I will never forget calling my 63-year-old patient, married all her life to the same man, to tell her she had Chlamydia. At the clinic we screened all our patients for Chlamydia even though many, like this woman, would not have appeared to be at high risk. Since most have no symptoms, and many partners do not share their non-monogamous indiscretions, many people assume they are not exposed when in fact they are.
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"Klumideeah" is a bacterial infection of the eye, lungs, genital tract that is the most common sexually transmitted infection in the United States and other developed countries. In the state of Alaska's Epidemiology Bulletin from August 2007, Chlamydia is by far the most common infectious disease reported in our state with 2,384 cases reported so far in June 2007, 116 of those in Southeast. Since most people with Chlamydia don't have symptoms, they don't come into the clinic for screening. And they have unprotected sex, and spread the disease to others, often without ever realizing it.
So a lot of young people have Chlamydia and don't know it. In studies where all the women are screened on their annual exam, without symptoms, up to 12 percent are found to have Chlamydia.
Surprisingly many insurance companies do not cover screening for Chlamydia unless a patient has symptoms. The Centers for Disease Control and Prevention recommend yearly screening for women under 26 who have sex, and for any women at risk. So any woman who has a new partner, or multiple partners needs to be screened along with anyone who has already had a sexually transmitted disease.
Screening is easy and quick and can be done on a urine sample or a swab from the cervix during a pelvic exam, or in men from the urethra on a penile exam. Treatment for Chlamydia is also simple, and now even quick with a single dose of an antibiotic by mouth or a 7-day dosing.
Untreated Chlamydia can result in serious infections like pelvic inflammatory disease, ectopic or tubal pregnancy, and infertility. Babies born to infected mothers with untreated Chlamydia can catch Chlamydia from inside their mothers leading to eye infections that can lead to blindness or lung infections that can be deadly.
Finding and treating Chlamydia could save $45 in health costs for every woman screened, per Dr. Soper of the American College of OB/GYN. So screening saves money in the long run. Right now, there are no recommendations for screening men without symptoms, though most men with Chlamydia also do not have symptoms. When a woman is found to have Chlamydia, it is recommended that her partners also be treated. Women who have sex with women should be screened the same way heterosexual women are screened. Men who have sex with men are also at risk for Chlamydia and may not have symptoms.
If you are a woman under 26 years old who has had sex, or a woman of any age with a new partner, multiple partners, or if your partner is non-monogamous, and if you don't always use condoms, then schedule a Chlamydia screening appointment at your clinic, even if you have to pay for it, even if you don't have symptoms.
Dr. Maureen Longworth is a family physician also certified in holistic medicine with a private practice in downtown Juneau.
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