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When Rockland County Health Commissioner Dr. Joan H. Facelle was asked which disease she wished had more media coverage, she replied: “The first that comes to mind is chlamydia because it can often be silent, and is so prevalent. Because it has consequences, it’s important to educate people about it.”
Chlamydia (kla-MID-e-ah), the most reported sexually transmitted disease in the United States, is one of the leading causes of infertility, because it often goes undiagnosed until it’s too late. There are about 2.8 million new cases of chlamydia each year, with the highest rate among females aged 15 to 19, according to the Centers for Disease Control and Prevention (CDC). It is theorized that young women are particularly at risk of contracting chlamydia because the cervix of teenage girls is not fully matured. And women infected with chlamydia are up to five times more likely to become infected with HIV if exposed.
Dr. Facelle believes that chlamydia doesn’t get the media attention it deserves because “it's less dramatic than the other diseases. It doesn't have the social stigma of gonorrhea and syphilis. Even most adults haven't heard about it."
The majority of those infected are unaware they carry the disease because three out of four women — and half of the men feel — no symptoms.
Teens at risk
According to a 2000 CDC report, “Tracking the Hidden Epidemics”, there are 15 million new STD cases a year. A quarter of these infections occur in teenagers. Some STDs are increasing in number, while others are decreasing. Chlamydia is thought to be going down in areas that have services to diagnose and treat it (through antibiotics), but is increasing in areas that do not provide those services.
According to the 2005 CDC report, “Trends in Reportable Sexually Transmitted Diseases in the United States”, when chlamydia goes untreated, “it can cause severe health consequences for women, including pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. Up to 40 percent of females with untreated chlamydia infections develop PID, and up to 20 percent of those may become infertile. Complications from chlamydia among men are relatively uncommon, but may include epididymitis and urethritis, which can cause pain, fever, and in rare cases, sterility.”
Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns. Infected mothers may also have difficulty carrying a baby to term. A premature birth can leave an infant with permanent disabilities such as mental retardation, cerebral palsy, blindness and epilepsy.
How chlamydia is transmitted
Chlamydia is transmitted through oral, anal and vaginal sex and from mother to child during vaginal birth. If symptoms do occur, they usually appear within one to three weeks after exposure, and may include an abnormal discharge from the penis or vagina and a burning sensation when urinating. For women there may be lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods.
According to a fact sheet released by the National Center for Health Statistics in December 2002, more teens are delaying sexual intercourse and are using birth control when they do. “At their first premarital intercourse, teens were most likely to choose condoms for birth control — 66 percent reported using a condom when they became sexually active. Teens are more likely in recent years to use contraception when they begin having intercourse — 79 percent in 1999-2002, up from 61 percent in the 1980s.”
Why such widespread STDs among teens when they are delaying sexual intercourse and increasing the use of birth control such as condoms? According to the CDC, latex male condoms, when used consistently and correctly, may somewhat reduce the risk of transmission of chlamydia. In their study, although male condoms were shown to reduce the risk of HIV, the results were mixed for condom effectiveness against chlamydia. But the study added: “However, some other epidemiologic studies show little or no protection against these infections (like chlamydia, gonorrhea and trichomoniasis).
The CDC concluded: “No protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD.” (Note about Genital Herpes: The CDC states that condom use should not be relied upon to reduce genital herpes infection because the condom does not cover all areas of the skin shedding the virus).
Getting checked
It is critical for sexually active men and women to be regularly checked for STDs. Male condoms and antibiotics may help reduce the chances of serious lifelong consequences, but they should not be relied upon as the answer. According to the CDC, “the surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.” Clearly the media, educators and parents need to get involved in the fight against STDs like chlamydia. Young men and women deserve to be aware that every act of sex with a person of unknown sexual history may affect not only their own health, but the health and very existence of their future generations.
Prevalence of STDs:
CDC Estimates or Reported Infections in 2005
Chlamydia: 2,800,000
Gonorrhea: 339,593
HIV/AIDS: 38,133
Chronic Hepatitis C: 36,000
Tick-borne Lyme disease: 3,305
West Nile: 3,000
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Total Other Diseases: 440,031
*www.cdc.gov/std/stats/tables/Table42.htm
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