Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)
I. IDENTIFICATION
A. CLINICAL DESCRIPTION: A sexually transmitted disease (STD) caused by an obligate intracellular bacteria, Chlamydia trachomatis. The disease is characterized by urethritis in males and macopurulent cervicitis in females. However, many males are asymptomatic. Possible complications in males include epididymitis that can lead to sterility. Individuals who engage in receptive anorectal intercourse may develop chlamydia proctitis. Common complications in women include salpingitis and chronic infection of the endometrium and fallopian tubes. These complications can lead to infertility and ectopic pregnancies. Endocervical chlamydia infection has been associated with increased risk of HIV infection.
B. REPORTING CRITERIA: Laboratory confirmation of Chlamydia trachomatis by cell culture or non-culture test.
C. LABORATORY CRITERIA FOR CONFIRMATION:
- Isolation of C. trachomatis by culture, OR
- Demonstration of C. trachomatis in clinical specimens by detection of antigen or nucleic acid.
D. WISCONSIN CASE DEFINITION: A laboratory confirmed infection.
II. ACTIONS REQUIRED / PREVENTION MEASURES
A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.
B. EPIDEMIOLOGY REPORTS REQUESTED:
- Acute and Communicable Diseases Case Report (DPH 4151).
- Sexually Transmitted Diseases Morbidity and Epidemiologic Case Report DPH 4243.
C. PUBLIC HEALTH INTERVENTIONS:
- Patients should be counseled for their risk of HIV and methods to reduce other STDs.
- Patients should also be tested and treated for gonorrhea.
- Patients should be advised to avoid sex until they and their partner(s) complete therapy.
- Source investigation by LHD. Interview women and asymptomatic men with chlamydia for all sexual partners within 60 days prior to examination and testing. For males with symptomatic chlamydia infection, the interview period is 30 days prior to the onset of symptoms.
- All contacts should be screened for STDs and preventively treated for chlamydia.
- Infection during pregnancy may result in conjunctival and pneumonic infection in the newborn. Chlamydia infections in neonates can be prevented by prenatal screening.
- All infants with conjunctivitis <30 days of age should be evaluated for chlamydia. Chlamydial pneumonia can occur one to three months after birth. These infants are at increased risk for abnormal pulmonary function later in childhood.
III. CONTACTS FOR CONSULTATION
A. BCDP / COMMUNICABLE DISEASES STD SECTION: (608) 266-7365.
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH / BACTERIOLOGY: (608) 262-1616.
D. MILWAUKEE BUREAU OF LABORATORIES: (414) 286-3526.
IV. RELATED REFERENCES
1. Heymann DL, ed. CHLAMYDIAL INFECTIONS. In: Control of Communicable Diseases Manual. 18 th ed. Washington, DC : American Public Health Association, 2004: 100-102.
2. Sexually Transmitted Diseases Treatment Guidelines --- 2002. MMWR 2002;51(RR06):1-80
3. Wisconsin Administrative Code, Chapter HSS 145, 1991, No. 430.
4. Recommendations for the Prevention and Management of Chlamydia trachomatis Infections, 1993.
V. DISEASE TRENDS
