Chlamydia in children is an infectious venereal disease caused by intracellular parasites Chlamydia (Chlamydia), which has 6 types of virus. Chlamydia is transmitted both sexually and in other ways.
Causes of Chlamydia in children
The most common form of chlamydia is urogenital, the causative agent of which is Chlamydia trachomatis, belongs to the elementary (highly virulent form of the pathogen, adapted to extracellular existence) and reticular (the form of the intracellular existence of the parasite, metabolically active, providing replication of the microorganism). Most often, children have urogenital and respiratory forms of chlamydia, the virus of the latter affects the respiratory organs. These manifestations are usually found in combination with damage to the mucous membrane of the eyes, causing so-called chlamydial conjunctivitis.
Chlamydia very well adapt to the intracellular existence, they parasitize intracellularly, and this contributes to the asymptomatic course of the disease. The virus is completely dependent on the cell in which it “lives” and in which it develops. Scientists identify several types of chlamydia:
- Ch. Pneumoniae. Transmitted by airborne droplets.
- Chlamydophila felis. Transmitted by contact from cats in which the pathogen has provoked conjunctivitis and rhinitis. You can become infected during the treatment of the animal’s eyes or by kissing it.
- Chlamydia psittaci. It is transmitted to children by airborne droplets or airborne dust from birds, affects the respiratory tract and the cardiovascular system.
- Chlamydophila abortus. Transmitted to children through constant contact with animals.
- Chlamydophila caviae. Transmitted from animals.
- Chlamydia trachomatis and Chlamydia pneumoniae. Transmitted from sick family members. Children can be infected in a household way from their parents, using common things, and in utero when passing through the birth canal, the fetus is infected vertically through the placenta.
The rate of chlamydia infection in pregnant women ranges from 3 to 40%, reaching 70% in chronic inflammatory diseases of the urogenital tract. Children are infected with chlamydial infection are infected in 63% of cases. Chlamydia can be congenital (from mother to child) and acquired (household infection).
Not only adults, but there are also ways of transmission. Infection of the fetus occurs transplacentally, often contact (intranatally), especially during aspiration of the fetus.
Children’s form of chlamydia is often confused with respiratory infections. It is a fact that it is not able to show any symptoms. Therefore, it is important to detect the infection in a child.
It appears that the child has received his family’s chastourism.
Infection can occur through household use such as a washcloth, towel and so on.
Characteristics of Chlamydia
Types – Diseases
Chlamydia trahomatis(human primary pathogen) – Trachoma, paratrahoma, urogenital chlamydia, pneumonia, venereal lymphogranuloma
Chlamydophila psittaci(primary pathogen of animals and humans) – Ornithosis (psittacosis), keratoconjunctivitis, sheep abortion
Chlamydophila pneumonia(human primary pathogen) – Pneumonia, acute respiratory infections, atherosclerosis, sarcoidosis, asthma
Pathogenesis during Chlamydia in Children
Chlamydia develops in the body of both women and children 48-72 hours. The following clinical forms of intrauterine chlamydial infection are distinguished: generalized infection; meningoencephalitis; intrauterine pneumonia (20%); respiratory distress syndrome; gastroenteropathy; conjunctivitis (40-45%); vulvovaginitis; local manifestations of infection (vesicles, omphalitis, rhinitis). Accordingly, each of the forms of chlamydia affects certain organs – eyes, kidneys, joints, vagina, lungs.
If there are people in the family who are infected with chlamydia, they pose a threat of infection to the rest of the family members and become virus carriers. If you do not start on time the treatment of all family members, it can lead to the resumption of foci of infection. Very often, family members are infected with a household method, this type of infection has been called the family chlamydia. Thus, family members can be infected in 2, and sometimes even in 3 generations, for example, grandparents, mothers and grandchildren.
If the parents are sick with urogenital chlamydiosis, and it has a chronic form, then in children it manifests itself in an extragenital form. In this case, there is a sluggish conjunctivitis or blepharoconjunctivitis. Note that the eye strain is different from the genital strain in clinical and epidemiological indicators. Ocular chlamydia causes trachoma, is more common in dry, hot climates, with low levels of hygiene. The genital strain is most often transmitted sexually, causing urogenital diseases. Chlamydia is associated with eye damage in both adults and children. As a result of infection of the child during childbirth in newborns, many eye and respiratory tract lesions are observed, resulting in pneumonia (pneumonia). Chlamydial virus in newborns can cause changes in all organs. Severe chlamydia is fatal.
