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Some New Developments in the Case of Chlamydia

April 11, 1986|ALLAN PARACHINI | Times Staff Writer

As recently as five years ago, doctors were accustomed to hearing patients they had just diagnosed as having chlamydia trachomatis say that the disease sounded like the name of a flower.

Today, the play on words is just another tired cliche and the obscurity of chlamydia is long since gone.

Chlamydia--elevated to a position just below herpes on the ranking of sexually transmitted diseases that have achieved prominence or even perverse trendiness in the 1980s--is increasingly being recognized as a major and common health problem for both men and women. But at the same time, it may already have reached its high-water mark in terms of incidence and have stabilized.

Some doctors even say it is already decreasing in frequency as a result of improved public awareness of it and other sexually transmitted diseases and growing fear of exposure through sex to not only herpes but AIDS, as well.

The New Puritanism

This fear, some experts say, has introduced what might almost be called a new puritanism in American sexual practices in some quarters, leading to greater personal restraint and care in selection of partners and, as a result, less contact with what are euphemistically called "social diseases."

Chlamydia is a microorganism first identified about 20 years ago. Though the disease is not part of mandatory reporting programs that require notification of state health departments when a case is discovered, the federal government's Centers for Disease Control in Atlanta has estimated there may be 4.65 million cases a year.

Chlamydia infects the reproductive tracts of both men and women and is a major cause of urinary tract infections in both sexes, and can lead to serious health problems for women, in particular, if it is not detected.

Men can also contract infections of the epididymis--the tube that carries sperm from the testis. Women can contract cervical infection, pelvic inflammatory disease and a variety of infections during pregnancy and after delivery--problems that can be passed on to a newborn child.

Health workers note, though, that the disease is comparatively easy to treat and lends itself to being discovered in screening programs that are now being advocated for women's health facilities.

Profile of Likely Victims

Within the last few months, there have been these developments in the case of chlamydia:

--Experts at a major West Coast chlamydia research center, Seattle's Harborview Medical Center, have developed what could be called a profile of women most likely to contract chlamydia and urge health workers to offer screening tests to women who fit. Among the criteria: The typical chlamydia-prone woman, the team says, is 24 or younger, with a statistically average age of 21.8. She has had sex with one or more new partners within the previous two months and either takes birth control pills or uses some other non-barrier method of birth control.

--New evidence has emerged buttressing the suspicion that barrier methods, like the diaphragm, offer an element of protection against chlamydia--or perhaps that the pill makes a woman more susceptible. Pill and other non-barrier method users appear at higher risk--a conclusion that represents a reversal of what doctors had previously believed. While both men and women get chlamydia, men usually do not develop symptoms and a smaller proportion of men than women develop the organism, to begin with.

--Chlamydia represents a potentially major health risk for women since, though chlamydia itself is a comparatively minor infection, it can lead to development of pelvic inflammatory disease, which itself is being recognized increasingly as a major threat to women's health. Two new studies establish that pelvic inflammatory disease is responsible for a higher death rate than syphilis. However, death rates for both diseases are apparently on the decline, with pelvic inflammatory disease killing .29 of every 100,000 women aged 15 to 44 and syphilis taking the lives of .17.

--Pelvic inflammatory disease remains widespread, however, with 300,000 women a year hospitalized with it and 2.5 million doctor's office visits required to treat it. PID, as pelvic inflammatory disease is called, imposed economic costs on society of $2.6 billion in 1984, with the figure expected to rise to $3.5 billion by 1990. The figures include an estimate of the costs of treating tubal pregnancy and infertility among women who have the disease.

--Treating chlamydia is comparatively simple, with the antibiotics tetracycline or erythromycin taken for seven days usually completely effective. If those two drugs don't work, effective agents can be found among other commonly used antibiotics.

Best Approach for Women

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