Current Overview of Sexual Transmitted Disease

1. Current Overview of Sexual Transmitted Disease Prevention and Treatment

2. Contents: • Concept of Sexual Transmitted Disease. • Clinical Manifestation of Common STD • Bacterial diseases: • Chlamydia (CT) • Gonorrhea (GC) • Syphilis

3. Viral diseases: • Human Papillomavirus (HPV) • Genital herpes (HSV-2 or HSV-1) • Hepatitis B

4. 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.

5. 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.

6. Chlamydia Infections in Women, Men, and Neonates

7. Men • Genitals {Urethritis, Epididymitis} • Rectum {Proctitis} • Throat {Pharyngitis} • Eyes {Conjunctivitis} • Systemic {Reiters’ syndrome}

8. Women • Genitals {Urethritis, PID, Cervicitis} • Rectum {Proctitis} • Throat {Pharyngitis} • Eyes {conjunctivitis}

9. Neonates • Eyes { Conjunctivitis} • Lungs {Pneumonia}

10. 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.

11. 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. 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).

17. 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).

18. 3.Syphilis • Syphilis is a sexually transmissible infection (STI) caused by a bacterium calledTreponema 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-to-skin 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.

19. Symptoms • There are three stages of syphilis. Only the first two stages are infectious. 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.

20. Second stage of syphilis 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.

21. Third Stage of syphilis • Third stage (may occur years later)The third stage of syphilis occurs in about one-third of untreated people. Severe brain or heart complications may occur during this stage.

22. 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. Treatment and Prevention

23. 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.

24. 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." Viral diseases:

25. Statistical information

26. 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.

27. 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.

28. 2.Genital herpes (HSV-2 or HSV-1)

29. 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 (HSV-2) 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.

30. 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.

31. Women Yeast infection Vaginitis UTI Menstrual complaint Hemorrhoids Allergies (condoms, sperm, spermicide, pantyhose Rash from sex, shaving, bike seat Men Folliculitis Jock itch “Normal” itch Zipper burns Hemorrhoids Allergy to condom Irritation from tight jeans, sex, bike seat Insect bite Genital HerpesPatient’s Perception of Etiology

32. 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.

33. 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. How can Herpes be prevented

34. 3. Hepatitis B

35. 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'.

36. 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).

37. How is hepatitis B spread? 1. Blood • 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. SexThe hepatitis B virus can be spread if people have unprotected sexual intercourse. 3. Mother to BabyMothers who have long-term hepatitis B sometimes pass the virus to their children. Some babies are infected in the womb or during birth.

38. 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.

39. 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.

40. References

41. http://www.mja.com.au/public/issues/188_02_210108/bow10751_fm.htmlhttp://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-topic-overview/healthwise--hw195073.html http://health.yahoo.com/hepatitis-overview/hepatitis-b-topic-overview/healthwise--tp13734.html