Chlamydia screening at Boots Pharmacy

in London, England

THE HIGH street chemist chain Boots has won a Department of Health contract to provide free chlamydia screening for 16-24 year olds across London.The new service, to be provided from all Boots' London pharmacies from November, is part of a Department of Health initiative to make it easier for young people to be screened and tested for chlamydia. Youngsters will be able to collect, over the counter, a test kit containing a urine sample pot, which they will return to the pharmacy. The pharmacy will send the sample to a laboratory for testing and analysis and the results will be forwarded to an NHS chlamydia screening officer. If the test proves positive patients will be offered an option of returning to Boots for antibiotic treatment issued by a pharmacist via a patient group direction or will be advised to visit a GP or genitourinary medicine clinic. Public health minister Caroline Flint said: "Chlamydia is the most common sexually transmitted infection in the UK and it's therefore important we make screening and treatment services accessible -- especially for young men and women under 25 who lead such busy lives."By making this free service available in pharmacies in the high street, it will make it easier for people to call in for a screening test -- helping to speed up both the detection and treatment of chlamydia cases."Boots says it expects to provide approximately 50,000 screens a year via its 201 pharmacies in London. Chlamydia testing and screening is currently available in 26 areas of England under the National Chlamydia Screening Programme.

Article by: Katie Roberts

Source: Practice Nurse. September 2005

A common STD in young US adults

Nov 04 (Reuters Health) –

More than 2 percent of young adults in the United States have a sexually transmitted disease (STD) called trichomoniasis including more than 10 percent of young black women, according to a new report. Although many persons with trichomoniasis have only mild symptoms or no symptoms at all, the infection can cause significant illness. Trichomoniasis is estimated to cost the US more than 34 million dollars annually in direct medical care costs.

For men and women, the prevalence was significantly higher for those 25 years of age or older than among 18 to 20 year olds. Trichomonas was considerably more prevalent among blacks (6.9 percent) and Native Americans (4.1 percent) than among whites (1.2 percent), the researchers observe, and prevalences were intermediate in Latinos (2.1 percent) and Asians (1.8 percent). The highest rates were seen in black (10.5 percent) and Native American (4.2 percent) women. White men had the lowest prevalence (1.3 percent). Very few men (2.3 percent) or women (2.0 percent) reported any symptoms associated with trichomoniasis.

Trichomoniasis was associated with a significantly higher prevalence of chlamydial infection, the investigators report. Nearly 13 percent of patients with trichomoniasis also had chlamydial infection, compared with an overall chlamydial prevalence of only 4.2 percent.

It is important to remember that the risk factor for any sexually transmitted infection is the presence of the infection in a sexual partner. Consequently, higher prevalence in subgroups leads to increased risk of acquisition because sexual partners are more likely to be infected.

Author: Brittany Jackson

SOURCE: Sexually Transmitted Diseases, October 2005.

CNN.com

Orgins of Syphilis 

Debate about the origins of syphilis has continued for nearly 500 years, ever since early sixteenth-century Europeans blamed each other, referring to it variously as the Venetian, Naples, or French disease. One hypothesis assumes a New World origin, and holds that sailors who accompanied Columbus and other explorers brought the disease back to Europe. Another explanation is that syphilis was always present in the Old World but was not identified as a separate disease from leprosy before about A.D. 1500. A third possibility is that syphilis developed in both hemispheres from the related diseases Bejel and Yaws. New studies by paleopathologists favor a New World origin.

Ancient and medieval sources have long been cited as evidence for syphilis in Europe before Columbus, but none of the descriptions by Greek and Roman authors are specific enough to be certain. Returning crusaders brought Saracen ointment containing mercury for treating lepers, an appropriate medication for syphilis but not for leprosy. Thirteenth- and fourteenth-century A.D. references to venereal leprosy may also indicate syphilis because leprosy is not sexually transmitted. But the first definite descriptions of syphilis begin around 1500. These may either reflect growing medical knowledge and ability to differentiate syphilis from other diseases or signal its arrival from the New World.

Syphilis is caused by the bacterium, Treponema palladium, and other bacteria in the same genus cause yaws and Bejel, which are transmitted through direct skin-to-skin contact or sharing of drinking vessels. Like syphilis, Bejel and yaws cause inflammation of tissue surrounding bone and modify the bones. To establish criteria for distinguishing among the three diseases based on skeletal changes the paleopathologists analyzed a North American collection of skeletons for syphilis cases (diagnosed at autopsy), a collection from Guam predating 1668 for yaws (the only treponemal disease on the island before then), and early historic Near Eastern Bedouin for Bejel (Bejel is common to the region). Paleopathologists were able to identify characteristic bone changes for each disease, for example, modifications to the shin and tibia particular to syphilis, or routine involvement of hand or foot in yaws but not syphilis or Bejel.

Using these criteria, paleopathologists examined 687 skeletons from archaeological sites in the United States and Ecuador ranging in age from 400 to 6,000 years. Populations to the south (New Mexico, Florida, and Ecuador) proved to have syphilis, while those to the north (Ohio, Illinois, and Virginia) had yaws. By contrast, examination of 1,000 Old World skeletons dated to before contact with the New World revealed no cases of syphilis. This suggests that syphilis was first present in the New World and was later brought to the Old World. Furthermore, the Rothschilds found that the earliest yaws cases in the New World collections were at least 6,000 years old, while the first syphilis cases were at least 800 years old and perhaps more than 1,600 years old. This suggests that syphilis may be a New World mutation of yaws, which has a worldwide distribution. The occurrence of the same mutation giving rise to syphilis independently in the New and Old worlds seems unlikely.

Identification of syphilis on an Old World skeleton predating Columbus would be strong evidence that the disease either originated in the Old World or occurred in both hemispheres. Olivier Dutour of the Faculty of Medicine at Marseilles has recently concluded that the skeleton of a seven-month-old fetus found in a fourth-century A.D. context at Costebelle, France, had lesions from congenital syphilis. But Bruce Rothschild, who has examined the Costebelle skeleton, contends that it is not a case of congenital syphilis but of lithopedion. Stone children or lithopedion, a rarity occurring in only 0.0045 percent of pregnancies, are the calcification of a fetus or of fetal membranes and were first described in a treatise on surgery by Albucasis (A.D. 936-1013). The Rothschilds and University of Texas at Austin archaeologist Leland Bement have recently identified a 3,100-year-old lithopedion case at the Bering Sinkhole site in Texas.

According to paleopathologists,Bruce Rothschild the lesions in the Costebelle case indicate lithopedion. The character of the pathology appeared to me to be calcified membranes/tissues, rather than periosteal reaction, he says. The skull lesions are unlike those of treponemal disease congenital syphilis and the dramatic forearm calcification is unlike anything that have previously witnessed in over 500 cases of adult syphilis, nor in the periosteal reaction that characterizes yaws and Bejel-disorders in which children (though probably not fetuses) are frequently affected.

Author: Andreal Nicholas

Source: CNN

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