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What STD is known for being a silent infection?


Sexually transmitted diseases (STDs) are infections passed from one person to another through sexual contact. Many STDs do not cause obvious symptoms, especially in the early stages of infection. This makes it easy for people to unknowingly transmit STDs to sexual partners. STDs that do not produce noticeable symptoms right away are sometimes called “silent” infections.

Chlamydia

The most common STD with minimal symptoms is chlamydia. According to the Centers for Disease Control and Prevention (CDC), around 1.7 million chlamydia infections were reported in the United States in 2017. However, the CDC estimates the actual number of new chlamydia cases per year is closer to 2.9 million because so many infections go undiagnosed and unreported.

Chlamydia is caused by the bacterium Chlamydia trachomatis. It can be transmitted through vaginal, oral, or anal sex with an infected partner. While some people with chlamydia develop symptoms like pain or burning during urination, abdominal pain, or abnormal discharge from the penis or vagina, most men and women with chlamydia exhibit no symptoms at all.

Without treatment, chlamydia can lead to serious complications:

– In women, untreated chlamydia can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID may result in permanent damage leading to chronic pelvic pain, infertility, or potentially fatal ectopic pregnancy.

– In men, chlamydia can spread to the epididymis causing pain and fever. Rarely, it can lead to sterility.

– In both sexes, chlamydia can infect the rectum, causing rectal pain, discharge, and bleeding.

– Chlamydia can also cause conjunctivitis and pneumonitis if it spreads to the eyes and lungs, which is rare.

Because chlamydia is so prevalent and silent without testing, the CDC recommends all sexually active women under age 25 get tested annually. Sexually active women over 25 should also get tested if they have new or multiple partners. Pregnant women should be tested again in the third trimester. Men who have sex with men or engage in other risky sexual practices should get tested every 3-6 months.

Diagnosing and Treating Chlamydia

Chlamydia is easily diagnosed through nucleic acid amplification tests (NAATs) on urine samples or swabs of infected sites. It is readily treated and cured with common antibiotics like azithromycin or doxycycline. The CDC advises retesting for chlamydia three months after treatment because re-infection is common. All sexual partners must also be treated to avoid ping-ponging infections back and forth.

Gonorrhea

Like chlamydia, gonorrhea is a bacterial STD that often produces no symptoms. It infects over 800,000 people in the U.S. every year. The CDC estimates that less than half of these infections are detected and reported to health authorities.

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. It spreads through unprotected vaginal, oral, or anal sex with an infected partner. The highest rates of infection are found among adolescents and young adults.

When symptoms do occur, they may include:

– Thick, cloudy, or bloody discharge from the penis or vagina
– Pain or burning sensation when urinating
– Swelling and pain in the testicles

In women, gonorrhea can spread into the uterus and fallopian tubes, causing PID. The damage leads to chronic abdominal pain and increased risk of ectopic pregnancy and infertility. Gonorrhea can also spread to the blood and joints, causing a condition called disseminated gonococcal infection (DGI) with symptoms like joint pain, rash, and fever.

If left untreated, gonorrhea can become a serious health threat. Like chlamydia, it is easily cured with antibiotics once detected through lab tests. The CDC recommends gonorrhea screening for all sexually active women under 25 years old and high-risk individuals. Getting regularly tested and treated is crucial for identifying infections without symptoms and avoiding complications.

HIV

Perhaps the most infamous STD associated with a “silent” phase is the human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS). HIV attacks and destroys white blood cells that normally fight infection, slowly weakening the immune system.

In the first few weeks after transmission, it is common for HIV to cause no symptoms whatsoever. Some people do experience temporary flu-like symptoms 2-4 weeks after infection:

– Fever
– Headache
– Sore throat
– Swollen lymph nodes
– Rash
– Muscle and joint aches
– Fatigue

These symptoms usually resolve on their own after a week or two. Then the virus enters a latent “clinical latency” stage that can last many years with no outward symptoms. Without antiretroviral therapy, the virus continues multiplying and destroying immune cells during this time.

Eventually, the damage to the immune system allows opportunistic infections like pneumonia, tuberculosis, and cancer to thrive, leading to the onset of AIDS. Thanks to modern treatments, people with HIV can live long and healthy lives by starting antiretroviral therapy as soon as possible after diagnosis.

HIV spreads through contact with infected bodily fluids like blood, semen, vaginal fluids, and breast milk. Practicing safe sex by correctly using condoms, getting tested regularly, and taking daily pre-exposure prophylaxis (PrEP) medications are the best ways to avoid HIV transmission. There is currently no cure, but early detection and treatment helps prevent AIDS from developing.

Hepatitis

Hepatitis refers to inflammation of the liver, often caused by viral infections. Several types of contagious hepatitis viruses can be transmitted sexually, including hepatitis B (HBV) and hepatitis C (HCV). Both are common silent infections.

According to the WHO, over 250 million people worldwide live with chronic hepatitis B, while 71 million have chronic hepatitis C. In the U.S., around 850,000 people have hepatitis B and 2.4 million have hepatitis C.

Hepatitis B and C usually cause no initial symptoms, allowing them to spread undetected. When symptoms do appear, they may include:

– Fever
– Fatigue
– Loss of appetite
– Nausea
– Vomiting
– Abdominal pain
– Joint pain
– Jaundice

Over years or decades, the viruses can cause liver scarring (cirrhosis) and liver cancer. But early diagnosis lets doctors provide antiviral treatments and ongoing monitoring to prevent serious liver damage.

