1. 6/6/2016 1 Pam Goldberg, RNC, BSN, CIC Infection Preventionist Community Medical Center Missoula City-County Health Department

2. 6/6/2016 2 Sexually Transmitted Infections

3. 6/6/2016 3 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.

4. 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. 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. 6/6/2016 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.

7. 6/6/2016 7 Abstinence Is Safest 100% guaranteed to prevent STI’s. (No body contact) 100% protects against pregnancy.

8. 6/6/2016 8 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.

9. 6/6/2016 9 Sexually Transmitted Infections Chlamydia Gonorrhea Genital Warts Herpes Hepatitis A,B,C HIV/AIDS Syphilis And there are more !!!

10. 6/6/2016 10 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

11. 6/6/2016 11 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.

12. 6/6/2016 12

13. 6/6/2016 13 Chlamydia Cases by Age

14. 6/6/2016 14 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

15. Symptoms of Gonorrhea Usually symptomatic Discharge (thick, yellowish) Burning on urination Complications, if not treated Infertility PID Swollen and tender testicles 6/6/2016 15

16. 6/6/2016 16 Gonorrhea Cases by Age

17. 6/6/2016 17 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

18. 6/6/2016 18 Human Papillomavirus Many types of Human Papillomavirus (HPV) Incubation period unclear Can infect men, women, and babies. HPV

19. 6/6/2016 19 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

20. 6/6/2016 20 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

21. 6/6/2016 21 Genital Warts No tests for genital warts Several types of treatment are available Warts may come back

22. 6/6/2016 22 Perianal Wart Source: Cincinnati STD/HIV Prevention Training Center HPV

23. 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. 6/6/2016 23

24. 6/6/2016 24 Genital Herpes Causes infection in men, women, and newborns. Herpes simplex viruses (HSV) cause genital herpes infections. Incubation period: 2 – 12 days Herpes

25. 6/6/2016 25 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

26. 6/6/2016 26 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

27. 6/6/2016 27 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

28. 6/6/2016 28 Hepatitis A,B,C,(D,E) Hepatitis A,B,C,(D,E) A-Food B-Sexually * C-Blood D-with B E-Water

29. 6/6/2016 29 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.

30. 6/6/2016 30 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.

31. 6/6/2016 31 “Forgotten but not Gone” SYPHILIS

32. 6/6/2016 32 Syphilis Syphilis is sometimes called “zipper cut” Syphilis is caused by a spirochaete. Incubation Period: 10-90 days (average 21 days) Can cause infections in men, women, and unborn babies during pregnancy Syphilis

33. 6/6/2016 33 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

34. 6/6/2016 34 Oral Primary Syphilis Chancre Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides Syphilis

35. 6/6/2016 35 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

36. 6/6/2016 36 Secondary Syphilis Rash Source: Cincinnati STD/HIV Prevention Training Center Syphilis

37. 6/6/2016 37 Secondary Syphilis Palm Rash Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides Syphilis

38. 6/6/2016 38 Symptoms of Syphilis Late Stage Paralysis Insanity Blindness Damage to joints Personality changes Syphilis

39. 6/6/2016 39 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

40. 6/6/2016 40 So, well…..What do we do??? Prevention

41. 6/6/2016 41 Questions ?????