Chlamydia

Responsible for the disease is Chlamydia trachomatis, an obligate intracellular bacterium (which, therefore, can only reproduce within a host cell). Five species are known, responsible for different infections:

• Chlamydia trachomatis
• Chlamydia pneumoniae
• Chlamydia psittaci (bird to human)
• Chlamydia suis (porcine pathogen)
• Chlamydia muridarum (pathogen of mice)

While pneumoniae and psittaci lead to the origin of pulmonary forms of infection, trachomatis is responsible for ocular inflammation and particularly sexually transmitted diseases (STDs).

Transmission occurs primarily sexually, with the exchange of fluids between an infected person and a healthy one, which can also occur indirectly through, for example, hands or sex toys.
Vertical transmission from mother to child can also occur during childbirth. In contrast, cases of transmission during pregnancy and postpartum are rare.

This disease is present all over the world. Numbers are particularly high in the United States, with 1,500,000 infected in 2015, but there is also a steady increase in Europe, particularly in the 20-24 age group.

Although Chlamydia Trachomatis is often asymptomatic or with vague symptoms, so it is also called Silent Epidemic, it develops several manifestations in individuals that if left untreated can result in serious consequences
Trachomatis infection has an incubation period between 7 and 21 days after infection and does not give immunity to any subsequent reinfection.
In women, cervicitis with stringy mucous discharge, irritation, bleeding, and sometimes urethritis with pyuria and dysuria are found. In some cases, it can also travel from the cervix to the Fallopian tube and give rise to pelvic inflammatory disease that can result in infertility (MIP).
Pregnant women can transmit the infection during delivery, and in newborns it can cause conjunctivitis and/or neonatal pneumonia.
In men, however, Trachomatis manifests with urethritis, irritation, itching and discharge, sometimes pain and enlargement of the testicles.
In the case of anal intercourse, the infection can spread to the rectum. This spread causes inflammation of the rectum characterized by intense pain, bleeding, and muco-purulent type discharge. Chlamydia Trachomatis can also result in painful pharyngitis in cases of oral transmission.
People affected by this STD, definitely have a higher chance than those who are not infected of acquiring and transmitting that from HIV.

Genito-urinary infections with Chlamydia Trachomatis account for about 50% of nongonococcal urethritis. It is diagnosed by molecular laboratory tests that rely on nucleic acid amplification with endocervical, urethral, vaginal, rectal, oral swabs or in urine samples.
In case of a positive test, it is also advisable to undergo serologic testing for HIV and other STDs. Again in case of positivity, it is advisable to extend this research to the sexual partner.

Therapy for Trachomatis is antibiotic-based and involves oral azithromycin or doxycycline. Alternatively, levofloxacin or erythromycin, also orally. Sexual partners should also be treated and testing repeated 3 months after therapy. In pregnant women, azithromycin is used and the test repeated 4 weeks after the end of treatment. It is necessary to abstain from sexual intercourse until 1 week after the end of therapy.

Prevention relies like other STDs on condom use, as there is no targeted vaccine. Spermicides and bactericidal agents, as well as intravaginal devices, are not a means to counteract any STD. The only avenue of prevention is the use of condoms in vaginal, oral, and anal intercourse and avoiding risky intercourse or otherwise when the health status of the partner is not known. In high-risk countries for Trachomatis or Lymphogranuloma Venereum (in order the United States and Eastern Europe for the former and Africa, India, and Southeast Asia for the latter), intercourse with premises should be avoided unless protected. In case of positivity, abstinence until negativization will avoid transmitting the infection. Then returning from a trip if one has had unprotected intercourse of any kind with locals, one should be checked for Trachomatis even if no symptoms are detected, given the large number of asymptomatic infections. The above also applies to mild symptoms such as burning, difficulty urinating, pain and swelling in the scrotum, and in women vaginal discharge, bleeding, dyspareunia (pain during intercourse). Always remember that international travel facilitates the rapid spread of sexually transmitted diseases globally.