Which of the following is the most common venereal disease in the U.S.: 1) * syphilis, 2) gonorrhea, 3) herpes? Answer: none of the above. In fact, the most prevalent of all sexually transmitted diseases is one that few people have ever heard of: chlamydia. This disease, named for the tiny bacterium (Chlamydia trachomatis) that causes it, strikes between 3 million and 10 million Americans each year. The bug is also a hidden agent in as many as one out of every two cases of pelvic inflammatory disease (PID), a painful, sometimes sterilizing infection that affects about 1 million American women each year. Chlamydia, like herpes, is rapidly becoming the bane of the middle class; up to 10% of all college students are afflicted with it. Says Dr. Mary Guinan of the Centers for Disease Control (CDC) in Atlanta: "Chlamydia is the disease of the '80s."
Then why are most Americans unfamiliar with it? For one thing, the bacterium that causes chlamydia could not be easily isolated and studied until 1965. "The bugs couldn't be grown in the laboratory, and people don't want to work with things that are difficult," says Julius Schachter, an epidemiologist at the University of California, San Francisco. Then, too, the presence of chlamydial infections until recently could be detected only by a complicated laboratory test that took up to seven days to complete and was offered at few medical centers in the U.S. As a result, chlamydia was rarely diagnosed. Says Dr. Ward Cates Jr., head of the CDC's division of sexually transmitted diseases: "Most physicians went to medical school when it was not recognized, and would have trouble spelling it, much less treating it."
In addition, chlamydia's signs are sometimes subtle and easily misinterpreted. Men with chlamydia can experience a burning sensation during urination and a mucoid discharge, but their illness is often diagnosed as gonorrhea. In women, chlamydia may also mimic gonorrhea, causing a vaginal discharge, or result in the frequent and sometimes painful urination associated with a urinary-tract infection.
When doctors confronted with chlamydial symptoms mistakenly prescribe penicillin, the usual treatment for gonorrhea, or order the drugs most commonly used for urinary-tract infections, the chlamydial infection rages on. Repeated doses of the antibiotics tetracycline or erythromycin over a period of one week are required to knock out the bug.
If the wrong drugs are used for chlamydia or if it is left untreated, the infection can spread throughout the reproductive tract. In men, it generally / leaves no lasting effects, though many continue to harbor the bacteria and can infect their sexual partners. In women, the bacteria may travel through the uterus into the fallopian tubes, which become inflamed and eventually scarred. While the infection in some cases causes severe lower abdominal pain, thus sending a clear danger signal, the symptoms in other women are barely noticeable. Many of these women remain unaware of their infection. Only after trying unsuccessfully to become pregnant do they discover that their fallopian tubes have been blocked by scar tissue.