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Sexually Transmitted Diseases (Std)

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Sexually transmitted diseases (STDs) are one of the largest health problems in the United States, as well as all over the world. There are fifteen million newly diagnosed cases each year in the United States, one fourth of which occur in teenagers. By the age of twenty four one in three Americans will contract a STD, and at least one in four will within their lifetime. Approximately sixty five million Americans have an incurable STD other than HIV. The United States has the highest rate of curable STDs in the developed world, higher even than some developing nations. Approximately 8.4 billion dollars are spent annually for treatment of STDs. There are many different types of STDs. Chlamydia, gonorrhea, syphilis, herpes, genital warts, hepatitis B, and human immunodeficiency virus (HIV) which leads to acquired immunodeficiency syndrome (AIDS) are some of the better known diseases.

Chlamydia is caused by bacteria known as Chlamydia trachomatis. This is the most common bacterial STD. This bacterium has been found to infect the eyes, causing conjunctivitis, particularly in newborns that contract it from their mother, the throat, usually in people who perform fellatio on an infected male, and both genital and rectal areas of the body after sexual intercourse or anal sex with an infected partner.

In men this disease can lead to problems such as inflammation

of the urethra, urethritis, of the epididymis, epididymitis, of the prostate, prostatitis, and/or the rectum, proctitis, as well as Reiter's syndrome, which is continuous urethritis, arthritis, conjunctivitis, and skin rashes even after the treatment of Chlamydia. In women it can cause pelvic inflammatory disease (PID) affecting fertility, urethritis, inflammation of the cervix, cervicitis, of the Bartholin's gland, bartholinitis, of the fallopian tubes, salpingitis, and of the liver, perihepatitis, also known as Fitz-Hugh Curtis syndrome, as well as causing reactive arthritis

Most people, fifty percent of males and seventy five percent of females, do not experience any symptoms. Symptoms for men include discharge from the penis, burning with urination, an itchy or irritated urethra, and redness at the tip of the penis. Symptoms for women include genital discharge, burning with urination, pelvic pain, and/or bleeding between periods or after intercourse.

No test for Chlamydia is one hundred percent accurate. Culturing for the bacteria is the oldest method of detection, now preferred to detect the disease in the throat or rectum. Testing for proteins and genetic material associated with Chlamydia has also been developed. The most accurate, ninety percent, is the polymerase chain reaction (PCR) or the ligase chain reaction (LCR) which test directly for the genetic material of Chlamydia through either swabs of urine.

Once detected, antibiotics are used to treat the disease. Although is may have long term affects Chlamydia itself is completely curable. Popular medicines include doxycycline, offlozcin, erythromycin, and azithromycin. Medicines must be taken for their full course. Follow up testing is also important to make sure it was effectively treated or that one has not been reinfected. Condoms are the best prevention method. (Lisa Marr, Sexually Transmitted Diseases, p123-31)

Gonorrhea is also caused by bacteria, known as Neisseria gonorrhoeae. One million people are affected annually in the United States. Women are more likely to contract this disease. Men have a twenty to thirty percent chance of contraction when sexually involved with the infected, while women have a sixty to eighty percent chance.

This disease has many of the same effects as Chlamydia, including urethritis, epididymitis, and prostatitis in men, urethritis, cervicitis, salpingitis, perihepatitis, and PID in women. Like Chlamydia it can also infect the throat, the eyes, and the rectum. Gonorrhea can also lead to joint infections, infections of the brain and spinal cord lining, known as meningitis, infections of the heart valves, known as endocarditis, and skin sores. It also puts the infected as a higher risk for contracting other STDs.

Most people do experience symptoms of gonorrhea, however about ten percent of men and twenty to forty percent of women do not. Symptoms can include all of those associated with Chlamydia as well as vaginal swelling in women, and frequent urination in men.

Culturing is the most prevalent method in testing for gonorrhea. The bacteria can also be identified under a microscope. LCRs and PCRs may also be used. All methods involve swabbing of possible infected areas.

Antibiotics are used to treat this disease. Depending on the severity of the infections different methods of administration can be used. A single injection of ceftriaxone, oral medications such as ofloxacin, cefixime, and ciprofloxacin are all used in treating gonorrhea. Condoms again are the best method of prevention. Follow up testing is also important. (Lisa Marr, Sexually Transmitted Diseases, p

Syphilis is a bacterial infection caused by the bacterium Treponema pallidum. Fifty thousand new cases of syphilis occur in the United States annually. One out of one thousand children are born with syphilis contracted from the mother. Syphilis can be contracted by contact of any mucus membranes.

There are three stages of symptoms. The first stage occurs after about three weeks and consists of a painless open sore, known as a chancre, at the site of primary infection and painless swelling of the lymph nodes. The second stage may consist of all or some of the following, a red painless rash over the entire body, swelling of the lymph nodes, fever, sore throat, joint pain, headaches, hair loss, and wart like lesions in the genital area. The tertiary or late stage of syphilis includes the destruction of the body systems and organs, including the brain which is known as neurosyphilis. It is this stage which is life threatening.

There are two ways to detect syphilis. The bacteria can be found under a microscope after swabbing an infected area, or a blood test to check for an immune system reaction to the disease. Often there are false positives in blood tests, so multiple tests are necessary.

Penicillin is the most common form of treatment for syphilis. It must be injected for successful treatment. Early stages may be cured with one injection, the later may involve more over several weeks. Neurosyphilis requires intravenous penicillin for up to two weeks. Those who are allergic to penicillin may be treated with doxycycline or tetracycline. Again follow up testing is used to measure the success of treatment. (Lisa Marr, Sexually Transmitted Diseases, p170-76)

Herpes is a viral infection. The virus is known as herpes simplex virus (HSV). There are two types, HSV-1 and HSV-2. HSV-1 usually causes cold sores



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