CHLAMYDIA

Causative organism Chlamydia trachomatis
Incubation period 2-60 days
How far to trace back 6 months
Usual testing method Nucleic acid amplification
Common symptoms

Asymptomatic (urogenital, anorectal, pharyngeal) in over 80% of

Mucopurulent cervical discharge, easily induced endocervical bleeding, urethritis with a mucoid or watery urethral discharge, dysuria.

People assigned female at birth: PID- Pelvic pain, abnormal bleeding patterns (intermenstrual bleeding or post coital bleeding), dyspareunia, fever, nausea, vomiting (see PID)

People assigned male at birth: epididymo-orchitis-scrotal pain, swelling, erythema (See Epididymitis)

Ano-Rectal - Anal discharge/pain

eye - conjunctivitis

throat - pharyngiitis

Likelihood of transmission per act of condomless intercourse <5%
Likelihood of long-term sexual partner being infected About two-thirds of partners will be infected
Protective effect of condoms High
Transmission by oral sex Low
Duration of potential infectivity

People assigned female at birth can be infected for years if left untreated, but on average 50% will clear a urogenital infection within 12 months. People assigned male at birth can be infected for months.

Anorectal infection: Can last for over 12 months if left untreatedLimited data on duration of infectiousness overtime

Important sequelae

PID/chronic pelvic pain/ infertility/ ectopic pregnancy

Epididymo-orchitis

Pregnancy and infants: Neonatal pneumonitis and conjunctivitis. Preterm labour and low birth weight.

Enhanced HIV transmission

Direct benefit of detection and treatment of contacts Reduces ongoing transmission and re-infection in index cases. Re-infection in people assigned female at birth substantially increases their risk of developing PID.
Usual management of contacts

Counselling, clinical examination and testing for chlamydia

People presenting as asymptomatic contacts of chlamydia should be tested and advised to await results. Consider presumptive treatment if there has been sexual contact within the past 2 weeks or when the person’s individual circumstances mean later treatment may not occur.  (Presumptively treat partners)

Provision of patient delivered partner therapy (PDPT) if appropriate.

If partners have (epididymo-orchitis) or PID (see sections)

Contact tracing priority High
Notification

Genital C. trachomatis infection is notifiable in all Australian states and territories by doctors or laboratories.

Genital C. trachomatis infection is not notifiable in New Zealand currently but voluntary laboratory notification occurs from most regions

Last updated 2016

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