By Julie Suchanek, MBA, MT (ASCP), Metropolitan Medical Laboratory, PLC
April is “STDs Education & Awareness Month.” The most frequently reported bacterial sexually transmitted disease (STD) in the United States is chlamydia, which is caused by Chlamydia trachomatis.
Who is at Risk for Chlamydia?
Any sexually active person can be infected with chlamydia. However, chlamydia is most common among young people. Chlamydia occurrence among sexually active young persons aged 14–24 years is almost three times the occurrence among persons aged 25–39 years. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 15 sexually active females aged 14–19 years has chlamydia.
A “Silent” Infection
Chlamydia is known as a “silent” infection because most infected people are without symptoms, and typically don’t show any abnormalities upon physical examination. The CDC cites two published studies that estimated only about 5–30 percent of women and 10 percent of men with laboratory-confirmed chlamydial infection develop symptoms.
The Potential Damage to Your Body
The initial damage from chlamydia often goes unnoticed. However, chlamydial infections can lead to serious health problems with both short-term and long-term consequences.
In women, chlamydial infections can lead to chronic pelvic pain, pelvic inflammatory disease (PID), tubal factor infertility (inability to conceive due to fallopian tube damage), and potentially fatal ectopic pregnancy (where the fertilized egg implants somewhere outside of the uterus). Having multiple chlamydial infections increases a woman’s risk of serious reproductive health complications.
For pregnant women, chlamydial cervical infection at the time of delivery can be spread from an untreated mother to her baby during childbirth. This may cause pre-term delivery, and possibly conjunctivitis or pneumonia in some exposed infants.
Reactive arthritis can occur in men and women following symptomatic or asymptomatic chlamydial infection.
Screening for Chlamydia
The CDC recommends yearly chlamydia screening of all sexually active women age 25 or younger, and of older women with risk factors for chlamydial infections. Any woman who is sexually active should discuss her risk factors with a health care provider to determine if more frequent screening is needed.
All pregnant women should be screened for chlamydia at their first prenatal visit. Pregnant women under 25 or who are at increased risk for chlamydia should be screened again in their third trimester. If positive, retesting should occur after completion of recommended therapy for pregnant women – at 3 weeks, and then again at 3 months.
Though evidence is insufficient to recommend routine screening for most men, it should be considered in clinical settings with a high prevalence of chlamydia (such as adolescent clinics, correctional facilities, STD clinics, etc.). An appropriate sexual risk assessment should be conducted for all who are sexually active, and might indicate more frequent screening in some circumstances.
Testing
The most sensitive laboratory tests are Nucleic Acid Amplification Tests (NAATs). The most commonly used specimens for females are an endocervical or vaginal swab, Pap specimens, or urine. For males, a urethral swab or urine is commonly used.
Other specimen types can also be tested for NAATs. The laboratory can advise as to what type of swab is needed based on the type of specimen to be collected. Since different laboratories often use different methodologies to perform this testing, the types of swabs used will vary across laboratories.
Treatment
Chlamydia can be easily cured with antibiotics. Although medication will stop the infection, it will not repair any permanent damage caused by the disease.
Repeat infection with chlamydia is common, especially if partners have not been appropriately treated. The CDC recommends that women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether or not they believe that their partners were successfully treated.
If you are concerned that you may have chlamydia, talk to your doctor right away about getting tested.
As Metropolitan Medical Laboratory celebrates our 100th year in 2014, your good health continues to be our passion. Metropolitan Medical Laboratory, PLC is one of the largest accredited laboratories in the states of Illinois and Iowa, and has provided this community with quality laboratory services for 100 years. Visit www.metromedlab.com. See Metro’s NEWEST location at the intersection of John Deere Road & 53rd Street in Moline. We are also located at 5401 44th Avenue Drive, Moline, Illinois 61265. Call 309-736-7370 or Fax 309-736-7344. Hours: Mon.-Fri. 7 a.m.–6 p.m.; Sat. 8 a.m.–noon.
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