The CDC recommends HBV testing for anyone with multiple sex partners, men who have sex with men, injection drug users, and household contacts of infected persons. HCV testing is recommended for anyone who has ever injected drugs and HIV-positive men who have unprotected sex with men.

Safe injection practices, safe sex, and HBV vaccination help prevent viral transmission. There are no vaccines for HCV, but new antiviral drugs can cure over 95% of infections.

Human Papillomavirus (HPV)

HPV is the most common sexually transmitted infection in the United States. Approximately 79 million Americans are currently infected, with 14 million new cases each year. Over 90% of sexually active adults will get at least one type of HPV at some point.

HPV is actually a group of over 150 related viruses, identified by number. Different strains cause warts on different parts of the body. About 40 types specifically infect the genitals and reproductive system.

Most cases of genital HPV produce no symptoms and resolve spontaneously within 1-2 years. But certain high-risk strains can persist for years and eventually cause cancer:

– HPV 16 and 18: responsible for 70% of cervical cancers
– HPV 16: linked to 60% of penile cancers
– HPV 16: causes 85% of anal cancers
– HPV 16: responsible for 60-70% of oropharyngeal cancers

Other low-risk HPV strains, like HPV 6 and 11, cause 90% of genital warts. These non-cancerous growths rarely cause symptoms, which may include itching, burning, and pain.

Doctors can detect HPV and cell changes through Pap tests, HPV DNA tests, and visual inspections. There is no treatment for the virus itself, but cervical precancerous lesions and genital warts can be removed. HPV vaccines help prevent infection from the most dangerous cancer-causing strains.

Trichomoniasis

Trichomoniasis is a common parasitic STD caused by the protozoan Trichomonas vaginalis. The CDC estimates around 3.7 million Americans have the infection. Only about 30% develop any symptoms, which may include:

– Thin, yellow-green vaginal discharge with a fishy odor
– Genital itching and soreness
– Pain during urination or intercourse

Without treatment, the parasite can be passed back and forth between sexual partners. In women, it raises the risk for premature delivery and transmission of HIV. It can also lead to inflammation of the prostate gland in men.

The infection is diagnosed by detecting the parasite through lab tests of genital discharge. Trichomoniasis is readily cured with prescription oral antibiotics. Sexual partners should also be treated to prevent reinfection.

Mycoplasma genitalium

Mycoplasma genitalium (MG) is a bacterium first identified in the 1980s that can be transmitted sexually. Estimates suggest it infects 1-2% of sexually active adults globally. Rates are higher in African American teens and young adults.

Like chlamydia and gonorrhea, MG often causes no initial symptoms. When present, symptoms tend to be mild and nonspecific. Women may experience vaginal discharge, bleeding after sex, or pelvic pain. Men may notice watery penile discharge or pain during urination and ejaculation.

Without treatment, MG can lead to urethritis, cervicitis, and PID in women. It may also increase susceptibility to HIV and raise risk for pelvic inflammatory disease after abortion.

Because symptoms are usually minor or nonexistent, many cases go undiagnosed. Diagnostic tests are not routinely available for MG in many regions. Treatment involves antibiotics like azithromycin and moxifloxacin. All sex partners should also be treated at the same time to prevent reinfection.

Syphilis

Syphilis is a complex, progressive STD caused by the bacterium Treponema pallidum. Transmission occurs through direct contact with syphilis sores, which mainly appear on the external genitals, vagina, anus, or rectum. These infectious sores are known as chancres.

The disease progresses through four stages. The first stage starts with one or more chancres developing around the infection site 10-90 days after transmission. The painless sores typically heal within 3-6 weeks even without treatment. While the chancres are open, the infection spreads throughout the body.

After the chancres disappear comes a latent period where no symptoms are present. This latent syphilis can last for years before the infection progresses to the tertiary stage. About one-third of untreated cases eventually develop severe late-stage symptoms like paralysis, numbness, blindness, dementia, and damage to the heart, brain, and other organs.

Early diagnosis through blood tests allows treatment with antibiotics to eliminate the infection before serious damage occurs. All sexual partners from the preceding 90 days must also be tested and treated.

Prevention

The most effective ways to avoid STDs include:

– Abstinence from vaginal, anal, and oral sex
– Being in a long-term, mutually monogamous relationship with an uninfected partner
– Using latex condoms correctly every time you have sex
– Limiting your number of sexual partners
– Getting vaccinated against HPV and hepatitis B
– Avoiding excessive alcohol and drug use, which can impair decision-making

Regular testing is crucial even if you do not have symptoms, especially if you are sexually active with multiple partners. Finding and treating STDs early prevents transmission and complications.

Conclusion

Many common STDs do not produce noticeable symptoms during the initial weeks and months after infection. This “silent” phase allows them to spread undetected to sexual partners. Chlamydia, gonorrhea, trichomoniasis, MG, hepatitis, HPV, syphilis, and most worryingly, HIV, can all be transmitted by people who are unaware they are infected. Practicing safe sex, limiting partners, and getting regularly screened are essential to stop the spread of asymptomatic STDs that can wreak havoc on reproductive health.