Chlamydia is a sexually transmitted disease (STD) caused by bacteria (chlamydia trachomatis) that can infect both men and women. It can cause serious and irreversible damage to the female reproductive system if left untreated and it may become hard for her to get pregnant. Chlamydia also puts you at risk for ectopic pregnancies (a pregnancy which develops outside the uterus).

Chlamydia is spread by vaginal, anal or oral sex and you can get it from someone who has it. It is carried in semen and vaginal fluids. Chlamydia can infect the penis, vagina, cervix, anus, urethra, throat and eyes. You can still get it even if your partner did not ejaculate and even if you have had it before and were treated for it if you have unprotected sex with someone who has chlamydia. In childbirth, chlamydia can be passed to the baby.

The only way to be 100% protected from any STD is abstinence, however if you are sexually active consider:

• Using latex condoms and dental dams the correct way every time you have sex;
• Being in a monogamous relationship with a partner who has been tested and shows no positive STD results.

Chlamydia is not spread through casual contact so you cannot get it from kissing, hugging, sharing drinks or foods, sneezing, sitting on a toilet or coughing.

Etiology of Chlamydia

You should consider getting tested for chlamydia if:

• You or your partner/s have any symptoms of chlamydia;
• You have had unprotected sex with a new partner;
• A condom breaks while having sex;
• A sexual partner has an STI;
• You are either pregnant or planning a pregnancy;
• You think you could have an STI;
• You or your partner have had unprotected sex with other people.

Other risk factors include:

• Age 15-24 years, especially under 19 years;
• Poor socioeconomic conditions, such as homelessness;
• Having multiple sex partners 
• Having been a foster child (for man only).

How common is Chlamydia?

In 2017 more than 1.7 million cases of chlamydia were reported to the CDC, however many go unreported so there is an estimate of around 3 million chlamydia cases every year. Both men and women can get infected with chlamydia but more cases in women are reported. Infection rates are higher in women between the ages of 15 to 24. In spite of the fact that patients with any STD are at increased danger of coinfection with another STD, coinfection of chlamydia and gonorrhea is generally normal. A little less than half of women and 20% of men with chlamydial infection are co-infected with gonorrhea. Patients with chlamydia likewise have a higher frequency of Reiter condition (urethritis, conjunctivitis, reactive arthritis) than the general population.

More than 1,000,000 sexually transmitted infections (STIs) are acquired each day around the world. C trachomatis (chlamydia) genital tract contaminations are fairly common, with an expected 127 million new overall cases in 2016. Surveys have documented comparable occurrence figures in Australia, New Zealand, France, Germany and the Netherlands. A report from the World Health Organization (WHO) Initiative for Vaccine Research (IVR) assessed that there were more than 140 million instances of C trachomatis contamination around the world.

Risks of Chlamydia in women

In women with chlamydia, especially the one caused by serotype G the risk for developing cervical cancer is increased as much as 6.5 times greater than women who are not infected.The danger of ectopic pregnancy in women who have had PID is 7-10 times greater than that for women without a background marked by PID. In 15% of women who have developed PID, chronic pain in the abdomen is a long-term symptom that is most likely related to pelvic adhesions in the ovaries and fallopian tubes (the place where the sperm fertilizes the egg).

Chlamydial infection is one of the main sources of infertility in women and a main source of PID. PID is a genuine sickness that frequently requires hospitalization for inpatient care, including intravenous (IV) antibiotics, testing to rule out tubo-ovarian abscess and intensive counseling on the complications of recurrent infections with STIs.

Chlamydia Symptoms

Many people infected with chlamydia show no symptoms. Most symptoms start to appear a few weeks after having sex with an infected person. It can still damage your reproductive organs even if you show no symptoms.

Chlamydia symptoms in women

Some of the most common chlamydia symptoms in women include:

• Painful sex (dyspaneuria);
• Abnormal vaginal discharge;
• Burning sensation when urinating;
• Pain in the lower abdomen or pelvis;
• Inflammation of the cervix (cervicitis);
• Bleeding between periods (spotting).

In addition to that, women can also develop a throat infection if they perform oral sex on an infected person.

