|
Other Important STDs
As medical science has become more precise in diagnosing infectious
diseases, the list of known sexually transmitted diseases (STDs) has
grown. The National Institute of Allergy and Infectious Diseases
(NIAID) has published separate fact sheets on some of the major
STDs: chlamydial infection; gonorrhea; trichomoniasis and other
vaginal infections; syphilis; genital herpes; genital warts; and
AIDS. NIAID has prepared this fact sheet to provide information on
some of the other diseases that can be transmitted sexually:
Although some of
these diseases are less well-known in the United States than other
STDs, they are still important - some are especially significant for
pregnancy women. Many of these infection are of serious concern for
people in other parts of the world, particularly in developing
countries.
Chancroid
Chancroid is an important bacterial infection caused by
Haemophilus ducreyi, which is spread by sexual contact. Periodic
outbreaks of chancroid have occurred in the United States, the last
one being in the late 1980s. These outbreaks are usually seen in
minority populations in the inner cities, especially in the southern
and eastern portion of the country. Globally, this disease is common
in sub-Saharan Africa among men who have frequent contact with
prostitutes.
The infection begins
with the appearance of painful open sores on the genitals, sometimes
accompanied by swollen, tender lymph nodes in the groin. These
symptoms occur within a week after exposure. Symptoms in women are
often less noticeable and may be limited to painful urination or
defecation, painful intercourse, rectal bleeding, or vaginal
discharge. Chancroid lesions may be difficult to distinguish from
ulcers caused by genital herpes or syphilis. A physician must
therefore diagnose the infection by excluding other diseases with
similar symptoms. People with chancroid can be treated effectively
with one of several antibiotics. Chancroid is one of the genital
ulcer diseases that may be associated with an increased risk of
transmission HIV.
Cytomegalovirus
Cytomegalovirus (CMV) is a very common virus that infects
approximately one-half of all young adults in the United States. It
rarely causes serious consequences except in people with suppressed
or impaired immune systems or in infants, whose immune systems are
still developing. The virus, a member of the herpesvirus family, is
found in saliva, urine, and other bodily fluids. Because it is often
found in semen as well as in cervical secretions, the virus can be
spread by sexual contact; it also can be easily spread by other
forms of physical contact such as kissing. Day-care center staff for
children under the age of 3 are at increased risk of CMV infection
and should carefully wash their hands after changing diapers. Like
other herpesvirus infections, CMV is incurable; people are infected
with it for life. Although the virus usually remains in an inactive
state, it can reactivate from time to time.
Symptoms
In healthy adults, CMV usually produces no symptoms of infection.
Occasionally, however, mild symptoms of swollen lymph glands, fever,
and fatigue may occur. These symptoms may be similar to those of
infectious mononucleosis.
Diagnosis
In healthy adults, CMV usually produces no symptoms of infection.
Occasionally, however, mild symptoms of swollen lymph glands, fever,
and fatigue may occur. These symptoms may be similar to those of
infectious mononucleosis.
Complications
Babies can be infected with CMV in the uterus if their mothers
become infected with the virus or develop a recurrence of a previous
infection during pregnancy. Although most babies infected with CMV
before birth do not develop any symptoms, CMV is the leading cause
of congenital infection in the United States. An estimated 6,000
babies each year develop life-threatening complications of
congenital CMV infection at birth or suffer serious consequences
later in life, including mental retardation, blindness, deafness, or
epilepsy. Investigators supported by NIAID are currently studying
how the virus interferes with normal fetal development and at which
stages the fetus is most susceptible to infection. Congenital CMV is
the most common cause of progressive deafness in children.
When CMV is acquired
after birth, or if it reactivates, it can be life-threatening for
persons with suppressed immune systems, such as those receiving
chemotherapy or persons who have received immunosuppressant drugs
for organ transplantation. Persons with HIV infection or AIDS may
develop severe CMV infections, including CMV retinitis, an eye
disease that can lead to blindness.
Treatment
NIAID scientists are testing new antiviral drugs that might be
effective against CMV infections. The antiviral drugs foscarnet and
ganciclovir have been approved for treating people with
AIDS-associated CMV retinitis.
Molluscum Contagiosum
This common viral infection
most often affects young children, who pass it to each other through
saliva. In adults, however, the virus is transmitted sexually,
resulting in lesions on the genitals, lower abdomen, buttocks, or
inner thighs. Most people with the infection do not have noticeable
symptoms, although sometimes the lesions, which are painless
wart-like bumps, may itch or become irritated. The lesions often
heal without treatment, although physicians may sometimes scrape
them off or treat them with chemical irritants.