Chlamydia most often affects the urogenital system, but the infection can cause diseases and other organs. Such lesions are called Reiter’s disease – an allergic reactive condition of the body, which has arisen on the basis of an infectious disease. Disturbances in the immune system that have arisen against the background of chlamydia affect the development of Reiter’s syndrome. Reiter’s disease is accompanied by damage to the eyes, urogenital system, joints and other internal organs. Ankle and knee joints are most often affected. At the same time there is an increase in body temperature, pain occurs during movement. In children, there are changes in the internal organs: inflammation of the heart muscle, disruption of the heart valves, damage to the kidneys, lungs, and nervous system.
Symptoms of Chlamydia in Children
Chlamydia is characterized by mild clinical symptoms or asymptomatic course of the disease. Most often after infection, the disease immediately becomes chronic with a small manifestation of symptoms.
During pregnancy, the disease can manifest as spontaneous miscarriages, the development of ectopic pregnancy, fetal fading, severe anemia, inflammation of the uterine lining and fetal membranes, which leads to malnutrition of the fetus, abnormal fetal development, prematurity of the child. All these manifestations in the history of pregnancy should pay attention to the doctor for the presence of infection in women. That is why early diagnosis and treatment is so necessary, because in the asymptomatic course of the disease leads to late appeal for medical help, already in the presence of formed pathologies.
The symptoms of chlamydia are very dependent on the strain and, accordingly, on the affected organ by the pathogen. Depending on the affected area, the following lesions and symptoms can be identified:
- Gastrointestinal – gastritis, enteritis and other symptoms of gastroenteropathy.
- Eyes. Specific conjunctivitis is a lesion of the cornea and heavy discharge from the eyes.
- Urethritis boys and vulvitis girls – newborn and older children tend to be affected. Most often this is the result of domestic infection from infected parents to a child. At the stage of infection appears runny nose, sinusitis, sore throat, nasofarangit, acute respiratory infections, temperature drops, otitis, Reiter’s syndrome, dry cough. These symptoms are similar to acute respiratory infections. The disease has mild symptoms and may turn into a chronic course.
Symptomatology develops slowly and may even appear several years after infection. For example, the strain Chlamydophila abortus does not manifest itself in childhood. It can be detected during pregnancy, this strain often leads to spontaneous abortions.
Diagnosis of Chlamydia in Children
Children who may potentially be infected from the mother are thoroughly examined immediately after birth. Children take scrapings from the conjunctiva of the eye to determine the presence of C. Trachomatis.
The survey must first be carried out in women who have such violations:
- inflammatory diseases of the genitals, erosive lesions of the cervix, endocervicitis, colpitis, profuse mucopurulent vaginal discharge
- infertility when not getting pregnant for 1-3 years
- pregnant women with a severe obstetric history (non-developing pregnancy, premature birth, spontaneous abortions, low birth weight children, premature babies) and a complicated course of this pregnancy (threat of termination, highhydration, fever of unclear etiology, hypertrophy of the fetus).
We emphasize that women before pregnancy should conduct a study on chlamydia, regardless of the results of a vaginal smear, because the disease is asymptomatic with a satisfactory picture of a vaginal smear. Also, a woman needs to undergo colposcopy, which suggests the presence of chlamydial infection.
Chlamydia can be diagnosed on the basis of history, assessment of the clinical symptoms of the disease, as well as laboratory research methods. Since genital chlamydia has a low symptom course, the main methods for determining the disease remain the laboratory diagnosis of this infection. It is very important for the diagnosis is the correct sampling of material for subsequent laboratory research. Laboratory tests include:
- Isolation of the pathogen in cell culture. This method is quite sensitive and specific. Is the selection of cell culture of the pathogen in the environment McCoy or HeLa.
- Serological method (determination of antibodies in the blood).
- Linked immunosorbent assay.
