About STD

A sexually transmitted disease (STD), also known as a sexually transmitted infection (STI), or venereal disease (VD), is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex. While in the past, these illnesses have mostly been referred to as STDs or VDs, in recent years the term sexually transmitted infections (STIs) has been preferred, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease. Some STIs can also be transmitted via the use of IV drug needles after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of years.


History
The first well-recorded European outbreak of what is now known as syphilis occurred in 1494 when it broke out among French troops besieging Naples.[28] From this centre, the disease swept across Europe. As Jared Diamond describes it, "[W]hen syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people's faces, and led to death within a few months," rendering it far more fatal than it is today. Diamond concludes,"[B]y 1546, the disease had evolved into the disease with the symptoms so well known to us today."In his Serpentine Malady (Seville, 1539) Ruy Diaz de Isla 'guesstimated' that over a million people were infected in Europe.

Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in 1746 at London Lock Hospital.[31] Treatment was not always voluntary: in the second half of the 19th century, the Contagious Diseases Act was used to arrest suspected prostitutes.

The first effective treatment for a sexually transmitted disease was salvarsan, a treatment for syphilis. With the discovery of antibiotics, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat.

During this period, the importance of contact tracing in treating STIs was recognized. By tracing the sexual partners of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, STI clinics could be very effective at suppressing infections in the general population.

In the 1980s, first genital herpes and then AIDS emerged into the public consciousness as sexually transmitted diseases that could not be cured by modern medicine. AIDS in particular has a long asymptomatic period—during which time HIV (the human immunodeficiency virus, which causes AIDS) can replicate and the disease can be transmitted to others—followed by a symptomatic period, which leads rapidly to death unless treated. HIV/AIDS entered the United States in about 1969 likely through a single infected immigrant from Haiti. Recognition that AIDS threatened a global pandemic led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain infection

Classification
(Bacterial, Fungal, Viral, Parasites, Protozoal)

Bacterial
• Chancroid (Haemophilus ducreyi)
• Chlamydia (Chlamydia trachomatis)
• Granuloma inguinale or (Klebsiella granulomatis)
• Gonorrhea (Neisseria gonorrhoeae)
• Syphilis (Treponema pallidum)

Fungal
• Tinea cruris (jock itch) May be sexually transmitted.
• Candidiasis (yeast infection)

Viral
• Viral hepatitis (Hepatitis B virus)—saliva, venereal fluids.
(Note: Hepatitis A and Hepatitis E are transmitted via the fecal-oral route; Hepatitis C (liver cancer) is rarely sexually transmittable,[3] and the route of transmission of Hepatitis D (only if infected with B) is uncertain, but may include sexual transmission.
• Herpes simplex (Herpes simplex virus 1, 2) skin and mucosal, transmissible with or without visible blisters
• HIV (Human Immunodeficiency Virus)— venereal fluids, semen, breast milk, blood
• HPV (Human Papilloma Virus)— skin and mucosal contact. 'High risk' types of HPV are known to cause most types of cervical cancer, as well as anal, penile, and vulvar cancer, and genital warts.
• Molluscum contagiosum (molluscum contagiosum virus MCV)—close contact

Parasites
• Crab louse, colloquially known as "crabs" or "pubic lice" (Pthirus pubis)
• Scabies (Sarcoptes scabiei)

Protozoal
• Trichomoniasis (Trichomonas vaginalis)

Prevention
Prevention is key in addressing incurable STIs, such as HIV & herpes. Sexual health clinics fight to promote the use of condoms and provide outreach for at-risk communities.

The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer with an infected partner. No contact minimizes risk. Not all sexual activities involve contact: cybersex, phonesex or masturbation from a distance are methods of avoiding contact. Proper use of condoms reduces contact and risk. Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom.

Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else. Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures.

Many diseases that establish permanent infections can so occupy the immune system that other diseases become more easily transmitted. The innate immune system led by defensins against HIV can prevent transmission of HIV when viral counts are very low, but if busy with other viruses or overwhelmed, HIV can establish itself. Certain viral STI's also greatly increase the risk of death for HIV infected patients.

Vaccines
Vaccines are available that protect against some viral STIs, such as Hepatitis A, Hepatitis B, Herpes simplex vaccine (both Herpevac and ImmunoVex), and some types of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection.

Treatment
High risk exposure such as that which occurs in rape cases may be treated prophylacticly using antibiotic combinations such as azithromycin, cefixime, and metronidazole.

An option for treating partners of patients (index cases) diagnosed with chlamydia or gonorrhea is patient-delivered partner therapy (PDT or PDPT), which is the clinical practice of treating the sex partners of index cases by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner.

Diagnosis

STI tests may test for a single infection, or consist of a number of individual tests for any of a wide range of STIs, including tests for syphilis, trichomonas, gonorrhea, chlamydia, herpes, hepatitis and HIV tests. No procedure tests for all infectious agents.

STI tests may be used for a number of reasons:
• as a diagnostic test to determine the cause of symptoms or illness
• as a screening test to detect asymptomatic or presymptomatic infections
• as a check that prospective sexual partners are free of disease before they engage in sex without safer sex precautions (for example, in fluid bonding, or for procreation).
• as a check prior to or during pregnancy, to prevent harm to the baby
• as a check after birth, to check that the baby has not caught an STI from the mother
• to prevent the use of infected donated blood or organs
• as part of the process of contact tracing from a known infected individual
• as part of mass epidemiological surveillance

Not all STIs are symptomatic, and symptoms may not appear immediately after infection. In some instances a disease can be carried with no symptoms, which leaves a greater risk of passing the disease on to others. Depending on the disease, some untreated STIs can lead to infertility, chronic pain or even death.[13] Early identification and treatment results in less chance to spread disease, and for some conditions may improve the outcomes of treatment.

There is often a window period after initial infection during which an STI test will be negative. During this period the infection may be transmissible. The duration of this period varies depending on the infection and the test.
Source: http://en.wikipedia.org/wiki/Sexually_transmitted_disease
by: bodengdeng