Prevention and Treatment

Abstinence, monogamous relationships, and condoms properly used can prevent transmission of the disease. All sexually active

648 Chapter 25 Genitourinary Infections

Microvilli

Chlamydias

Figure 25.10 Scanning Electron Micrograph of Chlamydia trachomatis Attached to Fallopian Tube Mucosa

Microvilli

Chlamydias

Figure 25.10 Scanning Electron Micrograph of Chlamydia trachomatis Attached to Fallopian Tube Mucosa women are advised to get tested for Chlamydia each year, or twice yearly if they have multiple partners or if their partner has multiple partners. Several antibiotics offer effective treatment and prevent serious complications if the disease is diagnosed and treated promptly. Azithromycin can be given as a single dose, whereas tetracyclines and erythromycin are less expensive alternatives. The sexual partner is treated at the same time.

The main features of chlamydial genital infections are summarized in table 25.9.

Syphilis

During the first half of the twentieth century, syphilis was a major cause of mental illness and blindness, and a significant contributor to the incidence of heart disease and stroke. Syphilis was common in the United States during World War II, present in about 5% of military recruits, but by the mid-1950s, it was almost eradicated. This was accomplished by aggressively locating syphilis cases and their sexual contacts and treating them with penicillin, which became generally available after the war. A number of factors, however, conspired to cause a resurgence of the disease. Inner-city poverty, prostitution, and drug use were linked to a high incidence of syphilis, which exceeded 100 new cases per 100,000 population in at least seven cities in 1990. Since then, renewed efforts in education, case finding, and treatment have caused a dramatic drop in new cases. The presence of the AIDS epidemic added urgency to syphilis control efforts, because syphilis, like other STDs that cause genital sores, promotes the spread of AIDS. By the end of 1998, the syphilis rate was down to 2.6 per 100,000, the lowest level since reporting began in 1941, surpassing the national health objective for the year 2000 of four or fewer cases per 100,000 population.

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