Chlamydia Information for Health Professionals

Chlamydia facts

There is an epidemic of Chlamydia trachomatis in the Hunter New England region and throughout Australia.
Chlamydia infection can occur at any age but infection is most common in young adults under the age of 25 years. Up to 10% of young people have the infection.
It is a common infection in both males and females.
It is a major preventable cause of infertility and can cause ectopic pregnancy and chronic pelvic pain.
It can increase the risk of HIV transmission.
Most infections (in men and women) are asymptomatic (up to 90%).
Infection can persist for years if untreated.
It is highly infectious � at least 50% of partners of a confirmed case will be infected. Treating contacts is thus very important (see below).

The following people should be offered routine testing at least annually:

Testing is also recommended for people who have:

Most men and women (up to 90%) will have no symptoms.
In women, infection may result in pain on urination, lower abdominal pain, or intermenstrual or post coital bleeding.
In men, infection may result in urethral discharge, pain on urination or urethral irritation.

The chlamydia PCR test is highly sensitive (95%+) and specific (95%+).
For men: Initial stream urine taken at any time of the day (plus an anal swab if indicated)*
For women: Initial stream urine or a cervical swab (plus an anal swab if indicated).* Other options include a Thin Prep specimen, or a high vaginal swab.

In pregnancy:

A repeat test should not be conducted less than 4 weeks after the initial positive test due to the likelihood of bacterial DNA still being present.
It is recommended that a pregnant woman testing positive be tested for cure at 4 weeks after treatment.
All others with a positive test should be retested at 3-6 months because of the high risk of reinfection.
The frequency of further testing should then be based on an assessment of continuing risk factors.

All sexual contacts for the past 6 months should be offered empirical treatment for chlamydia and tested for chlamydia and other STIs. A contact letter is available for use during this process. To download a contact tracing letter, see the Resources and Links page.
Further information for clinicians is available in the Australasian Contact Tracing Manual
Contact tracing information for patients is available elsewhere on this site. Patients can be directed to this resource by giving them the following web address: www.chlamydiahelp.net