Transcript here - Sexual Transmitted Disease

Current Overview of Sexual
Transmitted Disease
Prevention and Treatment
Contents:
• Concept of Sexual Transmitted Disease.
• Clinical Manifestation of Common STD
– Bacterial diseases:
1. Chlamydia (CT)
2. Gonorrhea (GC)
3. Syphilis
Viral diseases:
1. Human Papillomavirus (HPV)
2. Genital herpes (HSV-2 or HSV-1)
3. Hepatitis B
Concept of Sexual Transmitted
Disease.
• also known as sexually transmitted infection (STI) or
venereal disease (VD), is an illness that has a significant
probability of transmission between humans or animals by
means of sexual contact, including vaginal intercourse, oral sex,
and anal sex. While in the past, these illnesses have mostly been
referred to as STDs or VD, in recent years the term sexually
transmitted infection (STI) has been preferred, as it has a
broader range of meaning; a person may be infected, and may
potentially infect others, without showing signs of disease. Some
STIs can also be transmitted via use of an IV drug needle after
its use by an infected person, as well as through childbirth or
breastfeeding. Sexually transmitted infections have been well
known for hundreds of years.
Clinical Manifestation of
Common STD
– Bacterial diseases:
– Chlamydia (CT) {definitions of chlamydia}:
–
a sexually transmitted infection caused by bacteria
of the genus Chlamydia
coccoid rickettsia infesting birds and mammals;
cause infections of eyes and lungs and
genitourinary tract.
Chlamydia Infections in
Women, Men, and Neonates
Men
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Genitals {Urethritis, Epididymitis}
Rectum {Proctitis}
Throat {Pharyngitis}
Eyes {Conjunctivitis}
Systemic {Reiters’ syndrome}
Women
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Genitals {Urethritis, PID, Cervicitis}
Rectum {Proctitis}
Throat {Pharyngitis}
Eyes {conjunctivitis}
Neonates
• Eyes { Conjunctivitis}
• Lungs {Pneumonia}
Diagnosis & Treatment
• Diagnosis {Laboratory diagnosis including
DNA, enzyme immunoassay}.
If you don't have any symptoms, but are worried
you might have chlamydia, talk to your doctor.
Your doctor can perform a swab test, or a urine
test in some cases, to diagnose the infection.
What do I do if I have been
diagnosed with chlamydia?
• the infection can be treated easily with antibiotics. As chlamydia
is transmitted through unprotected sex, your doctor may suggest
you be screened for other sexually transmitted diseases .It's
important that you inform any recent sexual partners you may
have had that they might be at risk of chlamydia. Remember,
they might not display any symptoms but if they are not
informed about their risk of chlamydia, they could develop
serious conditions such as pelvic inflammatory disease, as well as
continue to spread the infection to others.
• You can also help prevent being infected with chlamydia by using
a condom when you have sex, particularly if you have more than
one sexual partner.
2.Gonorrhea (GC)
• Definition
Gonorrhea is a highly contagious sexually transmitted
disease that is caused by the bacterium Neisseria
gonorrhoeae. The mucous membranes of the genital
region may become inflamed without the development
of any other symptoms. When symptoms do occur,
they are different in men and women. In men,
gonorrhea usually begins as an infection of the vessel
that carries urine and sperm (urethra). In women, it will
most likely infect the narrow part of the uterus (cervix).
If untreated, gonorrhea can result in serious medical
complications.
Symptoms of gonorrhea in women
• As many as 80% of women with gonorrhea show no
symptoms. If present, symptoms may include the
following:
• bleeding between menstrual periods
• chronic abdominal pain.
• painful urination.
• vaginal discharge, often cloudy and yellow.
• in the case of oral infection, there may be no symptoms
or only a sore throat.
• anal infection may cause rectal itching or discharge.
Symptoms of gonorrhea in men
• Men are more likely to experience the following
symptoms:
• thick and cloudy discharge from the penis.
• burning or pain during urination.
• in the case of oral infection, there may be no symptoms
or only a sore throat.
• anal infection may cause rectal itching or discharge.
• In men, complications can affect the prostate, testicles,
and surrounding glands. Inflammation, tissue death and
pus formation (abscesses), and scarring can occur and
result in sterility.
The diagnosis of gonorrhea
• The diagnosis of gonorrhea can be made at a public
health clinic.. There are three methods available to test
for the presence of Neisseria gonorrhoeae. These include a
culture, a Gram stain, and an ELISA test. Culture of
secretions from the infected area is the preferred
method for gonorrhea screening in patients with or
without symptoms. A cotton swab can be used to
collect enough sample for a culture. The sample is
incubated for up to two days, providing enough time
for the bacteria to multiply and be accurately identified.
This test is nearly 100% accurate.
Gonorrhea: Treatment
• two drug treatment regimens are common.
