AIDS NOT ONLY SEXUALLY TRANSMITTED DISEASE; KNOWLEDGE CAN PREVENT THE WORST PROBLEMS OF STDs

While Acquired Immune Deficiency Syndrome, or AIDS, is the most serious, the most studied and the most talked-about sexually transmitted disease, it is not the only one.

Nurses at the Cape Girardeau County Health Department screen about 100 people a month for chlamydia, gonorrhea, syphilis, herpes or genital warts. Some 12 to 15 percent test positive for one of these ailments.

"What needs to be brought out is gonorrhea, left untreated, can cause death," Charlotte Craig, health department director, said. "Thirty percent of the men that walk into our facility have no symptoms. Men are traditionally informed by their peers that if they get gonorrhea they're going to get a discharge and that simply isn't always true. Many, many women are without symptoms."

Syphilis is also life threatening if left untreated.

Abstinence from sexual contact is the best way to prevent contracting an STD. After that, barrier contraceptives like condoms provide the best protection. The surest way to contract one of these conditions is through unprotected sex with an infected individual.

"If you have unprotected sex, just because you don't have symptoms does not mean that you have not contracted a sexually transmitted disease," Craig said. "And yes, you can get these infections with oral sex."

Chlamydia, the most common STD, gonorrhea and syphilis are all bacterial infections that can be cured. Doctors detect the presence of these germs with either a smear sample of the infected area or in the case of syphilis a blood test.

Once detected they are treated with antibiotics and penicillin.

Herpes and genital warts are viral infections that are not curable. Genital warts can be removed either surgically or with chemical solutions but the virus that causes them are not eliminated with these procedures. The symptoms of herpes, usually painful sores, can be alleviated but there is no cure yet for the disease.

Carolyn Sarff of the health department, is one of the nurses with the difficult task of telling people when they test positive for an STD.

"We wait and give them a chance to deal with it," she said. "Sometimes it's just touching them on the shoulder or giving them a hug or just let them sit there. A lot of them will cry and I wait until I think they're composed enough to say OK this is what we're dealing with. Let me explain to you that it is not the end of the world."

Sarff said there is a social stigma attached to STDs, especially herpes, that will cause many people to cry when they are told. What many people don't realize is herpes affects 30 million Americans with 500,000 new cases reported every year. Herpes simplex 1 is what causes cold sores on lips while the herpes simplex 2 causes genital sores.

Craig said the main difference between the two conditions is their location on the body.

"Herpes simplex 1 can be transmitted to the genital region," she said.

Even a common childhood ailment, chicken pox, is a form of herpes. The virus that causes the sores, fever and itching is not cured with treatment but retreats into cells in the nervous system and can cause additional ailments, like shingles, later in life. Mononucleosis is also a herpetic infection.

Dr. Thomas Heineman, assistant professor of internal medicine division of infectious disease at St. Louis University School of Medicine, said researchers have worked on a herpes vaccine since the 1930s.

"These are just very complicated viruses," Heineman said. "They have very complicated interactions with the immune system. They are many, many times more complicated than HIV, for example, or hepatitis. No one's yet found a single key point at which to attack these viruses."

Heineman said one of the most difficult aspects of controlling the spread of the disease is that only about a third of infected individuals shows any symptoms of the disease. The other two-thirds don't know they are infected and are capable of transmitting the virus.

"In a nutshell, herpes virus as a class they become latent after the initial infection," he said. "In order to prevent people from having recurrent disease you have to not only prevent them from having the primary disease you have to prevent the virus from somehow becoming latent. No one's figured out a way to do that."

The research into a vaccine goes on, with a guaranteed 30 million customers eager for a cure and the rest of the nation grateful for a preventative treatment.

"There's an awful lot of people working on this because anyone who comes up with a herpes vaccine would be -- illness aside -- economically very important," Heineman said. "That's right, they'd be rich."

PREVENTION OF STDs

The best ways to avoid contracting a sexually transmitted disease is to abstain from having sexual contact or to use barrier contraceptives such as condoms.

Bacterial infections.

Bacterial sexually transmitted diseases are curable with antibiotic treatments.

Gonorrhea:

Symptoms show from two to 21 days after contact. Most women and many men have no symptoms.

Yellow or white discharge from vagina or penis, burning or pain when urinating, urinating more often, (women) bleeding between periods or after sex, (women) heavier and more painful periods, (women) cramps or pain in the lower abdomen sometimes with fever or nausea, (men) pain and swelling in the testes.

Gonorrhea can cause permanent damage to the pelvis and sex organs and cause sterilization. Women can have gonorrhea in the cervix, uterus, fallopian tubes, ovaries and urethra. Men can have gonorrhea in the urethra and sperm ducts.

It can be cured with a shot or antibiotic pills.

Chlamydia.

Symptoms may be mild. As many as 80 percent of women and 30 percent of men with chlamydia don't have symptoms. When present, it may mean (for women) pain during urination, vaginal discharge and lower abdominal pain, (for men) there may be a burning sensation when urinating and a discharge.

It is the No. 1 sexually transmitted disease in the United States.

It is easily treated with antibiotics.

Syphilis

The first symptom is the appearance of a chancre 10 days to three months after exposure. A chancre is a type of liquid filled blister that is not painful and may not even be visible. It may go away within a few weeks whether treated or not.

Second stage is a skin rash that appears three to six weeks after the chancre. The rash may cover the whole body or only appear in a few places like the palms of the hands or soles of the feet. Other mild symptoms at this time could be headaches, sore throat, fever, fatigue, patchy hair loss and swollen lymph glands.

The rash usually heals after a few weeks and the disease goes into a latent stage where the infected person does not have noticeable symptoms.

If left untreated the disease can damage the heart, eyes, brain, nervous system, bones, joints.

Syphilis is usually treated with penicillin.

Viral infections

The virus that causes these infections cannot be killed. The symptoms can be treated but the disease does not go away.

Genital herpes

Herpes affects an estimated 30 million Americans and as many as 500,000 new cases are reported every year.

Within a few days of contact an infected person can experience a fever, headache, muscle aches, painful or difficult urination, vaginal discharge, swollen glands and painful sores at the point of infection.

Recurrent episodes of the sores is a common sign of herpes.

The symptoms of herpes can be treated, but the disease cannot be cured.

People with early signs of herpes outbreak or with visible sores should not have sexual contact. There are times when the virus can be transmitted without having visible signs.

Genital warts

It is estimated that 1 million new cases of genital warts are diagnosed in the United States each year.

The disease is highly contagious and is spread through direct contact. Warts can occur nearly anywhere in the genital region or mouth. They can be tiny and occur in groups that may over time form into a single larger mass.

The warts can be removed with either medicinal creams or surgery, but the virus that causes the warts can return.