By Clare Gyorke
I’m sure many of you remember the movie, “Mean Girls“ and have heard Coach Carr’s famous caution that “if you touch each other, you will get chlamydia, and die.” As it turns out, he was sadly misinformed. Though it cannot kill you, Chlamydia trachomatis is actually the most common bacterial sexually transmitted infection (STI) in the USA and worldwide. How does chlamydia earn this award? Well, first, anyone can get chlamydia. Though this is true for most STIs (as technically any human can become infected with a human pathogen), the breadth of people infected with chlamydia is more broad than most other STIs. In fact, chlamydia infection is seen across all ages, races, genders, and socioeconomic statuses. That being said, infection is most common in people age 14-24, and women are more likely to get chlamydia than men (at a ratio of 2:1). Furthermore, Alaska has the highest incidence of infection in the USA, followed by the southeastern states (including North Carolina!). Incidence is on the rise too: according to the CDC, 1.6 million infections were reported in 2016, up 60% from just 10 years before. Health care providers and epidemiologists suspect that reduced condom use is one contributing factor to this observed increase, but it turns out the answer is not quite that simple.
The nature of chlamydia infection itself might also contribute to increased infection rates. Though chlamydia infection can be cured with a round of antibiotics, chlamydia is sneaky – up to 90% of infected women and men show no symptoms and don’t know they’re infected. And if you don’t know you’re infected because you have no symptoms, it’s unlikely you’ll go to the doctor to get treated. For those that do have symptoms, they typically include general pelvic pain, pain during intercourse, abnormal vaginal discharge, and pain/burning during urination. In about 10% of cases, symptoms are bad enough that a patient is diagnosed with Pelvic Inflammatory Disease. But since most people don’t have any pain, what’s the big deal? Well, the serious part of this is that untreated infection in women can persist for months and even years, and can cause irreversible damage to a woman’s reproductive system that will make it difficult or impossible to become pregnant later on.
One of the things doctors and scientists are trying to understand is how chlamydia can persist in people for such a long time without them knowing. Other (and more typical) infection symptoms of fever, swelling and general discomfort are signs your immune system knows there is a foreign invader and is killing it off – so they’re actually a good thing! How is chlamydia different? The immune system certainly responds to chlamydia, but infected people can have no symptoms because the response is not big enough to alert them of pain. This subtler immune response persists over time, and the irreversible reproductive damage actually comes from immune cells fighting infection and damaged tissues repairing and healing. In this case, healing means the formation of a scar: while a scar is fine on your skin, it will prevent normal function in the uterus and fallopian tubes and can cause infertility. The medical research community is still trying to understand how this happens without the strong symptom response seen in other infections.
So, though chlamydia can’t kill you, it sure can cause damage — some of which is irreversible. The best way to avoid long-term damage from chlamydia infection is to practice safe-sex, and to have regular visits with your doctor. Condoms (when used correctly) are the only way to prevent transmission, and regular check-ups include STI screening. For now, chlamydia can be cured — but only if you know you have it!
Edited by Rowan Beck