Medications used to treat gonorrhea include
ceftriaxone, cefixime, spectinomycin,
ciprofloxacin, and ofloxacin. Ceftriaxone and
doxycycline or azithromycin are often given
simultaneously to treat possible co-existing
chlamydia (in pregnant women, erythromycin
should be substituted for the aforementioned
anti-chlamydial agents).
Gonorrhea: Prevention
• Currently, there is no vaccine for gonorrhea, but
several are under development. The best
prevention is to abstain from having sex or to
engage in sex only when in a mutually
monogamous relationship in which both
partners have been tested for gonorrhea, AIDS,
and other sexually transmitted diseases. The next
line of defense is the use of condoms, which
have been shown to be highly effective in
preventing disease (and unwanted pregnancies).
3. Syphilis
• Syphilis is a sexually transmissible infection (STI) caused by a
bacterium called Treponema pallidum and can affect both men and
women.. Almost all recent cases have been in gay men. Blood
tests will show if a person has the infection.
You can catch syphilis through oral, vaginal or anal sex with a
person who has the infection. It is transmitted through skin-toskin contact with an infected area. Syphilis is highly contagious
when the sore or rash is present. Pregnant women who have
syphilis can pass on the infection to their unborn baby. It can
also be transmitted by blood transfusion.
Symptoms
• There are three stages of syphilis. Only the first two stages are
infectious.
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First stage (4 to 6 weeks)
The first stage of syphilis occurs as a sore on the penis, vulva
(lips of vagina), anus or mouth. The sore:
May be hidden from view, in the rectum or on the cervix
Is usually painless
Appears three to four weeks after infection – however, it can
occur any time between 10 days and 90 days after infection
Normally heals completely within four weeks.
Second stage of syphilis
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Second stage (0 to 24 months)
During the second stage of syphilis, there may be:
A flat, red skin rash, which is very contagious and may
occur on the soles of the feet or palms of the hands, or
may cover the entire body
Enlarged lymph nodes
Hair loss
Lumps on the genitals
General tiredness.
Third Stage of syphilis
• Third stage (may occur years later)
The third stage of syphilis occurs in about onethird of untreated people. Severe brain or heart
complications may occur during this stage.
Treatment and Prevention
• How Is Syphilis Treated?
• Syphilis is treated with parenteral penicillin.
This means that the penicillin is either
injected into the muscle or given
intravenously. Oral penicillin has not been
shown to be effective in treating syphilis.
How Can Syphilis Be Prevented?
• As with many other STDs, using latex male
condoms properly during sexual intercourse may
give some protection from the disease.Screening
and treatment of infected individuals, or
secondary prevention, is one of the few options
for preventing the advanced stages of the
disease. Testing and treatment early in pregnancy
are the best ways to prevent syphilis in infants
and should be a routine part of prenatal care.
Viral diseases:
1. Human Papillomavirus
(HPV)
• It is a papillomavirus that
infects the skin and mucous
membranes of humans. It
impacts the health of women
far more than it impacts men.
Approximately 130 HPV
types have been identified.
Some HPV types can cause
warts (verrucae) or some
types of cancer, while others
have no symptoms. "Most
people who become infected
with HPV do not even know
they have it."
Statistical information
How can people prevent HPV
• A vaccine can now protect females from the four types
of HPV that cause most cervical cancers and genital
warts.
• An HPV DNA test, which can find high-risk HPV on a
woman’s cervix, may also be used with a Pap test in
certain cases. The HPV test can help healthcare
professionals decide if more tests or treatment are
needed. Even women who got the vaccine when they
were younger need regular cervical cancer screening
because the vaccine does not protect against all cervical
cancers.
Is there a treatment for HPV
• There is no treatment for the virus itself, but there are treatments
for the diseases that HPV can cause:
• Visible genital warts can be removed by patient-applied
medications, or by treatments performed by a health care
provider.
• Cervical cancer is most treatable when it is diagnosed and
treated early. There are new forms of surgery, radiation therapy,
and chemotherapy available for patients.
• Other HPV-related cancers are also more treatable when
diagnosed and treated early. There are new forms of surgery,
radiation therapy, and chemotherapy available for patients.
2.Genital herpes (HSV-2 or HSV-1)
Genital Herpes Overview
• Genital herpes is a common and highly contagious
infection usually spread through sex. Usually this
infection is caused by the herpes simplex virus-2 (HSV2) although herpes simplex virus-1 (HSV-1), the virus
usually responsible for cold sores, may cause genital
herpes. Genital herpes treatment includes medicines to
help sores heal faster and prevent outbreaks.
What are the signs of Genital Herpes
• Most people infected with HSV-2 are not aware of their
infection. However, if signs and symptoms occur
during the first outbreak, they can be quite pronounced.
