Nasty Infectious Diseases You Want To Avoid - Gonorrhea
This is the most commonly reported communicable disease in the United States, most often affecting the genitourinary tract and (sometimes) the pharynx, eyes, or rectum. Since 1980 the number of people with gonorrhea has been generally declining; still millions of Americans are infected. Many more cases go unreported. People are at risk if they have more than one sex partner or don't use condoms. Most victims (75 percent) are between the ages of 15 and 24. Gonorrheal infections must be reported to local health departments in the United States.
Cause - The disease is caused by a spherical bacterium, Neisseria gonorrhoeae, that is always grouped in pairs. It is passed from one person to the next during sex. It is not possible to get gonorrhea from toilet seats or swimming pools. A woman who has unprotected sex with an infected man has an 80 to 90 percent chance of being infected herself, which is a much higher rate than with other STDs. But a man who has unprotected sex with an infected woman has only a 20 to 25 percent chance of becoming infected. Men have less risk because it's harder for bacteria to enter the body through the penis than through the vaginal walls.
Symptoms - Between three to five days after exposure, symptoms will appear in the genital or rectal area, or in the throat (depending on the sexual practice). Up to 80 percent of infected men experience painful urination, frequent urge to urinate, and white or yellow thick pus from the penis. About half of infected women have swelling of the vagina, abnormal green-yellow vaginal discharge, vaginal bleeding between periods, pelvic discomfort (itching and burning), and pain when urinating. Very few pregnant women have symptoms. As the infection spreads-which is more common in women than in men-there may be nausea and vomiting, fever, and rapid heartbeat, or peritonitis. Inflammation of the tissues surrounding the liver also may occur, causing pain in the upper abdomen. Severe cases of gonorrhea are also more common in women and are characterized by signs of blood poisoning, with tender lesions on the skin of the hands and feet and inflammation of the tendons of the wrists, knees, and ankles. If the disease spreads to the conjunctiva of the eyes, there may be scarring and blindness. In both men and women, infection in the throat causes a mild, red, sore throat.
Diagnosis - Culture of the organism from body fluids.
Treatment - For many years, penicillin was the drug of choice, but in the late 1970s the bacteria became resistant. The most resistant strains are found in New York, California, and Florida, but resistance is seen in all states and most of Canada. Today, treatment involves two antibiotics: a shot of ceftriaxone and doxycycline pills. The pills will also cure chlamydia, which has similar symptoms to gonorrhea (many people have both infections). Alternatively, instead of a shot a doctor may give a single dose of cefixime, ciprofloxacin, or ofloxacin. Pregnant women get a shot of ceftriazone and erythromycin pills. An infant born with the symptoms of gonorrhea must be hospitalized and given ceftriaxone.
Complications - Pelvic inflammatory disease develops in almost 40 percent of untreated women and causes scars in the tubes, infertility, and tubal pregnancies. Untreated pregnant women may experience an infection in the amniotic fluid, smaller babies, or premature birth. Babies born to infected mothers may have gonorrhea conjunctivitis during delivery; untreated infants can become blind. For this reason, drops are placed in all babies' eyes at birth to prevent gonorrhea and chlamydia conjunctivitis. In men, untreated gonorrhea can lead to infections of the testicles or scar the urethra, which can lead to sterility.
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