Chlamydia symptoms in men

Symptoms in men include:

• Yellow or green discharge from their penis;
• A burning sensation when urinating;
• Pain and swelling in one or both testicles (less common);
• Pain in the lower abdomen.

Newborns who have contracted a chlamydial infection may present the following:

• Pneumonia-like symptoms, beginning at 1 to 3 months that is accompanied by cough and sometimes fever;
• Symptoms of conjunctivitis at around 1 to 2 weeks, which involves eye discharge, swelling or both.

Men and women can also get infected with chlamydia in their rectum that may or may not be accompanied by symptoms. However they might include rectal pain, discharge and bleeding.

If you notice any of these symptoms (including other STD symptoms like an unusual sore, a smelly discharge or spotting between periods) or suspect you may have become infected with chlamydia or any other STD talk to your doctor.

Chlamydia in Throat

Although STIs generally affect the genital areas, STIs like chlamydia can be spread via oral sex to the throat and cause throat problems. It is medically known as a pharyngeal chlamydia infection. Additionally, getting oral sex from someone with chlamydia of the throat can potentially transmit the bacteria to your genitals. It is important to note that chlamydia cannot be contracted from mouth-to-mouth kissing.

Pharyngeal chlamydia infection often does not cause symptoms. Most people with throat infections think they may only have a sore throat due to a common cold or flu.

Some common symptoms of chlamydia in the throat include:

• A sore throat;
• Dental problems;
• Mouth pain;
• Mouth sores that will not go away;
• Sores around the lips and mouth.

Chlamydia in the throat is not generally a part of usual STI testing. If you think you may have chlamydia, have any sores that won’t go away or have a partner that you have had oral sex with who tested positive for chlamydia in the throat consider asking your doctor about a pharyngeal chlamydia testing. The doctor may swab your throat and send the specimen to a lab to test for pharyngeal chlamydia. However, it is important to note that the FDA has not yet approved a swab test for pharyngeal chlamydia.

Chlamydia in Eye

Inclusion conjunctivitis

The ocular manifestation of Chlamydia is thought to be caused by poor personal hygiene and the transfer of infected vaginal fluids to the eye, either by autoinoculation or through a sexual partner. Various diagnostic testing found that 40 to 90 percent of adults with inclusion conjunctivitis also had genital chlamydia.

Mucopurulent discharge, lid swelling, discomfort, foreign body feeling, redness, an enlarged preauricular lymph node, and diffuse mixed papillary follicular conjunctivitis are signs and symptoms of adult inclusion conjunctivitis. If the condition is not treated, it can cause superficial vascularization, peripheral scarring, superficial punctate epithelial defects, and peripheral subepithelial infiltrates.

Adult inclusion conjunctivitis normally resolves on its own. If the infection does not clear up, the absence of antibiotic medication can prolong the condition for years, albeit it will not progress beyond peripheral corneal involvement.

A cytological examination of coloured smears from tissue can diagnose Chlamydial conjunctivitis. Giemsa staining of conjunctival cells can identify trachoma and acute chlamydial conjunctivitis, as well as intracellular inclusion bodies. Unfortunately, this approach is insensitive for detecting adult chlamydial conjunctivitis, but it is quite sensitive for newborns. Newer and more precise approaches include immunofluorescent antibody labeling of chlamydial antigen and nucleic acid amplification of conjunctival smears.

Topical and systemic antibiotics are both recommended treatments for inclusion conjunctivitis. Adult chlamydial conjunctivitis is often treated with a two-to-three week regimen of erythromycin or tetracycline ointment combined with systemic tetracycline, doxycycline, or erythromycin. Ocular redness and mucous discharge can be controlled with a single oral dosage of azithromycin.

Furthermore, in the eradication of C. trachomatis, this dose azithromycin is as successful as 10-day doxycycline treatment. Systemic tetracyclines, macrolides, or azolides should be taken by infected moms and their partners. Infants are often treated for one week with erythromycin eye ointment and two to three weeks with erythromycin.