The first outbreak usually occurs within two weeks after
the virus is transmitted, and the sores typically heal
within two to four weeks. Other signs and symptoms
during the primary episode may include a second crop
of sores, and flu-like symptoms, including fever and
swollen glands. However, most individuals with HSV-2
infection never have sores, or they have very mild signs
that they do not even notice or that they mistake for
insect bites or another skin condition.
Genital Herpes
Patient’s Perception of Etiology
Women
Men
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Yeast infection
Vaginitis
UTI
Menstrual complaint
Hemorrhoids
Allergies (condoms, sperm,
spermicide, pantyhose
• Rash from sex, shaving, bike
seat
Folliculitis
Jock itch
“Normal” itch
Zipper burns
Hemorrhoids
Allergy to condom
Irritation from tight jeans,
sex, bike seat
• Insect bite
Is there a Treatment for Herpes
• There is no treatment that can cure herpes, but
antiviral medications can shorten and prevent
outbreaks during the period of time the person
takes the medication. In addition, daily
suppressive therapy for symptomatic herpes can
reduce transmission to partners.
How can Herpes be prevented
To avoid genital herpes, you have to
abstain from sexual contact, or to
be in a long-term mutually
monogamous relationship with a
partner.
• Genital ulcer diseases can occur in
both male and female genital areas
that are covered or protected by a
latex condom. Correct and
consistent use of latex condoms
can reduce the risk of genital
herpes.
• Persons with herpes should abstain
from sexual activity with
uninfected partners when lesions
or other symptoms of herpes are
present. It is important to know
that even if a person does not have
any symptoms he or she can still
infect sex partners. Sex partners of
infected persons should be advised
that they may become infected and
they should use condoms to reduce
the risk. Sex partners can seek
testing to determine if they are
infected with HSV. A positive
HSV-2 blood test most likely
indicates a genital herpes infection.
3. Hepatitis B
What is hepatitis?
• Hepatitis is the name for several different illnesses
which all cause an inflamed (swollen or painful) liver.
The liver is a vital part of the body. If it does not
function properly, it can cause serious illness and
sometimes death.
• Drinking alcohol in large quantities or taking drugs or
medication can cause hepatitis. It can also be caused by
certain viruses. The different types of virus are known
by different letters - A, B, C, D and E - so the different
forms of the disease are called 'hepatitis A', 'hepatitis B'
and so on. Sometimes people shorten the name, and
say 'hep A' or 'hep B'.
What are the symptoms of hepatitis
B?
• Some people who are infected with hepatitis B do not
become very ill. Some do not become sick at all.
Children are less likely to have symptoms than adults
even when they are infected.
• In more severe cases, hepatitis B can cause:
• Loss of appetite
• Nausea and vomiting
• Pain in the liver (under the right rib cage)
• Fever
• Pain in the joints
• Jaundice (when the eyes and skin become yellow).
How is hepatitis B spread?
1. Blood
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Sharing equipment used for injecting drugs.
Piercing the skin with equipment which is not properly cleaned and sterilized.
Sharing razor blades or toothbrushes.
One person's blood coming into contact with open cuts on another person.
People who get blood transfusions do not run the risk of hepatitis B infection because
blood donations are screened for the virus.
2. Sex
The hepatitis B virus can be spread if people have unprotected sexual intercourse.
3. Mother to Baby
Mothers who have long-term hepatitis B sometimes pass the virus to their children.
Some babies are infected in the womb or during birth.
Can I be immunized against
hepatitis B?
• There is a good vaccine available, and
immunization is the most effective way to
protect against hepatitis B infection.
• For adults to obtain maximum protection you
must receive three doses of the vaccine. The
second dose is given one month after the first
dose, and the third dose is given five months
after that.
Is there a treatment for hepatitis B?
• Treatment is available and some treatments are covered
by the Pharmaceutical Benefits Scheme (PBS).
• People with long-term hepatitis B may require
treatment. The aim of the treatment is to suppress
replication of the virus and reduce liver damage.
• The current treatments available include interferons and
antiviral medications. For more information on
treatment, consult your doctor.
References
http://en.wikipedia.org/wiki/Sexually_transmitted_disease
http://www.healthinfonet.ecu.edu.au/infectiousconditions/hepatitis/reviews/background-information-ab
http://www.herpes.com/hsv1-2.html
http://en.wikipedia.org/wiki/Gonorrhea
http://www3.niaid.nih.gov/topics/genitalWarts
http://www.communityvoices.org/Uploads/Koger_00108_00119.pd
f
http://www.mja.com.au/public/issues/188_02_210108/bow10751
_fm.html
http://www.health.qld.gov.au/cervicalscreening/women/hpv.asp
http://health.yahoo.com/sexualhealth-overview/syphilis-topicoverview/healthwise--hw195073.html
http://health.yahoo.com/hepatitis-overview/hepatitis-b-topicoverview/healthwise--tp13734.html