Women's fertility at risk from "silent" sexual disease
Women's fertility at risk from "silent" sexual disease
By Steve Hays
AMSTERDAM (Reuter): Chlamydia is known in the medical profession as "the silent threat". A sexually transmitted disease without any symptoms, it is one of the biggest causes of infertility in women in the industrialized world.
The condition can go undetected -- and untreated -- for years, even though once diagnosed it can be easily cured by antibiotics.
Scientists say the danger of chlamydia has been overshadowed by hysteria about the AIDS (Acquired Immune Deficiency Syndrome) epidemic. They are urgently trying to bring it into the public eye as they press ahead with the search for a vaccine.
"Chlamydia infection is a huge problem both medically and economically," said Professor Jan Holmgren of the University of Gothenburg in Sweden, who is working on a vaccine.
In the United States alone about one million women each year are treated for pelvic inflammatory disease (PID) caused by chlamydia. The cost is $5 billion annually.
Sufferers may not know it, but chlamydia can scar and damage the fallopian tubes. Left untreated, PID leaves between 15 and 25 percent of infected women infertile, Dutch doctors say.
It is also the main cause of ectopic pregnancies, where the human egg develops outside the womb, and can be passed from mother to child, damaging the baby's eyes.
The inflammation in the genital tract caused by chlamydia leaves minute ulcerations which scientists believe also make women more vulnerable to Human Immunodeficiency Virus (HIV) -- believed to cause AIDS.
Chlamydia infections are believed to have been steadily increasing in Europe and North America since the mid-1980s. Four million people in the U.S. alone are affected each year and more than 20,000 women annually become infertile as a result, according to the Centers for Disease Control (CDC) in Atlanta.
More common
Chlamydia has become far more common in the U.S. than the more well-known sexually transmitted diseases gonorrhea and syphilis, according to the American journal Medicine.
An average of five percent of American female college students and pregnant middle class women are infected, compared with less than one percent with gonorrhea, it said.
The problem with chlamydia is that women are the main victims. Scientists say the disease is not given the attention it would get if it affected men as seriously.
"Chlamydia is not an acute killing disease so it lacks the drama of HIV. Perhaps to some extent it is also still seen as a female disease, though men spread it too," said Holmgren.
"Unfortunately women are underprivileged in medicine."
Chlamydia hit the headlines in the Netherlands recently when Professor Otto Bleker, head of the Department of Obstetrics and Gynecology at Amsterdam's top Academic Medical Center, called for more attention to be paid to the disease.
"Chlamydia is very infectious, but also very easy to control and it is always the woman that is more at risk than the man," Bleker said.
He said women who have unprotected sex with an infected partner stand a one in two chance of catching chlamydia. For men the risk is roughly one in four.
As far as scientists know, chlamydia does not harm men, Bleker said.
"Teenagers between the ages of 16 and 20 are quite often the bearers of chlamydia because their first sexual contacts tend to be unprotected. They have no symptoms. They don't go to the doctor and they carry the infection to others," he said.
In two studies of American military personnel, about 10 percent of otherwise healthy young men were found to have "silent" chlamydia infections of the urethra.
Around 50,000 people are affected by the disease in the Netherlands each year, though Bleker believes public health campaigns to encourage safe sex may have halted a rise in chlamydia cases here.
A key problem with attempts to develop vaccines for sexually transmitted diseases is to find a carrier which will take the vaccine to the protective membranes within the genitals, Holmgren said.
He is optimistic about tests with a potential carrier he developed from an oral cholera vaccine. He hopes testing on humans can begin next year.
"I think a commercial vaccine could be available in four to five years," he added.
In January, the U.S. pharmaceutical firm Syntello signed an agreement with the National Institute of Allergy and Infectious Diseases to work on a chlamydia vaccine developed by NIAID's Doctor Harlan Caldwell.