Trachoma

Trachoma is a chronic, inflammatory, follicular type of keratoconjunctivitis caused by repeated infection with gram negative C. trachomatis. Trachoma affects around 84 million people worldwide, with 8 million becoming blind as a result of disease. Trachoma accounted for approximately 3.6 percent of global blindness in 2002, and it is one of the primary causes of infectious blindness.

The illness is more common in developing countries that lack the medical resources needed to battle recurring chlamydial infections. It is difficult to establish whether personal behaviors or situations enhance the risk of trachoma, although the presence of multiple young children, limited access to water, poor sanitation and hygiene, and high fly densities are some of the most significant household dangers.

Endemic trachoma has been linked to seasonal outbreaks of bacterial conjunctivitis (Hemophilus, pneumococcus, or Moraxella), which contribute to the severity of the ocular illness. Because other serious eye disorders, such as severe papillary conjunctivitis, might be misinterpreted as trachoma, cytological examinations are required for an accurate diagnosis.
Trachoma is distinguished by follicles on the tarsal conjunctiva. Papillae occur between the follicles and, in extreme cases, the papillae connect, giving the conjunctiva a thicker and velvety appearance. Mucopurulent ocular discharge and damaged limbal follicles are two further symptoms. Follicles larger than 0.5 mm in size on the upper tarsal conjunctiva, as well as inflammatory thickening concealing more than half of the normal deep tarsal capillaries, are indicators of active illness, with the latter indicating severe disease.

Significant scarring constricts the tarsal conjunctiva, causing the lid margin to roll towards the eye and resulting in trichiasis. The rubbing of the lashes on the cornea is unpleasant, and if left untreated, it leads to fast scarring and opacification, which leads to blindness. Scarring, trichiasis, and corneal opacity are symptoms of cicatricial trachoma, the last stage of the disease.

How is Chlamydia tested?

Screening for chlamydia is done with a urine test or a swab test and does not always require a physical examination by a nurse or doctor. The tests are simple, painless and generally reliable and involve sending a sample of cells to a lab for analysis. The two main ways of collecting cells are:

• Using a swab. A small cotton bud is gently wiped over the area that might be infected, such as inside the anus or vagina;
• Urinating into a container (men will be usually asked to provide a urine sample).

The results will normally be available in about 7 to 10 days.

If you test positive for chlamydia you have to get another test around 3 months after being treated as young adults who test positive for chlamydia have an increased risk of contracting it again.

You can get tested for chlamydia at a sexual health clinic, a genitourinary clinic and most contraceptive clinics. You can also buy chlamydia testing kits to do at home.

Due to the chance of different sexually transmitted infections, all patients with any sexually transmitted disease (STD) ought to be assessed for a possible chlamydial infection.

Endocervical, urethral, rectal, or oropharyngeal samples should be obtained and further tested for C trachomatis disease in both males and females based on the patient’s sexual practices that can be known by history.A voided urine specimen, regardless of whether midstream or first-void, viably catches the chlamydial infection for nucleic acid amplification testing (NAAT). NAATs are the most sensitive tests for these samples and are accordingly suggested for detecting C trachomatis disease. Self-gathered vaginal swab examples are comparable in sensitivity to those gathered by a clinician utilizing NAATs.

In babies with suspected chlamydia pneumonia, the doctor should perform a nasopharyngeal swab for chlamydia culture. As of now accessible fast tests are not yet approved for use on such samples. In extreme or complicated cases, the doctor might consider sending bronchoalveolar lavage fluid for chlamydial culture too. A complete blood count (CBC) uncovering peripheral eosinophilia in the proper clinical circumstance is additional proof supporting C trachomatis pneumonia.

In babies with suspected chlamydial conjunctivitis, a doctor will most likely play out an antigen/DNA detection test, chlamydial culture, or both, utilizing scrapings from the palpebral conjunctiva.

On the off chance that the mother had a documented chlamydial disease during pregnancy that was untreated, the baby will probably be put on treatment even without confirmation of contamination to avoid further possible complications of the chlamydial infection in the infant.

