Disease Transmission and Treatment/Prevention

Disease Transmission 

Infant with conjunctivitis from Chlamydia trachomatis (4)

Since Chlamydia is a sexually transmitted disease we know that the disease is transmitted sexually. The bacterium Chlamydia trachomatis attacks epithelial cells of humans, where mucous membranes are found(3). Although the most common area of infection is the urogenital tract infection can also occur in the eyes , the rectum and the respiratory tract (3). Transmission is from person to person through sexual contact.
Specifically, it can be passed through vaginal, anal and oral sex (2). This infection cannot be passed through famine vehicles, meaning it cannot be spread by toilet seats, bed linens doorknobs, or swimming pools (2). Unfortunately this disease can be passed from mother to child, leading to conjunctivitis or pneumonia in the infant (3).To the right we see a picture of an infant infected with chlamydia in his/her eye. 

Anyone who is sexually active can be infected with chlamydia(6). Many are infected and do not know it. The CDC  Estimates that 1/20 sexually active women aged 14-19 have Chlamydia. Although anyone can be infected with chlamydia there are some people who have a higher risk than others. Sexually active young people are at higher risk of acquiring the disease due to behavioral,biological and cultural reasons (5). Many adolescents do not consistently use condoms and move on from one relationship to the next. Since the incubation period of chlamydia can vary from 1-3 weeks, a person may be infected and not know it (5).  If people are not monogamous, or changing partners often, they may pass the infection without knowing. The CDC states that "the higher prevalence of chlamydia among young people may reflect multiple barriers, such as lack of transportation, cost, and perceived stigma. (5)"  Adolescents may not own a car to travel to their local physician, or have money to pay for the treatment, leading to the higher prevalence of the diseases. Chlamydia is the most common STD in Europe and the United states. In 2013, the CDC reported that chlaydia was highest in the the South 5.1 per 100,000 population, followed by the Midwest, the West, and the Northeast(7). In 2014, 48 states were surveyed in the united states and it was found that cases of chlamydia were highest among non-hispanic black men and women(8). This may be due to the differences in socio economic status between african americans and other races (9). 

Treatment/Prevention 

From health classes and BSCI348M we know that the only way to ensure the disease is not spread is by practicing abstinence (5). 

Since this bacterium does not have a peptidoglycan cell wall it is not susceptible to the antibiotic penicillin, which attacks the enzyme that links the wall together (3). Therefore, other antibiotics such as Azithromycin and doxycycline are used (10). In response to the infection the human body produces antibiotics, however since the infection lies within the hosts cells, the immune response will only inhibit the growth of the infection, therefore the antibiotics above are used to clear the disease(4). Doxycycline inhibits the protein production in the bacterial cell, thus restricting the bacterial growth. Azithromycin also inhibits protein synthesis (4). 

As stated previous abstinence is the only sure way to avoid infection with chlamydia and other STD's However, condoms can help to prevent infection (4). Preventative measures have been taken to promote STD testing, specifically in low income areas. Additionally, the health department has made efforts to provide free condoms to promote safe sex (4). Videos like the one above are used to provide information about STDS in endemic areas. 

I personally believe that other preventative measures need to take place. Chlamydial infections are still extremely high today. I believe the measures taken to reduce the infections are somewhat effective, but more need to be done. From a public health perspective, I believe that the highest(at risk) group needs to be educated on the disease and its mode of transmission. Meaning, that high school sex education needs to be more comprehensive rather than just explaining abstinence. Additionally, I believe there needs to be higher availably of STD testing sites, to ensure that people have places to get tested. 

Sources: 

(1) http://www.ncbi.nlm.nih.gov/books/NBK248300/

(2) http://youngwomenshealth.org/2012/11/20/chlamydia/

(3) http://web.clark.edu/tkibota/240/Disease/Chlamydia.pdf

(4) https://pedclerk.bsd.uchicago.edu/sites/pedclerk.uchicago.edu/files/uploads/conjunctivitis_0.png

(5) BSCI348M Lectures

(6) http://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm

(7) http://www.cdc.gov/std/stats13/chlamydia.htm

(8) http://www.cdc.gov/std/stats14/tables/11b.htm

(9) FMSC410 Lectures

(10) http://emedicine.medscape.com/article/214823-clinical

(11) https://www.youtube.com/watch?v=6u2oFE2nPlM