6/6/ Pam Goldberg, RNC, BSN, CIC Infection Preventionist Community Medical Center Missoula City-County Health Department

6/6/ Sexually Transmitted Infections

6/6/ Infection Preventionist Investigates Reportable Communicable Diseases. There are 62 Reportable Diseases in Missoula County. STI’s are included as reportable. Montana Health Care providers are required to report. Active Surveillance helps identify outbreaks or emerging health concerns.

Reporting of a Sexually Transmitted Infection. Confidential Health Department will call to: determine that you received the correct medication. answer any questions that you may have. discuss where and from who you may have acquired the disease, and who you have exposed to the disease. 6/6/2016 4

5 Sexually Transmitted Infections Are equal opportunity bugs! If you’re a warm body, you’ll do. 1 out of 4 U.S. teenagers that are sexually active will get an STI. The best protection is KNOWLEDGE. KNOW THE FACTS !!!!!

6/6/ THE FACTS !! Anyone can get an STI by having sex with someone who has an STI. Most STI’s show no symptoms. Most STI’s can be treated and cured. Many STI’s can not be treated and cured. STI’s can cause serious health problems. People CAN protect themselves from STI’s.

6/6/ Abstinence Is Safest 100% guaranteed to prevent STI’s. (No body contact) 100% protects against pregnancy.

6/6/ Safer Sex Guidelines: These can help protect against STI’s, but not 100%. Don’t allow any other persons body fluids to enter your body. No body to body contact with someone who has an infection. (Warts, Herpes, MRSA) Don’t ever have sex when you are drunk or using drugs. Always use a condom.

6/6/ Sexually Transmitted Infections Chlamydia Gonorrhea Genital Warts Herpes Hepatitis A,B,C HIV/AIDS Syphilis And there are more !!!

6/6/ Chlamydia Most commonly reported STI in the nation, in Montana, in Missoula. 76% of Chlamydia cases in Montana are between the ages of 15-24yrs. Caused by a bacteria. Incubation Period: 2-3 weeks

6/6/ Symptoms of Chlamydia Usually asymptomatic Discharge (may be runny, whitish) Burning on urination Complications, if not treated: # 1 Infertility PID Swollen and tender testicles Babies born to mothers with this can develop pneumonia.

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6/6/ Chlamydia Cases by Age

6/6/ Gonorrhea Gonorrhea is sometimes called clap. Incubation period: 1 – 14 days. Caused by a bacteria. Can cause infections in men, women, and new babies. Babies born to mothers with this can suffer blindness. Gonorrhea

Symptoms of Gonorrhea Usually symptomatic Discharge (thick, yellowish) Burning on urination Complications, if not treated Infertility PID Swollen and tender testicles 6/6/

6/6/ Gonorrhea Cases by Age

6/6/ Testing & Treatment for Gonorrhea and Chlamydia Easily detected by a urine test or swab; and Easily cured with antibiotics; but Any damage to the body cannot be repaired. Gonorrhea

6/6/ Human Papillomavirus Many types of Human Papillomavirus (HPV) Incubation period unclear Can infect men, women, and babies. HPV

6/6/ Genital HPV: Two Types Low-risk HPV types can cause genital warts. High-risk HPV types can cause serious cervical lesions, cervical cancer, and other genital cancers. HPV

6/6/ Symptoms of Genital HPV Infection Usually asymptomatic and brief (6 – 12 months) Genital warts (usually infected with low-risk type of HPV) –Warts on the penis, vagina, anus or urethra – May have itching, bleeding, burning, or pain along with the warts HPV

6/6/ Genital Warts No tests for genital warts Several types of treatment are available Warts may come back

6/6/ Perianal Wart Source: Cincinnati STD/HIV Prevention Training Center HPV

Gardasil A cervical cancer vaccine that protects against 4 HPV types. 2 types cause 70% of cervical cancer cases. 2 types cause 90% of genital warts. Approved for ages 9 – 26. Approved for males and females. 6/6/

6/6/ Genital Herpes Causes infection in men, women, and newborns. Herpes simplex viruses (HSV) cause genital herpes infections. Incubation period: 2 – 12 days Herpes

6/6/ Genital Herpes: Two Types There are 2 types of HSV: HSV-1 and HSV-2. –HSV-1 causes oral infections (cold sores, fever blisters) and some genital infections. - HSV-2 causes most genital infections. Herpes

6/6/ Symptoms of Genital Herpes Numerous painful lesions (sores) –On the genital area. –Last up to 4 – 21 days Other symptoms may include headache, fever, muscle aches, swollen lymph nodes, and difficult urination. Symptoms may or may not come back. Herpes

6/6/ Genital Herpes Without Symptoms Many people with herpes do not have any symptoms. Most people with herpes can pass the virus to sex partners even when they do not have symptoms. People with this are contagious 1 day before they have a lesion. Herpes

6/6/ Hepatitis A,B,C,(D,E) Hepatitis A,B,C,(D,E) A-Food B-Sexually * C-Blood D-with B E-Water

6/6/ HIV / AIDS HIV / AIDS Human Immunodeficiency Virus (HIV) Acquired Immune Deficiency Syndrome (AIDS) 26 positive in Montana in past 2 years. Still increasing in numbers world wide.

6/6/ HIV/AIDS In Montana, since 1985, there have been 724 cases. 624 – men 94 – women 6 – children < 13 In Missoula County, since 1985, there have been 106 cases.

6/6/ “Forgotten but not Gone” SYPHILIS

6/6/ Syphilis Syphilis is sometimes called “zipper cut” Syphilis is caused by a spirochaete. Incubation Period: days (average 21 days) Can cause infections in men, women, and unborn babies during pregnancy Syphilis

6/6/ Symptoms of Syphilis Primary Stage A painless sore called a chancre may be located on the genitals or mouth. It occurs because of direct contact with the exudates. The chancre will last 1-5 weeks and heal without treatment Syphilis

6/6/ Oral Primary Syphilis Chancre Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides Syphilis

6/6/ Symptoms of Syphilis Secondary Stage Skin rashes lasting 2 – 6 weeks (average of 4 weeks) on the palms of the hands, bottoms of the feet, or any part of the body Other symptoms include fever, swollen lymph glands, headache, hair loss, and muscle ache Symptoms will go away without treatment Syphilis

6/6/ Secondary Syphilis Rash Source: Cincinnati STD/HIV Prevention Training Center Syphilis

6/6/ Secondary Syphilis Palm Rash Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides Syphilis

6/6/ Symptoms of Syphilis Late Stage Paralysis Insanity Blindness Damage to joints Personality changes Syphilis

6/6/ Testing & Treatment for Syphilis Easily detected by a blood test; and Easily cured with antibiotics; Any damage done to the body cannot be repaired. Syphilis

6/6/ So, well…..What do we do??? Prevention

6/6/ Questions ?????