Pubic Lice
Pubic lice (pediculosis pubis
or crab lice) are very tiny insects that infest the pubic hair and
survive by feeding on human blood. These parasites are most often
spread by sexual contact; in a few cases, they may be picked up
through contact with infested bedding or clothing. An estimated 3
million people with new cases of the infestation are treated each
year in the United States.
Symptoms
The primary symptom of infestation is itching in the pubic area.
Scratching may spread the lice to other parts of the body; thus,
every effort should be made to avoid touching the infected area,
although this may be difficult.
Diagnosis
Pubic lice are diagnosed easily because they are visible to the
naked eye. They are pinhead size, oval in shape, and grayish, but
appear reddish-brown when full of blood from their host. Nits, the
tiny white eggs, also are visible and usually are observed clinging
to the base of pubic hair.
Treatment
Lotions and shampoos that will kill pubic lice are available both
over the counter and by prescription. Creams or lotions containing
lindane, a powerful pesticide, are most frequently prescribed for
the treatment of pubic lice. Pregnant women may be advised not to
use this drug, and a physician's recommendations for use in infants
and small children should be followed carefully. Itching may persist
even after the lice have been eradicated. This is because the skin
has been irritated and requires time to heal. A soothing lotion such
as calamine may offer temporary relief.
Prevention
All persons with whom an infested individual has come into close
contact, including family and close friends as well as sex partners,
should be treated to ensure that the lice have been eliminated. In
addition, all clothing and bedding should be dry-cleaned or washed
in very hot water (125? F), dried at a high setting, and ironed to
rid them of any lice. Pubic lice die within 24 hours of being
separated from the body. Because the eggs may live up to six days,
it is important to apply the treatment for the full time
recommended.
Scabies
Scabies is a skin infestation
with a tiny mite, Sarcoptes scabiei. Scabies has become
relatively common throughout the general population. It is highly
contagious and is spread primarily through sexual contact, although
it also is commonly transmitted by contact with skin, infested
sheets, towels, or even furniture.
Symptoms
Scabies causes intense itching, which often becomes worse at night.
Small red bumps or lines appear on the body at sites where the
female scabies mite has burrowed into the skin to lay her eggs. The
areas most commonly affected include the hands (especially between
the fingers), wrists, elbows, lower abdomen, and genitals. The skin
reaction may not develop until a month or more after infestation.
During this time, a person may pass the disease unknowingly to a sex
partner or to another person with whom he or she has close contact.
Diagnosis
Scabies may be confused with other skin irritations such as poison
ivy or eczema. To make an accurate diagnosis, a doctor takes a
scraping of the irritated area and examines it under a microscope,
to reveal the presence of the mite.
Treatment
As with pubic lice, lindane is an effective treatment for scabies.
Pregnant women should consult a doctor before using this product.
Nonprescription remedies such as sulfur ointment also are available.
Sulfur is fairly effective but may be objectionable because of its
odor and messiness. Itching can persist even after the infestation
has been eliminated because of lingering skin irritation. A
hydrocortisone cream or ointment or a soothing lotion may provide
relief from itching.
Prevention
Family members and sex partners of a person with scabies are advised
to undergo treatment. Twenty-four hours after drug therapy, a person
with scabies infestation is no longer contagious to others, even
though the skin irritation may persist for some time. As with pubic
lice, special care must be taken to rid clothing and bedding of any
mites.
Human T-Cell Lymphotropic
Virus
The human T-cell lymphotropic
viruses (retroviruses), HTLV-I and HTLV-II, are uncommon in the
general U.S. population. They appear to be most prevalent among IV
drug users and persons who have multiple sex partners, genital
ulcers, or a history of syphilis. The virus can be transmitted by
blood or intimate sexual contact, and can be passed from mother to
child during pregnancy and through breast milk.
Most infected persons
remain healthy carriers of the virus. In rare cases, however, HTLV-I
can cause adult T-cell leukemia/lymphoma (ATL), a rare and
aggressive cancer of the blood. Infected persons also may develop
myelopathy, a neurologic disorder that affects the muscles in the
legs. In addition, researchers think that HTLV-I plays a role in the
development of B-cell chronic lymphocytic leukemia. HTLV-II can
cause another rare cancer called hairy-cell leukemia. Because the
chances of curing ATL rely on early detection, scientists are
studying protein in the blood of HTLV-I-infected persons that may
help predict who will develop the disease.
Blood donations are
screened routinely for HTLV-I. Because lab tests cannot easily
distinguish between HTLV-I and HTLV-II, experts believe many cases
of HTLV-II are eliminated from the blood supply as well.
Note: All information
is based upon materials published by the National Institute of
Allergy and Infectious Diseases (NIAD).
|
