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Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Appendixes

Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Appendix A Sexually Transmitted Pathogens and Associated Diseases, Syndromes, and Complications

Twenty-Five Sexually Transmitted Pathogens And Associated Diseases Or Syndromes

Pathogen

Associated Disease or Syndrome

BACTERIA

 

Neisseria gonorrhoeae

Urethritis, epididymitis, proctitis, cervicitis, endometritis, salpingitis, perihepatitis, bartholinitis, pharyngitis, conjunctivitis, prepubertal vaginitis, prostatitis (?), accessory gland infection, disseminated gonococcal infection (DGI), chorio-amnionitis, premature rupture of membranes, premature delivery, amniotic infection syndrome

Chlamydia trachomatis

All of the above except DGI, plus otitis media, rhinitis, and pneumonia in infants and Reiter's syndrome

Mycoplasma hominis

Postpartum fever, salpingitis (?)

Ureaplasma urealyticum

Nongonococcal urethritis

Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Treponema pallidum

Syphilis

Gardnerella vaginalis

Bacterial ("nonspecific") vaginosis (in conjunction with Mycoplasma hominis and vaginal anaerobes, such as Mobiluncus spp)

Haemophilus ducreyi

Chancroid

Calymmatobacterium granulomatis

Donovanosis (granuloma inguinale)

Shigella spp

Shigellosis in homosexual men

Campylobacter spp

Enteritis, proctocolitis

VIRUSES

Human immunodeficiency virus, types 1 and 2

AIDS

Herpes simplex virus

Initial and recurrent genital herpes, aseptic meningitis, neonatal herpes

Human papillomavirus (more than 70 types identified)

Condyloma acuminata, laryngeal papilloma, cervical intraepithelial neoplasia and carcinoma, vaginal carcinoma, anal carcinoma, vulvar carcinoma, penile carcinoma

Hepatitis B virus

Acute hepatitis B virus infection, chronic active hepatitis, persistent (unresolved) hepatitis, polyarteritis nodosa, chronic membranous glomerulonephritis, mixed cryoglobulinemia (?), polymyalgia rheumatica (?), hepatocellular carcinoma

Hepatitis A virus

Acute hepatitis A

Cytomegalovirus

Heterophil-negative infectious mononucleosis; congenital CMV infection with gross birth defects and infant mortality, cognitive impairment (e.g., mental retardation, sensorineural deafness); protean manifestations in the immunosuppressed host

Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×

Molluscum contagiosum virus

Genital molluscum contagiosum

Human T-cell lymphotrophic virus, types I and II

Human T-cell leukemia or lymphoma

Human herpes virus type 8

Kaposi's sarcoma (?), body cavity lymphoma

PROTOZOA

Trichomonas vaginalis

Trichomonal vaginitis

Entamoeba histolytica

Amebiasis in men who have sex with men

Giardia lamblia

Giardiasis in men who have sex with men

FUNGI

Candida albicans

Vulvovaginitis, balanitis

ECTOPARASITES

Phthirus pubis

Public lice infestation

Sarcoptes scabiei

Scabies

Selected Syndromes And Complications Of Sexually Transmitted Pathogens

Syndrome or Complication

Associated Sexually Transmitted Pathogen

IN MEN

AIDS

Human immunodeficiency virus, types 1 and 2

Urethritis

Neisseria gonorrhoeae, Chlamydial trachomatis, herpes simplex virus, Ureaplasma urealyticum

Epididymitis

C. trachomatis, N. gonorrhoeae

Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×

Intestinal infections

Proctitis

N. gonorrhoeae, herpes simplex virus, C. trachomatis

Proctocolitis or enterocolitis

Campylobacter spp, Shigella spp, Entamoeba histolytica

Enteritis

Giardia lamblia

Hepatitis

Hepatitis A and B viruses, cytomegalovirus, Treponema pallidum

IN WOMEN

AIDS

Human immunodeficiency virus, types 1 and 2

Lower genitourinary tract infection

Vulvitis

Candida albicans, herpes simplex virus

Vaginitis

Trichomonas vaginalis, C. albicans

Vaginosis

Gardnerella vaginalis, Mobiluncus spp, other anaerobes, Mycoplasma hominis

Cervicitis

N. gonorrhoeae, C. trachomatis, herpes simplex virus

Urethritis

N. gonorrhoeae, C. trachomatis, herpes simplex virus

Pelvic inflammatory disease

N. gonorrhoeae, C. trachomatis, M. hominis, anaerobes, Group B streptococcus

Infertility

Postsalpingitis, postobstetrical, postabortion

N. gonorrhoeae, C. trachomatis, M. hominis (?)

Pregnancy morbidity

Several STDs have been implicated in one or more of these conditions.

Chorioamnionitis, amniotic fluid infection, prematurity, premature rupture of membranes, preterm delivery, postpartum endometritis, ectopic pregnancy

 

IN MEN AND WOMEN

Neoplasia

Human papillomavirus

Cervical, vulvar, vaginal, anal, and penile; intraepithelial neoplasia, carcinoma

 

Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×

Hepatocellular carcinoma

Hepatitis B virus

Kaposi's sarcoma, non-Hodgkin's lymphoma

Human immunodeficiency virus, types 1 and 2

Genital ulceration

Herpes simplex virus, T. palladium, Haemophilus ducreyi, Calymmatobacterium granulomatis, C. trachomatis (LGV strains)

Acute arthritis with urogenital or intestinal infection

N. gonorrhoeae, C. trachomatis, Shigella spp, Campylobacter spp

Genital warts

Human papillomavirus

Molluscum contagiosum

Molluscum contagiosum virus

Ectoparasite infestations

Sarcoptes scabiei, Phthirus pubis

Heterophil-negative mononucleosis

Cytomegalovirus, Epstein-Barr virus (some evidence for sexual transmission)

Tropical spastic paraparesis

Human T-cell lymphotrophic virus, type I

IN NEONATES AND INFANTS

TORCHES syndromea

Cytomegalovirus, herpes simplex virus, T. pallidum

Conjunctivitis

C. trachomatis, N. gonorrhoeae

Pneumonia

C. trachomatis, U. urealyticum (?)

Otitis media

C. trachomatis

Sepsis, meningitis

Group B streptococcus

Cognitive impairment, deafness

Cytomegalovirus, herpes simplex virus, T. pallidum

NOTE: For each of the above syndromes, some cases cannot yet be ascribed to any cause and must currently be considered idiopathic. An ''?" indicates a possible associated syndrome.

a TORCHES is an acronym for toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis. The syndrome consists of various combinations of encephalitis, hepatitis, dermatitis, and disseminated intravascular coagulation (DIC).

SOURCES: Cates W Jr., Holmes KK. Sexually transmitted diseases. In: Last JM, Wallace RB, eds. Maxcy-Rosenau-Last public health and preventive medicine. 13th ed. Norwalk, CT: Appleton & Lange, 1992:99-114; 121-3. Holmes KK, Handsfield HH. Sexually transmitted diseases. In: Isselbacher KJ, Braunwald E, Wilson JD, Martin JB, Fauci AS, Kasper DL, eds. Harrison's principles of internal medicine. 13th ed. New York: McGraw Hill, 1994:534-43.

Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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This page in the original is blank.
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Page 304
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Page 305
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Page 306
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Page 307
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Page 308
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Page 309
Suggested Citation:"APPENDIX A." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
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Page 310
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The Hidden Epidemic: Confronting Sexually Transmitted Diseases Get This Book
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The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission.

The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included.

The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexuality—the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame.

The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches.

The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality.

The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

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