- Direct (with monoclonal antibodies) and indirect immunofluorescence. The method of direct immunofluorescence makes it possible to identify chlamydial inclusions in a characteristic yellow-green glow. The method of indirect detection is based on the determination of antibodies produced by the human body in response to the introduction of the pathogen virus.
- Polymerase chain reaction.
- Ligase chain reaction.
- DNA diagnostics. The material is taken directly from the source of the pathogen. The method is very sensitive.
Treatment of Chlamydia in Children
Treatment of chlamydia in children takes quite a long time. The problem of treatment is that the infection is in human cells. It is very difficult to conduct a course of treatment without damaging the internal organs. The treatment includes antibiotics, fortifying and disinfecting drugs. In the case of lesions of the respiratory tract using physiotherapy, massage, expectorant, exercise therapy. Biological preparations are prescribed to prevent dysbiosis. Patients with chlamydia, transmitted by airborne droplets, are placed in a hospital.
In the presence of infection with chlamydia of a pregnant woman, treatment is given after 12 weeks of gestation. First-line antibiotics are used – azithromycin (1 g once – with fresh urogenital chlamydia; 250 mg / day for 10 days – for the chronic process), erythromycin (0.5 g 2 times a day, 7 days). Rovamycin (0.3 g 3 times a day, 10 days), josamycin (vilprafen) (2 g 3 times a day, 10 days). Amoxicillin (1 g 3 times a day, 7 days), clindamycin (0.3 g 3 times a day). If necessary, use an alternative drug – Bactrim. Antibacterial drugs reserve – tetracyclines (not used in pregnant women and children under 8 years of age).
In the complex therapy, nystatin is prescribed (500 thousand AU 4 times a day, 7-10 days), Viferon (in candles), Wobenzym (5 tablets 3 times a day, 3 weeks).
Repeated courses are prescribed in the presence of clinical and ultrasound signs of infection in the fetus and before delivery in case of a manifest course of the disease.
A newborn born to a mother with a chlamydial infection is examined (scraping from the conjunctiva and serological reactions) at 1-3 days after delivery, in the case of a negative response if there is a clinical picture, the examination is repeated at 5-7th and 10-14th day of life. In order to prevent chlamydial infection, it is recommended that the newborn take courses of viferon and bifidumbacterin. In the presence of a clinical picture, specific antibacterial therapy is carried out.
Azithromycin (10 mg / kg on the first day of therapy and 5 mg / kg in the next 4 days) is the drug of choice for treating newborns.
Prevention of Chlamydia in Children
Chlamydia prophylaxis is the same as with other STDs. But due to the fact that the infection is widespread and asymptomatic, it is impossible to detect the virus without laboratory testing. We note a few rules of prevention:
- Sexual behavior. It is necessary to have a clear-cut attitude towards the choice of a partner, not to allow casual sex, to use a condom. But still it is worth remembering that even a condom does not provide guarantees for protection against STDs. Therefore, people who have more than one sexual partner should get tested for STDs several times a year.
- Preserving loyalty to the partner In the case of such a lifestyle, the risk of STD infection is reduced.
- Immunity support. Do not douche, do not wash the external genitalia with chlorine-containing antiseptics, as they wash out the entire microflora of the vagina, even the one that protects the mucosa from invading pathogenic microorganisms. And this indicates a decrease in immunity.
- Observance of intimate hygiene of the genital organs, regular examination by a gynecologist to determine the state of the vaginal microflora.
- A married couple who plans to conceive a child must undergo a full examination by a urologist and a gynecologist, and they must also be tested for STDs, because, even without symptoms, they can have a hidden disease. This is very important, because in case of a positive result, the spouses can be treated before conception. Not yet becoming parents, the couple is already responsible for the future person, which is the best preventive measure for the newborn.
- It is important for sexual partners to undergo treatment together, as well as with other family members. So in some cases, you have to resort to the treatment of children, parents, grandparents. Before the end of treatment, the patient should use individual hygiene items. It is important to check all family members, otherwise the patient, after a course of treatment, may re-become infected from them. With repeated infection the risk of complications increases.
Note that there is no vaccination against sexually transmitted diseases, so the best preventive measures are to comply with the above rules. Treatment of chronic chlamydia is much more difficult than the treatment of the disease in an acute form.