Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur "silently" before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.

Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. In 2006, 1,030,911 chlamydial infections were reported to CDC from 50 states and the District of Columbia. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing. Also, testing is not often done if patients are treated for their symptoms. An estimated 2,291,000 non-institutionalized U.S. civilians ages 14-39 are infected with Chlamydia based on the U.S. National Health and Nutrition Examination Survey. Women are frequently re-infected if their sex partners are not treated.

Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.

Chlamydia is known as a "silent" disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.

In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum.

Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.

Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

If untreated, chlamydial infections can progress to serious reproductive and other health problems with both short-term and long-term consequences. Like the disease itself, the damage that chlamydia causes is often "silent."

In women, untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease(PID). This happens in up to 40 percent of women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, andpotentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.

To help prevent the serious consequences of chlamydia, screening at least annually for chlamydia is recommended for all sexually active women age 25 years and younger. An annual screening test also is recommended for older women with risk factors for chlamydia (a new sex partner or multiple sex partners). All pregnant women should have a screening test for chlamydia.

Complications among men are rare. Infection sometimes spreads to the epididymis (the tube that carries sperm from the testis), causing pain, fever, and, rarely, sterility.

Rarely, genital chlamydial infection can cause arthritis that can be accompanied by skin lesions and inflammation of the eye and urethra (Reiter's syndrome).

In pregnant women, there is some evidence that untreated chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns.

There are laboratory tests to diagnose chlamydia. Some can be performed on urine, other tests require that a specimen be collected from a site such as the penis or cervix.

Chlamydia can be easily treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative.

All sex partners should be evaluated, tested, and treated. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible.

Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple infections increases a woman's risk of serious reproductive health complications, including infertility. Retesting should be encouraged for women three to four months after treatment. This is especially true if a woman does not know if her sex partner received treatment.

The surest way to avoid transmission of STDs is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.

CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health care provider should always be conducted and may indicate more frequent screening for some women.

Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles could mean an STD infection. If a woman has any of these symptoms, she should stop having sex and consult a health care provider immediately. Treating STDs early can prevent PID. Women who are told they have an STD and are treated for it should notify all of their recent sex partners (sex partners within the preceding 60 days) so they can see a health care provider and be evaluated for STDs. Sexual activity should not resume until all sex partners have been examined and, if necessary, treated.

http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm

Accurate blood tests
There are currently four FDA-approved, gG-based blood tests that can give accurate results for herpes. Like any blood test, these tests cannot determine whether the site of infection is oral or genital. However, since most cases of genital herpes are caused by HSV-2, a positive result for type-2 antibodies most likely indicates genital herpes.

It may be necessary to request on of these tests by name from your health care provider. These accurate, type-specific tests are:

• biokitHSV-2 Rapid Test
• HerpeSelect® HSV-1 and HSV-2 tests
• Herpes Western blot
• CAPTIA™ HSV IgG Type-Specific ELISAs

The biokitHSV-2 Rapid Test (manufactured by biokit USA) is a blood test that can be done in a doctor's office and provides results for HSV-2 in less than 10 minutes. For more information on the biokitHSV-2 Rapid Test, please have your health care provider call 1-800-926-3353 or log on towww.biokitusa.com. This test is also available under the name Sure-Vue™ HSV-2 Rapid Test from Fisher HealthCare. For more information on the Sure-Vue™ HSV-2 Rapid Test, please have your health care provider call 1-800-766-7000 or log on to www.fishersci.com.

There are two blood tests manufactured by Focus Diagnostics, Inc. under the name HerpeSelect®: the ELISA and the Immunoblot. Both of these tests require blood to be drawn by your health care provider and sent off to a lab that carries HerpeSelect® for results. If you are interested in HerpeSelect®, you can log on to www.herpeselect.com or call 1-800-505-0536.

The Herpes Western blot can also accurately distinguish between HSV-1and HSV-2. However, this test is primarily used for research purposes and is not readily available. If you are interested in the Herpes Western blot, your doctor will need to call the University of Washington in Seattle, WA at 1-206-598-6066 to order the test.

The CAPTIA™ HSV IgG Type Specific ELISAs can detect HSV-1 and/or HSV-2 antibodies. Blood drawn by your health care provider will be sent to a lab for results. For more information, have your health care provider contact the manufacturer, Trinity Biotech USA, at 1-800-325-3424 or log on to www.trinitybiotech.com.

Accurate Blood Test Quick Reference Guide
We have created the Blood Test Quick Reference Guide, a chart that outlines and compares the accurate, FDA-approved type-specific blood tests available for herpes simplex antibodies. To determine which test might be best for your situation - or to show your doctor which tests are available (since herpes is not routinely included in STD screenings), click here for our BLOOD TEST QUICK REFERENCE GUIDE (PDF, 108K).

For healthcare providers, we've developed the Herpes Testing Toolkit, which was reviewed by leading experts in this field. The 10-page guide explains the increasing role of type-specific herpes serologic assays, presents clinical scenarios in which serologic testing are beneficial, and reviews key factors in a differential diagnosis for genital herpes. To learn more about the toolkit, click here.>>

http://www.ashastd.org/herpes/herpes_learn_testing.cfm