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Sexually Transmitted Diseases

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					Sexually Transmitted
     Diseases
    A Plague of Epic Proportions
 Worldwide  400 million new cases/year
 The U.S.  15 million/year
 Hits the 15-25 age group hardest
 ¼ by 21!
 Teen women  gonorrhea & Chlamydia
 Genital warts and Aids are huge threats
 Pelvic Inflammatory Disease a frequent
  consequence
         The Biggest Threats?
   Aids/HIV  deadly and dreaded

   But other STDs, especially Chlamydia and
    genital warts are more prevalent
           Why the Epidemic?
   An explosion of risk behaviors
     multiple partners
     unprotected sex

   Oral contraceptive use
     increase susceptibility
     decrease condom use
             More Reasons
   Public Health failures
    meager access to prevention/treatment
    MDs don’t ask enough questions

   Symptoms are often latent

   Shame
                 Chlamydia
   An urogenital infection caused by the
    bacteria chlamydia trachomatis
 Very common and dangerous
 Increase of 400% from ’87 to ’99
 3-5 million new cases in US each year
 Teens suffer the highest infection rates
 Oral contraceptives & douching increase
 Often transmitted through fingers
       Chlamydia Symptoms
 Two types
 One infects the lower reproductive tract
  with just mild burning
 The other manifests as a PID of the upper
  reproductive tract, infecting the uterus,
  fallopian tubes or ovaries
Common PID Consequences
 For women:
     disrupted menstrual periods
     chronic low back and pelvic pain
     fever/nausea/headaches
     Salpingitis infertility and entopic
  pregnancies
     IUDs to be ineffective
 For men: epididymis and urethra infections
          If that wasn’t enough
 For many, the symptoms are not
  noticeable, can spread unknowingly
 Also causes Trachoma, the world’s
  leading cause of preventable blindness
 Many other effects on infants


   Fortunately, easily treated with
    Doxycycline and Azithromycin
                  Herpes
   The most common viral STD

   Two types of interest:
     HSV-1 usually lesions or sores on
    mouth (cold sores)
     HSV-2 lesions on and around the
    genitals
            How Bad is it?
 Huge #s
       HSV-1  100 million
       HSV-2  50 million
 With 1 million new cases a year
 20-25% US adults over 12
 Unprotected sex with multiple partners?
  Guaranteed Exposure
               Transmission
   Both types can be spread through a
    variety of ways
      oral sex can spread either type
      recently many cases of genital herpes
    arose from HSV-1 rather than HSV-2
    The Horror of Viral Shedding
 While victims with sores can easily spread
  the infection, HSV can be transmitted
  even in the absence of symptoms through
  “viral shedding”
 Many spread HSV without even knowing
  that they are infected
 Condoms provide some, but not
  complete, protection
 Fingers can spread the virus
                Symptoms
   HSV2
    2-14 day incubation
    20 days of symptoms:
    one or more small, painful red bumps or
    “papules” in the genital areas or around
    the anus
              It gets worse
 The papules fill with nasty infectious
  particles permeating pus
 They burst to form red, ringed sores
 The sores crust and heal but can still
  infect someone for another 10 days

   Other symptoms can be present also
             As for HSV1
 Papules form on the lips, and occasionally
  on the inside of the mouth, tongue, or
  throat
 Crust over and heal within 10-16 days
 Other symptoms – fever, muscle aches, flu
  like maladies, bleeding in the mouth
             Recurrence
 The infection retreats up nerve fibers
  where it can lie dormant, perhaps
  permanently
 Usually though, it flares up periodically
  with less severe symptoms and a more
  rapid course
 Prodromal symptoms warn of eruption and
  ability to infect others
Factors which Trigger Recurrences
 Emotional stress
 Anxiety
 Depression
 Fever
 Ultraviolet light
 Menstruation
 Fatigue
                Complications
   Few for men, but for women:
    1) Cervical cancer, rare but still calls for an
    annual Pap smear.
    2) Infection of a newborn
       viral shedding can cause infection as the
    child passes through the birth canal
       cesarean delivery prevents the severe
    danger to the child
       Treatment of Herpes
 Currently nothing can cure herpes
 Three Antiviral drugs help manage it
 Two treatment strategies:
   Suppressive – take daily to prevent
   Episodic – to minimize an outbreak
 Neither eliminates viral shedding
              Genital Warts
 Viral   warts, caused by the virus
 human papillomavirus (HPV)
 which appear on the genitals

 40 million victims in North America
 Five million new cases/year
                 Top This
 “Most sexually active people will get HPV.”
 Recent survey – 27% of all women, 44%
  between 20 & ?
 Even condoms fail to protect!
 Most commonly spread by the
  asymptomatic!
    A Disgusting Sight, Usually
 First appear 3 weeks to 8 months after
  contact
 Women  usually on the bottom of the
  vaginal opening
 Men  throughout the penis
 Can appear on the anus
 In moist areas – pink/red, soft cauliflower
 Dry – hard, yellow/grey
           But Then Again
 Many, probably most, do not develop
  visible symptoms despite infection
 In other words, you can’t see it, but you
  can certainly get it
 From any one of 40+million people
             Complications
 Bleeding & obstruction of the urethra
 Association with various cancers
 Account for 85-90% of attributable risk for
  cervical cancer.
 Can be transmitted to infants at birth
            Treatment (?)
 Nothing has been shown to remove or
  prevent recurrence
 Freezing is 60-70% effective
 More aggressive treatments such as
  surgical removal can cause serious side
  effects
 Perhaps vaccines will, some day, help
  prevent infection

				
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posted:9/1/2011
language:English
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