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SEXUALLY TRANSMITTED DISEASES TOP NEW LIST

© 1996 by James Q. Jacobs

The three most common infectious diseases in the United States are sexually transmitted according to a new Centers for Disease Control report. In 1995, the Center reported about 475,000 cases of chlamydia, 390,000 of gonorrhea and 71,500 new cases of AIDS. Chlamydia was included for the first time in the annual survey. Infections among women account for more than 80% of the reported chlamydia cases while males reported 81% of the AIDS cases. Persons having multiple sex partners are most at risk. "Safer" sex practices, such as condom use, reduce the risk.

Chlamydia is the most prevalent and damaging of the STDs (sexually transmitted diseases). Symptoms in males may include frequent, painful or burning urination and a clear, watery mucous discharge. Females may have a white vaginal discharge, burning urination and painful intercourse. Often there are no symptoms. Typically 5 to 20 days after exposure a painless pimple or blister develops on the genitalia. About 2 to 12 weeks later the lymph nodes enlarge painfully. Sores may appear on the genitals. Scarring may produce narrowing of the affected orifices.

In females chlamydia infection can result in pelvic inflammatory disease. The microorganism may spread through the reproductive tract and develop into inflammation of the Fallopian tubes, increasing the risk of ectopic pregnancy and sterility. Antibiotics usually clear up the infection.

Gonorrhea is a bacterial infection almost exclusively acquired through sexual contact. Males experience extremely painful urination and copious secretions. Females may have abnormal bleeding, some discharge, abdominal discomfort or, not infrequently, express no symptoms at all. The Gonococcus bacterium can infect non-genital orifices with few symptoms. Untreated gonorrhea can spread in the reproductive system and cause scarring that results in infertility or painful urination. The bacteria can spread via the bloodstream and infect other body parts. Blood poisoning, a medical emergency, can result. Long term effects can include pelvic inflammatory disease, infertility and increased risk of ectopic pregnancy. Because of the prevalence of resistant strains, penicillin is no longer recommended for routine treatment and tetracycline is avoided as the sole treatment.

AIDS, acquired immune deficiency, is the most serious STD. AIDS is a susceptibility to many diseases caused by the human immunodeficiency virus, HIV. There is no known cure for AIDS. Until a cure for AIDS is found contracting HIV or infecting another person can result in death. Anyone who has had unprotected sexual contact since about 1978 is at risk of having the virus without knowing it. The disease came to public attention in 1980. The Centers for Disease Control and Prevention reported more than 200,000 cases of AIDS by 1990.

The virus is transmitted by infected breast milk, semen, vaginal fluids, and blood. HIV can be transmitted to a fetus during pregnancy or during delivery. Infected hypodermic needles are a common form of transmission. By destroying blood cells the HIV virus weakens immune response. The HIV virus takes over the nucleus of a white blood cell, known as CD4 lymphocyte, and uses it to reproduce itself. The cell then dies and releases more virus into the blood stream.

Many people have no symptoms when first infected with HIV. Some have a short, feverish illness with sore throat and swollen glands. In some individuals no symptoms appear for ten years or longer. First pronounced symptoms are typically swollen glands in the neck, armpits and groin. Chronic diarrhea, weight loss, cough, fatigue, chills, night sweating, fever and infections can follow. Patients may or may not rapidly develop AIDS and complicating disorders. These include rare bacterial, viral or fungal infections, sarcomas, pneumonia, tuberculosis, meningitis, brain infections and nervous system infection resulting in progressive dementia.

Medical treatments can delay onset of AIDS in HIV positive patients. A blood test can determine if you are HIV positive (your body has developed antibodies to the virus.) This typically occurs 4 to 12 months after exposure. A positive test means you can be infectious to others.

Other STDs are also serious diseases. A bacterium called Treponema pallidum causes syphilis. During the first stage of the disease small, painless sores, called chancres, appear, usually in the genital area, but also on the mouth or elsewhere. These are highly infectious through contact with mucous membranes or open sores. During the second stage, about six weeks after the chancres have healed, sore throat, fever and headache will develop, glands will swell, and a skin rash of red scaling bumps develops. Spots may appear on the hands and the feet, and gray patches appear on the mucous membranes. Rashes can also develop. All these skin conditions are highly infectious. They heal in about six weeks.

The third stage of syphilis flares up several years later and can affect the brain, causing paralysis, dementia, disequilibrium and even blindness. The heart and other organs can also be affected. Syphilis can be treated during the first stage and sometimes during the second stage. It is irreversible once blood vessels or the brain is damaged. Any suspicious sore in an area of sexual contact warrants diagnosis by blood test for syphilis.

Herpes genitalis, a painful, sexually-transmitted infection of the genitals, is produced by the herpes simplex virus. About a week after contact with an infected partner itching and pain of the genitals may develop, accompanied by fever and headache. Blisters on the genitals and nearby skin follow. Blisters can form within the female genitalia, where they can go unnoticed, resulting in unknowingly infecting partners. When the blisters break they become very painful sores for up to 3 weeks. After the sores subside the virus remains in the body and recurrences with less severe symptoms are common. In time symptoms typically disappear.

Herpes can be transmitted only when the infection is active. Pregnant females with active infections at the time of delivery need cesarean surgery to avoid transmission to their infants. About 15% of the cases result from a virus that causes cold sores in the mouth and from oral-genital contact. The virus can spread to the bloodstream and affect internal organs. No cure is known for genital herpes. Some cases of cervical cancer may be caused by herpes, so females infected with herpes need to have annual Pap smears.

Safer sex will not prevent all sexually transmitted infections and is useless against some. Blood sucking lice that inhabit body hair, commonly called crabs or pubic lice, are a readily visible form of infestation no condom can stop. They typically inhabit pubic hair, but may occur on eyebrows, eyelashes and other body hair. They may not cause overt symptoms, but typically their activity results in itchiness, especially at night. An insecticide shampoo or lotion will readily eliminate the 1 - 2 mm. insects. Their eggs must also be killed to avoid recurrence. All clothing and bedding must be treated, preferably by heating in water to near boiling. If no new crabs appear within forty days after treatment you could still get reinfected by partners from the grandchildren of the critters you passed on.

The above are the most common STDs, but not the complete listing. Other diseases can also be sexually transmitted, including hepatitis B and possibly hepatitis C. For further information several resources on the Internet are useful. A good starting point is the Centers for Disease Control and Prevention Homepage and their STD Prevention page. While surfing these subjects I even encountered a Virgin Pride page. For information on AIDS you can call the National AIDS Hotline, a toll-free 800 number.

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