Chlamydia treatment

Chlamydia can be cured with the right treatment, which is an antibiotic prescribed by your doctor. If the medication is taken properly it will stop the infection and can decrease the chances of having any complications later on. Chlamydia medication should never be shared with anyone.

However, repeated infection with chlamydia is frequent therefore you should be tested again about three months after the treatment even if your partner was also treated.

During the chlamydia treatment you should not have sex until both you and your partner have completed the treatment. If you are taking a one time antibiotic dose, oral sex or intercourse should be avoided for at least 7 days. If you take a longer course, you should always wait until you have finished the entire treatment before having sex again.

Your doctor will tell you how long to wait before you can have sex again depending on the treatment plan. After you have taken all your medication it is a good idea to always have protected sex (with a condom or oral sex with dental dams) to avoid contracting new infections.

Lower genital diseases caused by Chlamydia can be treated with single-dose, directly observed treatment. This is encouraged when it is possible to diminish noncompliance caused by cost, privacy issues, motivational issues, and maturity issues. Upper genital tract disease, particularly in young people, should be thoroughly sought out. With the approach of more up to date, more sensitive DNA and antigen detection kits that utilize urine samples rather than a pelvic assessment, the possibility to presume a chlamydial contamination in uncomplicated lower tract disease is concerning. Inadequate treatment of PID can lead to sepsis, infertility, and ongoing pelvic pain. A large number of practitioners advise admission the treatment for patients and monitoring of response whenever PID is suspected, in light of the fact that a lot of youths tend to overlook symptoms, and to guarantee follow-up.

Management of PID, in any event, when gonorrhea is also present, ought to consistently incorporate treatment against C trachomatis, just as N gonorrhoeae (gonorrhea) and anaerobic bacteria. Randomized preliminaries have shown that parenteral and oral regimens have comparable clinical viability for mild to moderate PID, in spite of the fact that doxycycline is given orally if possible, since that intravenous infusion can be painful.

With inpatient regimens for PID, proof of critical clinical improvement and trust in finishing of clinical treatment should be available before the patient is released. Suggested parenteral regimens incorporate cefoxitin or cefotetan alongside a 14-day course of doxycycline or, then again, clindamycin in addition to gentamicin or ampicillin-sulbactam in addition to doxycycline.

Outpatient regimens for PID incorporate a single-dose of intramuscular treatment with a second-or third-generation cephalosporin in addition to 14 days of doxycycline, with or without metronidazole 500 mg twice every day for 14 days. In view of the development of quinolone-safe N gonorrhoeae, regimens that incorporate a quinolone are not, at this point, suggested for PID treatment.

Chlamydial conjunctivitis and pneumonia are normally treated in about 14 days.

Treatment additionally is advised for sexual partners of the record case if the time of the last sexual experience was within 60 days of onset of symptoms. Treatment of chlamydial infection is used for patients being treated for gonorrhea, too.

Chlamydia left uncured

At first, chlamydia damage often goes unnoticed. However, chlamydia can lead to serious health problems especially in women. It can spread to the uterus and fallopian tubes and can later cause PID (pelvic inflammatory disease). PID often has no symptoms, but some women report pelvic and abdominal pain. PID can lead to permanent damage to your reproductive system and it may become hard for a woman with PID to get pregnant. Remember that PID is a medical emergency and some of the symptoms include:

• Fever;
• Severe pelvic pain;
• Nausea;
• Abnormal vaginal bleeding between periods (also known as spotting).

Other risks of untreated chlamydia infections include:

• Increased risk for ectopic pregnancies which can be life threatening;
• Increased risks for preterm delivery in pregnant women;
• Inflammation of the upper genital tract;
• Perihepatitis (an inflammation of the capsule that surrounds the liver), also known as Fitz-Hugh-Curtis syndrome;
• Reactive arthritis (a form of inflammatory arthritis) or Reiter syndrome;
• Cervical cancer.

Men rarely have serious health problems due to an infection with chlamydia, however the infection can sometimes spread to the tube that carries sperm from the testicles and can cause pain and fever.

In both men and women, a chlamydia infection may increase the chances of infecting and becoming infected with HIV, the virus that causes AIDS.

