge
- Rectal pain (anal intercourse)
If the infected secretions come into contact with the eye then it can also cause conjunctivitis in both men and women.
In women there may also be:
- Abnormal vaginal bleeding
- Vaginal discharge
- Lower abdominal pain
In men there may also be:
- Scrotum pain and swelling
Chlamydia may also infect the cervix in women and sometimes this can spread upwards to infect the other parts of the female reproductive system resulting in pelvic inflammatory disease (PID). This can lead to a host of complications like scarring and obstruction of the fallopian tubes which may be the cause of infertility in women.
Treatment of Chlamydia
Chlamydia can be very effectively treated with antibiotics. There are first-line drugs which should be used initially when chlamydia is diagnosed. These drugs are effective for 9 out of 10 chlamydia infections. If these drugs fail to resolve the infection then second-line drugs are considered. These second-line drugs are usually less effective and have more side effects but should be attempted when first-line drugs fail to act.
First-line drugs for chlamydia include:
Some second-line drugs include:
Chlamydia antibiotics may be prescribed as a single-dose (which is taken one time) or as a course of antibiotics which may be used over a period of 5 to 10 days depending on the antibiotic and the strength. It needs to be taken as prescribed and a course of antibiotics should not be discontinued before it is completed, even if the symptoms resolve.
Death from chlamydia is very rare but possible. It is more likely to occur when complications arise and are left untreated. An abscess that forms around the fallopian tubes or ovaries that ruptures can then cause peritonitis which may be fatal. Due to scarring of the fallopian tubes from severe chlamydia, the risk of ectopic pregnancy is much higher. It is the ectopic pregnancy that can lead to death if it is not promptly treated.
WARNING: Never attempt to treat chlamydia with any antibiotic other than the type prescribed for the infection. Do not use ‘leftover’ antibiotics from other infections. Always consult with a medical doctor.
Prevention of Chlamydia
The body does not develop immunity against chlamydia after the infection is contracted the first time. Using a condom can prevent infection. Abstaining from sexual intercourse or only being active with one partner are other ways of preventing the infection.The latter may not always be a guarantee if the patient’s partner has multiple other partners.
Pregnant woman who have chlamydia need to inform the doctor. The risk of the mother spreading it to the baby during childbirth is as high as 50% to 60%. It has to be treated as early as possible in pregnancy. It is important to note that douching after intercourse is not a suitable preventative measure.