Chlamydia in women primarily affects the uterine cervix (the narrow end of the neck of the uterus). However, Chlamydia is also found in the rectum, urethra, Fallopian tubes, uterus, and the glands surrounding the vaginal opening. Untreated Chlamydia infections in women can lead to life-threatening complications, such as pelvic abscess and PID (pelvic inflammatory disease). An infected pregnant woman may pass the infection to her baby during labor and delivery, which may cause serious lung or eye infections.
Chlamydia is a sexually transmitted infection spread through direct sexual contact and caused by the Chlamydia trachomatis bacterium. In the US and anywhere else in the world, it is the most common bacterial STDs (sexually transmitted diseases) particularly predominant among young women.
What is Chlamydia Trachomatis?
Chlamydia Trachomatis is an atypical bacterium, which only survives and reproduces inside the cells of a host organism. In the course of its life cycle, it only has two forms: the elementary body and the reticulate body. The elementary body is the Chlamydia Trachomatis form that infects cells lining the genitourinary, gastrointestinal, or respiratory tracts or the eye surface. It attaches itself to the cell surface and is absorbed into the phagosome, which is an intracellular compartment. There it is then transformed into the metabolically active reticulate body form. Consuming the host's energy supply, the reticulate body, then go through numerous rounds of cellular division producing 100 to 500 offspring within the phagosome. Then the reticulate bodies mature into elementary bodies, which are then released from the host cell to infect other cells.
Incidence – In the US how common are Chlamydia infections?
Every year, the Centers for Disease Control and Prevention (CDCP) gather update reports on all incidences of infection from every state of the US. An approximate 500,000 cases of Chlamydia infections are reported every year, but actual annual report incidence estimates are at 10 to 20 times more. From observation, with more than half of those with Chlamydia experiencing little or no symptoms, determining the true extent of Chlamydia infection is difficult. Extensive screening programs are necessary for identifying who among the people who are asymptomatic actually has Chlamydia. Also, according to CDCP some states are more obliging than others in gathering, compiling and reporting data on known cases of Chlamydia in their regions. Resources for screening programs are limited if such programs existed at all, and many infected persons don’t submit for screening. Even with so many concealed cases, Chlamydia still incurs over $2.4 billion in direct and indirect costs every year.
Risks – Who are susceptible to Chlamydia?
Women 15-24 years of age are the most predominant numbers in Chlamydia infection statistics. They are more at risk for infection especially when they are of the minority race, live in a large city, are poor, are unmarried, and became sexually active at an early age. In addition to engaging in sex with multiple sex partners, exposure to a partner who has multiple sex partners, and illicit drug use, which are the prime risk factors for most STDs for both men and women.
The reported Chlamydia infection of an overall 0.6% of the male population only, compared to 3.0% of women in the same age groups, is both reassuring and alarming. These apparently lower reported incidence in men suggests that many probable male sex partners of women with chlamydia are not being accounted for. Asymptomatic men are less likely to receive medical treatment, compared to asymptomatic women.
Chlamydia symptoms in women and its complications
Most of the time women with chlamydia have no symptoms. Some, may complain of abdominal pain, develop yellowish mucus and pus discharge from the cervix or vagina, or experience bleeding between menstrual periods. Chlamydia infection of the urethra (the passage of urine) frequently have symptoms like that of a bladder infection; painful frequent urination (burning sensation during urination) and painful intercourse.
When left untreated, the infection can ascend from the lower to the upper genital tract, leading to infection of the internal lining of the uterus (endometritis) and infection of the fallopian tubes (salpingitis) also known as pelvic inflammatory disease (PID), which are more serious conditions.
Complications of endometritis are the infection of pelvic blood vessels and bloodstream (bacteremia) and septic shock, which is life-threatening. While for salpingitis are ectopic (tubal) pregnancy, chronic pelvic pain, and permanent infertility. These complications develop, unfortunately, because upper genital tract infections caused by Chlamydia are asymptomatic, increasing a woman's vulnerability to long-term complications.
Implications of Chlamydia Infection to pregnancy
Due to its asymptomatic nature, Chlamydia infection poses great risks to pregnant women as in non-pregnant women. Infection can easily go undetected, the only Chlamydia symptoms in women who are pregnant is a yellowish mucus pus discharge similar to the discharge caused by the inflammation of the cervix (cervicitis).
Although pregnant women have natural protection against potential complications like; fetal membranes that help prevent the ascension of infection into the uterus or fallopian tubes, there are still complications specific to pregnancy.
One major concern is the risk of transmission from mother to baby during vaginal delivery. When the baby comes in contact with the mother's genital secretions. Resulting in complications such as eye infection (conjunctivitis) or lung infection (pneumonia). Conjunctivitis caused by Chlamydia causes one of the most common preventable blindness worldwide. This can be prevented by administering erythromycin ophthalmic ointment preventing eye infections from developing. This is less effective though in preventing Chlamydia eye infection than protecting against gonorrhea caused conjunctivitis.
Early diagnosis through screening and administering of the appropriate treatment in pregnant women before labor is the best and most effective way of managing prevention of Chlamydia infection in newborns. The CDCP recommends these for all pregnant women at least 25 years of age, with new or multiple sex partners.