Don’t blow your cover

Volume 11, No. 39, March 23, 2006

Don’t take risks. Wear a condom.
Catch chlamydia today and do nothing about it....you can develop serious medical problems such as infertility, pelvic adhesions with chronic pelvic pain, ectopic pregnancy or reactive arthritis to name a few.
This article explains how you can prevent the risk of catching chlamydia and prevent the risk of passing it on to someone innocent, someone like you.
Sexually transmissible infections (STIs) are defined as any infection characteristically transmitted by sexual contact (World Health Organisation 2000).
Currently in Australia there are six important STI’s other than HIV:

• chlamydia
  
• gonorrhoea
  
• syphilis
  
• trichomoniasis
• herpes simplex virus and
• human papillomavirus.
  

While there are clear indications that the number of chlamydia infections in Australia is rising, undiagnosed chlamydia is the topic of much concern for sexual health experts. Calls for a national screening program have been made.

Despite strenuous and consistent efforts in prevention and education, sexually transmitted infections remain a public-health problem in Australia.

The numbers of chlamydia cases reported to Defence Health Services are approximately 100 per year but many more may go unreported as personnel often go outside of the ADF system for treatment.

The extent of undiagnosed chlamydia circulating in ADF personnel remains to be determined. While these figures appear to be relatively low they indicate that some ADF members continue with unsafe practices.

What is chlamydia
Chlamydia is a bacteria that causes a sexually transmissable infection similar to, but often more serious and common than, gonnorrhoea. It can infect both men and women.

Chlamydia in women
In women, chlamydia can infect the cervix (the passage from the vagina into the uterus or womb) causing ‘cervicitis’. Symptoms can include an abnormal vaginal discharge, abnormal vaginal bleeding and painful intercourse, though many women get no symptoms at all.

Chlamydia can also infect the urethra (passage from the bladder through which urine passes) in women. This may cause painful urination as well as frequency.

The infection can spread up into the uterus and Fallopian tubes, causing pelvic inflammatory disease (PID). A woman with PID may have abdominal pain and fever and feel very unwell, or she may have very mild symptoms or no symptoms at all.

PID can damage or block the Fallopian tubes and cause infertility, ectopic (tubal) pregnancy or chronic pain.

Chlamydia can live in a woman’s cervix, undetected, for many months. Infection can flare up at any time in the future. Chlamydia can pass from the cervix to a baby at birth, and cause eye and ear infections and pneumonia.

Chlamydia in men
In men, chlamydia can infect the urethra (the tube along which urine and semen passes through the penis).

This infection is called “non-specific” or “nongonococcal urethritis” (NSU or NGU).

Symptoms include pain when passing urine and a discharge from the penis, though some men get no symptoms at all.

The infection can spread to the prostate and epididymis (sperm-carrying tubes) and may cause chronic pain and fertility problems.

How you catch chlamydia
Chlamydia is passed on by having oral, anal or vaginal sex with someone who carries the infection. It can also be transmitted from the genital area to the eyes, causing conjunctivitis.

The bacteria cannot live outside the body so you can’t catch it from toilets, swimming pools, spas or normal social contact with people. You can reduce the chance of catching chlamydia and other STIs by using condoms.

How do you find out if you have it
Chlamydia is often symptomless and will not be picked up during routine health checks or by your two-yearly Pap smears. If you suspect you have been exposed to this infection ask your doctor for a chlamydia swab.

This is a simple test and only takes a few minutes. Chlamydia can also be detected by urine tests in both men and women. chlamydia commonly occurs together with other STIs, and tests for these should be done at the same time.

Treatment
Chlamydial infection is treated with antibiotics taken by mouth, or in severe cases by intravenous injection in hospital.

The full course of treatment must be completed. Your sexual partners should be checked and treated as well. It is important to avoid intercourse during treatment and for seven days after the end of treatment.

You will need to have a re-test in three months.

Re-infection can occur if partners are not treated.

The diagnosis of an STI provides an ideal opportunity for counseling patients about their sexual risk behaviour and encouraging safe sex. This can include specific advice on how to use condoms and how to negotiate condom use with partners.

When you should be tested
You should have a chlamydia test if:

• You have signs or symptoms of genital infection
  
• You have been diagnosed with another STI, for example, gonorrhoea, herpes or wart virus
  
• You have a sexual partner who has been diagnosed as having chlamydia or another STI
  
• Your Pap smear test suggests an infection
  
• You have irregular or breakthrough bleeding on the oral contraceptive pill
  
• You have more than one sexual partner or have recently changed partners, or
• Your sexual partner has had sex with a person who could be infected.
  
  

Tracing contacts
Sexually transmitted infections always involve more than one person. All sexual contacts which the patient has had within the last six months should be considered as potentially infected.

The patient should be encouraged to contact these partners so that they can seek testing and treatment. They may be infected butasymptomatic.

Contact tracing is likely to be important in reducing the prevalence of infection and it complications in the community.

Where to go for help

• Your local RAP/health facility
  
• Advice can be given from the Sexual Health and Family Planning Clinic
  
• http://www.shfpact.org.au
  

ADF personnel are encouraged to attend their own medical facility..

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