Part II:
Bacterial STDs:
Easy to Treat But Often Discovered Too Late

Crawling on the bottom of our TV screens and splashed across our newspapers recently are the chilling statistics that half of our nation's sexually-active youth carry at least one sexually-transmitted disease. The Centers for Disease Control and Prevention report that almost half of all new cases of STDs come from those between ages 15-24.

We cringe, but expect to hear that these STDs are the viral kind (see Runaway Viruses) and that the rapid spread has much to do with the fact that viral diseases have no "cures."

Ironically, two of the three fastest spreading STDs among our youth are bacterial, highly curable and sadly, often diagnosed long after the damage is done.

Chlamydia: The Silent Disease

Chlamydia, the most frequently reported bacterial STD, infects at least four million adolescents and young adults annually, and health officials believe that it is grossly under-reported.

Any sexually-active person can contract chlamydia, but the teenage girl is at greater risk for infection if exposed because the cervix has not fully matured.

Chlamydia is stealthy and has earned its "silence." More than three-quarters of infected women and about half of the infected men are asymptomatic.

When symptoms do occur, a woman may experience a foul and/or yellowish discharge, vaginal bleeding or spotting, and pelvic pain 1-3 weeks after exposure. In advanced stages, fever and severe abdominal and back pain may be present.

Men can have a discharge and burning upon urination.

If chlamydia is diagnosed early, it can be treated with a single dose or single course of antibiotics for the patient and her partner.

If untreated, up to 40 percent of women with chlamydia may develop pelvic inflammatory disease (PID) as the infection spreads from the cervix to the fallopian tubes and ovaries. Permanent damage to the reproductive organs can occur.

PID leads to the scarring of the fallopian tubes. Blocked fallopian tubes increase the chance of ectopic pregnancies (pregnancy occurring outside the uterus-in this case, the fallopian tube.) At best, scarred fallopian tubes cause infertility; undetected ectopic pregnancy can be fatal if the tube ruptures.

Trichomoniasis: "Trich"

The CDC terms trichomoniasis as the most common curable STD in young, sexually-active women. This single-celled protozoan parasite, Tricomonas vaginalis, is one of the three fastest growing STDs affecting our youth.

And as with most other STDs, symptoms are more obvious in women than men, even though just as many men can be affected and infected.

Symptoms in women include a yellowish discharge with strong odor and may cause itching and/or pain with urination or intercourse. Usually, symptoms appear 5-28 days after exposure.

Women who have given birth while infected with trichomoniasis may have low-weight or pre-term babies.

Women can be diagnosed through pelvic exam and laboratory tests, then treated with a single dose of metronidazole, a medication that kills parasites and some bacteria.

Syphilis: The Great Imposter

Syphilis has made a dubious come-back as a major player on the STD field. In addition to damaging the internal organs, women can pass syphilis-a bacterial infection-- to the developing fetus. Recent rises in syphilis are attributed to the activities of men who have sex with men.

Luckily, the syphilis spirochete (bacterial name) has not done much changing over the years. While researchers fight to stay one step ahead of other craftier bacteria, like streptococcus and staphylococcus, syphilis is still sensitive to penicillin and other antibiotics.

"The interesting thing about syphilis is that the incidence of new infection tends to run in cycles, going up and down," says Lisa M. Hollier, MD, assistant professor in maternal-fetal medicine in the Department of Obstetrics, Gynecology and Reproductive Sciences at The University of Texas Medical School at Houston . "And it looks like we are in a bit of an 'up' right now."

The CDC report that the incidence of infectious syphilis was highest in women ages 20-24 and in men 35-39.

Primary syphilis (first stage) is usually marked by a single sore or chancre that appears at the site of bacterial entry. First symptoms can appear anywhere from 10 to 90 days from exposure. The sore will heal on its own, without treatment in 3-6 weeks. However, the disease itself will continue on to the secondary stage, if left untreated.

Rashes on other parts of the body, just as the chancre seems to be healing, herald the secondary stage of syphilis. In addition, swollen lymph nodes, sore throat and generalized aches and fatigue are signals that the disease has gone systemic.

Effects of late stage syphilis, which can surface years later, range from gradual blindness to paralysis and dementia. Rampant, untreated syphilis can lead to death.

The effects of syphilis are devastating to the children born of infected women.

Hollier notes that the most striking problem is the racial disparity among those who are infected. "Seventy-five percent of infections are in the African-American population. We still have women who get or who are infected in the pregnancies and occasionally still see babies who die from syphilis when moms get inadequate prenatal care."

Vaginosis

Bacterial vaginosis is not really an STD, but a "sexually-associated" condition. It can occur in women who are not sexually active. In this condition, there are changes in the vaginal flora, the bacteria that normally colonize in the vagina. It has been associated with serious problems such as postoperative infection, preterm birth, and infection after delivery.

"All these strides in medicine are wonderful, especially for women, who carry a disproportionate burden because of the effects of STDs on fertility as well as adverse pregnancy outcomes," comments Hollier.

But all the new diagnostic tests and medications are useless if people don't talk with their physicians. "Because many STDs are asymptomatic, annual screening of sexually-active women aged 20 to 25 years is recommended by the CDC as is screening of older women with risk factors (such as a new sexual partner)," Hollier says.

Hollier is a contributor and a guest editor to the recent issue of Obstetrics and Gynecology Clinics of North America-Infectious Disease and Women's Health , Volume 30, Number 4, published by W.B. Saunders Company. The other editor is George D. Wendel, Jr., MD, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical School.

Every year more than 12 million cases of STDs are reported in the U.S. says the CDC, which recently published updated guidelines for the treatment of STDs. Highlights are discussed in Hollier's new book.

http://www.cdc.gov/nchstp/dstd/disease_info.htm

Last Updated: 3-11-2004

Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us

©2000-2009 Office of Institutional Advancement, UT-Houston