Fitting advising of contaminated people should be performed. You should expect your doctor or GP to educate you regarding the possible long term dangers and complications of this disease, including the chance of infertility. You should be instructed about the danger of different STDs and be given guidance to find ways to prevent a possible reinfection or infections with other STDs. You ought to avoid sexual contact until your treatment is finished and all partners additionally have been assessed and treated. You should also make sure to consider utilizing latex condoms to limit the odds of reinfection.

Complications of Chlamydia

In men:

• Inflammation of the testicles. In men, chlamydia can spread to the testicles and epididymis causing them to become swollen and painful. This inflammation is usually treated with antibiotics. If not, it may affect your fertility.
• Reactive arthritis. Chlamydia is the most common reason for sexually acquired reactive arthritis (SARA), where your joints, eyes or urethra become inflamed, usually within the first few weeks from contracting chlamydia. It can also affect women, although it is more common in men. Currently, there is no cure for SARA but most people generally get better in a few months. NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen can help alleviate the symptoms.

In women:

• Pelvic inflammatory disease (PID). The symptoms of PID are similar to those of chlamydia. PID is generally treated with antibiotics and treatment usually lasts for 2 weeks. If treated early, the risks associated with it lower, so it is important to seek medical help as soon as possible if you show symptoms of this condition.
• Pregnancy complications. While you are pregnant it is important to know if you have chlamydia, since there is a chance you could pass the infection on to your baby. If this happens, your baby might develop conjunctivitis (an eye infection), pneumonia (a lung infection) and a nasopharyngeal infection. Untreated chlamydia in pregnancy can also lead to an increased risk of problems such as premature birth or a baby with a low birthweight.

Can chlamydia affect your baby if you are pregnant?

The only way chlamydia can be passed to the baby is during delivery and can cause an eye infection and even pneumonia in your newborn. Chlamydia also puts you at risk of having to deliver preterm. Most prenatal tests include a chlamydia test.

Recommendations

It is recommended that all sexually active women who are 25 years old and younger get tested for chlamydia every year, as well as older women with risk factors such as multiple or new partners.

An act of sexual assault can raise the risk for contracting chlamydia and other STDs. Aim to get screened as soon as possible if you were forced into any sexual activity (including oral sex).

How can chlamydia be prevented?

You can help prevent the spread of chlamydia by:

• Using a barrier form of contraceptives every time you have vaginal, anal or oral sex;
• Not sharing sex toys. If you do share sex toys it is important to wash them thoroughly or cover them with a new condom between each person who uses them.

Chlamydia Koala

A silent killer is wreaking havoc on Australia's koala population, creating a threat that wildlife experts warn may wipe out the famous animal throughout most of the country. Chlamydia, a sexually transmitted disease that infects more than 100 million individuals globally each year and can cause infertility in humans if left untreated, is the culprit.

However, chlamydia is no laughing matter for koalas. According to surveys, certain wild populations have a 100% infection rate, which commonly results in blindness, severe bladder irritation, infertility, and death. Researchers have discovered that antibiotic therapy may cause further issues for the marsupials by unsettling their gut microorganisms and making it difficult for them to digest the eucalyptus leaves that are a mainstay of their diet.

Adult koalas get chlamydia through sexual transmission, but young koalas can become infected by eating pap, a nutritious form of excrement generated by infected moms. Antibiotics are used to treat diseased koalas, however the koalas frequently lose weight and die even after therapy.

Conclusion

Chlamydia is a prevalent sexually transmitted disease caused by Chlamydia trachomatis infection. Cervicitis, urethritis, and proctitis can all be caused by it. Chlamydia can infect a woman's cervix, rectum, or throat. Chlamydia can infect men in the urethra, rectum, or throat. The majority of people who have the virus have no symptoms and do not seek treatment.

Untreated infection in women can progress to the uterus and fallopian tubes, resulting in pelvic inflammatory disease (PID). PID can permanently harm your reproductive system. Long-term pelvic discomfort, infertility, and ectopic pregnancy can result from this. Women who have had several chlamydia infections are at a higher risk of major reproductive health issues.