Chlamydia is an infection caused by the bacteria Chlamydia trachomatis. It presents as gonorrhea in the way it manifests and how it is spreads. Chlamydia is mostly asymptomatic i.e. has no symptoms; hence it is transmitted without knowing. Chlamydia trachomatis is an obligate bacterium that is intracellular and affects the human hence is a pathogen. It is from the genus Chlamydia (Ryan 20). It is found both in men, in the urethra, and in women both infecting the, urethra and the cervix. The bacteria through dissemination can also be found in the throat and the rectum. Chlamydia is infective in both men and women.
In the cervix, it manifests as Cervicitis, in many is asymptomatic, but vaginal discharge and abdominal pain may be experienced by others. In the urethra, it presents as urethritis, patient experiences pain while urinating, and frequent urges to urinate.
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The bacterium is highly destructive in women as it is in men. In women, its known to affect the fallopian tubes that may lead to Pelvic Inflammatory Disease (PID) that is severe and its Symptoms include fever, pain with intercourse, abdominal pain, or pelvic cramping. PID can also cause difficulty in becoming pregnant and may even lead to infertility when not treated and due to the fallopian destruction it may lead to ectopic/tubal pregnancy, premature births, as the infant passes through the birth canal it might get infected, causing serious eye damage (Trachoma) and pulmonary infections. In men, it causes epididymitis and prostatitis, may have symptoms like proctitis which is rectal bleeding and presents similar to gonorrhea (Richard, 54). The infection is transmitted sexually and is classified as a sexually transmitted infection (STI). As it's mostly asymptomatic it's not treated, this makes it spread to other people hence its largely distributed.
Biology of the Patghogen
Chlamydia trachomatis has two forms in its lifecycle i.e. reticulate and elementary body. The elementary body is the form dispersed, and its morphology is similar to that of a spore. The elementary body once in the target cell brings about endocytosis; this prevents phagolysosomal fusion hence intracellular bacterial survival, and this is because the immune system is unable to eliminate it. In the target cell, this elementary body develops into the reticulate body due to the glycogen produced (Stamm, 56). The reticulate body, which is the second form of the bacterium, has no cell wall and is considered a cell inclusion; it divides through binary fusion usually at about two hours per generation. The reticulate has an incubation period of about 7-21 days in the host. After division, the reticulate forms transforms back to the elementary form and is therefore, released through exocytosis, each target cell producing elementary bodies ranging from 100-1000. The elementary body gets to a target cell and the cycle continues.
Reproduction through binary fusion is advantageous to the bacterium as it leads to the production of lots of infective bacteria that burst from the infected cell; a large number is advantageous as it increases the chance of the neighboring cells being infected. By undergoing endocytosis, the bacterium avoids fusion of phagolysosomal fusion hence it can't be degraded also when in the reticulate form i.e. an inclusion in the cell they are not identifiable by the immune system hence divide without interruption until they become irreversibly severe, all this make the bacterium more infective.
Additionally, it is asymptomatic and is transmitted, this is effective in the sense that, when an individual that is infected and happens to be asymptomatic, the individual won't seek medical attention hence would be a carrier for this bacteria. Human behavior in this generation and time is a key concern for all STDs, Chlamydia included. Through multiple sex partners and the heterosexual, homosexual and the bisexual nature, the infection is widely spread. This creates a network of carriers hence disseminates widely. In areas of poor sanitation, the bacteria could be spread from the genitalia to the eye via the hands causing trachoma; the major cause of blindness in adults and neonatal in the world
Scope of the Problem
Chlamydia is actually the most reported case of sexually transmitted bacterial infection in the U.S.A, this is the case even though a large number of infected people aren`t accounted for as the awareness is low, the infection being asymptomatic. Cases in point, in the year 2010, 1,307,893 cases of Chlamydial infections were reported from 50 states and the District of Colombia to the Centre for Disease Control (CDC). It is estimated that 2.8 million Chlamydial infections occur annually in the U.S with women being re-infected if partners are left untreated (CDC 2011).
Complications and symptoms are different depending on gender and area of infection. In women, the bacteria spreads to the fallopian tubes, later on to the uterus causing PID, this happens in about 10-15% of women who are infected but not treated. The infection is referred to as “silent” as it’s asymptomatic. The continuous damage of the fallopian tubes causes chronic abdominal pain, sterility and a possible formation of an ectopic pregnancy. For an infected pregnant woman, it really affects the baby`s health, as it may cause premature birth i.e. the infant is born before the completion of the gestation period. Leading to later complications in baby`s health. Also, during birth the baby might come into contact with bacterium containing fluid in the birth canal that causes eye infection (trachoma) that if untreated causes preventable blindness (Ryan, 76).
In men, it may lead to a considerably painful infection in the testicles that may lead to reduced fertility. In some it may lead to infection of the tubes whereby sperm develop in the testicles, with epididymitis they also may experience atrophy of the infected testicle, abscesses in the scrotum could be found and may lead to complete infertility.
Generally, both men and women may suffer from swelling joints, Reiter`s Syndrome, can also occur and is also called Sexually Acquired Reactive Arthritis. This though is usually more in women than men. The eye once infected through contact of genital secretions it causes irritation, swelling in and also around the eye causing what is known as Chlamydial conjunctivitis.
Control and Mediation
Being a sexually transmitted disease, the best method of prevention is abstinence or a mutual monogamous sexual relationship with an uninfected partner. The use of latex condoms is also advocated for. Yearly screening of sexually active women of the age of twenty five and below, older women with multiple partners and also pregnant women is supposed to be performed.
Curative methods against the infection are the use of antibiotics i.e. azithromycin, tetracycline or erythromycin. These are given on a 7 day period whereby both the patient and the sex partner abstain from sex to avoid re-infection. Once treated, the patient is encouraged to report back for screening of chlamydia again after 3 months. Up to 20% of women less than 25 years are re-exposed to chlamydia which needs to be treated again, the most common reason for re-exposure being an untreated partner (Mpiga, 34).
All this methods are economically feasible, as STDs are screened generally. Although sensitization and screening of all risk groups is challenging given that the infection is asymptomatic.
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