Mona Khanna, MD, MPH discusses the risks and concerns associated with Chlamydia and why we are seeing an increase in the number of people diagnosed with this disease.
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Chlamydia: The concerns The Centers for Disease Control and Prevention have just released 2006 statistics and what those statistics tell us is that there is a record number of cases of Chlamydia. There's more than one million cases that were seen, diagnosed, and treated, and that's very, very scary. Other couple of things also that are new overseas help us put Chlamydia into perspective, in other words, it really is an increasing infectious disease, increasing in numbers and we really need to be concerned about it. What's happening in England is that they are giving free Chlamydia tests to women who come in for emergency contraception. So again, this is something that they're paying more attention to. And then in some other European countries, they've recently done a study and while we used to think most cases of cervical cancer, in fact, almost all cases of cervical cancer were associated with the human papillomavirus, researchers in other European countries have now told us that some cases of cervical cancer, the women actually have very high rates of Chlamydia infection. So that's the first step in determining whether or not Chlamydia, in fact, is associated with cervical cancer, so lots of new information about Chlamydia. Chlamydia: Why has there been an increase in cases? Unfortunately, with Chlamydia, it's not a reportable disease. So what that means is that we don't necessarily have all of the statistics. So what we do see is, we do see that the number of cases that we diagnose is dependent upon a number of variables. First of all, people have to get tested, secondly the tests have to be reported in some way, many of them aren't and many of them are. Another concern with Chlamydia is that we haven't had for many years the test that's very sensitive that can detect it. So in other words, you could have a Chlamydia infection but the tests we had just weren't effective enough. That has recently changed; we now even have a urine test, where we can test for a Chlamydia infection. So all of these factors come together and those are some of the changes that help us understand how prevalent this is in the United States. Chlamydia: What do I need to be concerned with if I have Chlamydia? There're several issues to think about when we talk about Chlamydia. The first thing is it doesn't have any signs and symptoms in most women who actually are carrying the bacteria and that's the real problem because that's normally when we go to see the doctors when we have signs or symptoms we're concerned about something whether it's a lesion or something else. So the fact that you can be carrying the infection and they can be doing its damage internally, without any signs and symptoms is a big problem. So the first challenge we have is diagnosis. After that if you are diagnosed, you should be very concerned and the reason for that is because long-term infection with the Chlamydia bacteria can lead to, in worst cases, infertility. Also, pelvic inflammatory disease, it can lead to back pain, it can lead abdominal pain, a burning when you urinate; those are some of the problems that you can have if you carry this infection around for a long time. The other concern is that this infection is passed in a sexually transmitted way. So you can be carrying it, not have any signs or symptoms, and continue to pass it on to other partners, so a big problem. Chlamydia: How can it be prevented? It's very, very difficult with Chlamydia because we don't have signs and symptoms in many cases for most women and 50% of men. That's why screening is so important. We now recommend that people who are sexually active be screened every year for some sexually transmitted illnesses like Chlamydia. So screening is very important. But let's take a step back; before you actually get it, what are some of the risk factors? First of all, unprotected intercourse, that's why you should use condoms if you're going to have intercourse. Chlamydia is also found more frequently