Other Important STDs
As medical science has become more precise in diagnosing
infectious diseases, the list of known sexually transmitted diseases
(STDs) has grown. The National Institute of Allergy and Infectious
Diseases (NIAID) has published separate fact sheets on some of the
major STDs: chlamydial infection; gonorrhea; pelvic inflammatory
disease (PID); trichomoniasis and other vaginal infections; syphilis;
genital herpes; genital warts; and AIDS. NIAID has prepared this fact
sheet to provide information on some of the other diseases that can
be transmitted sexually:
Although some of these diseases are less well-known in the United
States than other STDs, they are still important - some are
especially significant for pregnant women. Many of these infections
are of serious concern for people in other parts of the world,
particularly in developing countries.
Chancroid ("shan-kroid") is an important bacterial infection
caused by Haemophilus ducreyi
, which is spread by sexual contact.
Periodic outbreaks of chancroid have occurred in the United States,
the last one being in the late 1980s. These outbreaks are usually
seen in minority populations in the inner cities, especially in the
southern and eastern portion of the country. Globally, this disease
is common in sub-Saharan Africa among men who have frequent contact
The infection begins with the appearance of painful open sores on
the genitals, sometimes accompanied by swollen, tender lymph nodes in
the groin. These symptoms occur within a week after exposure.
Symptoms in women are often less noticeable and may be limited to
painful urination or defecation, painful intercourse, rectal
bleeding, or vaginal discharge. Chancroid lesions may be difficult to
distinguish from ulcers caused by genital herpes or syphilis. A
physician must therefore diagnose the infection by excluding other
diseases with similar symptoms. People with chancroid can be treated
effectively with one of several antibiotics. Chancroid is one of the
genital ulcer diseases that may be associated with an increased risk
of transmission of the human immunodeficiency virus (HIV), the cause
Cytomegalovirus (CMV) is a very common virus that infects
approximately one-half of all young adults in the United States. It
rarely causes serious consequences except in people with suppressed
or impaired immune systems or in infants, whose immune systems are
still developing. The virus, a member of the herpesvirus family, is
found in saliva, urine, and other bodily fluids. Because it is often
found in semen as well as in cervical secretions, the virus can be
spread by sexual contact; it also can be easily spread by other forms
of physical contact such as kissing. Day-care center staff for
children under the age of 3 are at increased risk of CMV infection
and should carefully wash their hands after changing diapers. Like
other herpesvirus infections, CMV is incurable; people are infected
with it for life. Although the virus usually remains in an inactive
state, it can reactivate from time to time.
Symptoms. In healthy adults, CMV usually produces no symptoms of
infection. Occasionally, however, mild symptoms of swollen lymph
glands, fever, and fatigue may occur. These symptoms may be similar
to those of infectious mononucleosis.
Diagnosis. The ELISA (enzyme-linked immunosorbent assay) test is
commonly used to detect levels of antibodies (disease-fighting
proteins of the immune system) in the blood. A number of other blood
tests can suggest a diagnosis of CMV infection, but no blood test can
reliably diagnose it. Although CMV can be isolated from urine or
other body fluids, it may be excreted months or years after an
infection; therefore, isolation of the virus from these fluids is not
a reliable method of diagnosing recent infection.
Complications. Babies can be infected with CMV in the uterus if
their mothers become infected with the virus or develop a recurrence
of a previous infection during pregnancy. Although most babies
infected with CMV before birth do not develop any symptoms, CMV is
the leading cause of congenital infection in the United States. An
estimated 6,000 babies each year develop life-threatening
complications of congenital CMV infection at birth or suffer serious
consequences later in life, including mental retardation, blindness,
deafness, or epilepsy. Investigators supported by NIAID are currently
studying how the virus interferes with normal fetal development and
at which stages the fetus is most susceptible to infection.
Congenital CMV is the most common cause of progressive deafness in
When CMV is acquired after birth, or if it reactivates, it can be
life-threatening for persons with suppressed immune systems, such as
those receiving chemotherapy or persons who have received
immunosuppressant drugs for organ transplantation. Persons with HIV
infection or AIDS may develop severe CMV infections, including CMV
retinitis, an eye disease that can lead to blindness.
Treatment. NIAID scientists are testing new antiviral drugs that
might be effective against CMV infections. The antiviral drugs
foscarnet and ganciclovir have been approved for treating people with
AIDS-associated CMV retinitis.
This common viral infection most often affects young children, who
pass it to each other through saliva. In adults, however, the virus
is transmitted sexually, resulting in lesions on the genitals, lower
abdomen, buttocks, or inner thighs. Most people with the infection do
not have noticeable symptoms, although sometimes the lesions, which
are painless wart-like bumps, may itch or become irritated. The
lesions often heal without treatment, although physicians may
sometimes scrape them off or treat them with chemical irritants.
Pubic lice (pediculosis pubis or crab lice) are very tiny insects
that infest the pubic hair and survive by feeding on human blood.
These parasites are most often spread by sexual contact; in a few
cases, they may be picked up through contact with infested bedding or
clothing. An estimated 3 million people with new cases of the
infestation are treated each year in the United States.
Symptoms. The primary symptom of infestation is itching in the
pubic area. Scratching may spread the lice to other parts of the
body; thus, every effort should be made to avoid touching the
infected area, although this may be difficult.
Diagnosis. Pubic lice are diagnosed easily because they are
visible to the naked eye. They are pinhead size, oval in shape, and
grayish, but appear reddish-brown when full of blood from their host.
Nits, the tiny white eggs, also are visible and usually are observed
clinging to the base of pubic hair.
Treatment. Lotions and shampoos that will kill pubic lice are
available both over the counter and by prescription. Creams or
lotions containing lindane, a powerful pesticide, are most frequently
prescribed for the treatment of pubic lice. Pregnant women may be
advised not to use this drug, and a physician's recommendations for
use in infants and small children should be followed carefully.
Itching may persist even after the lice have been eradicated. This is
because the skin has been irritated and requires time to heal. A
soothing lotion such as calamine may offer temporary relief.
Prevention. All persons with whom an infested individual has come
into close contact, including family and close friends as well as sex
partners, should be treated to ensure that the lice have been
eliminated. In addition, all clothing and bedding should be
dry-cleaned or washed in very hot water (125? F), dried at a high
setting, and ironed to rid them of any lice. Pubic lice die within 24
hours of being separated from the body. Because the eggs may live up
to six days, it is important to apply the treatment for the full time
Scabies is a skin infestation with a tiny mite, Sarcoptes scabiei
Scabies has become relatively common throughout the general
population. It is highly contagious and is spread primarily through
sexual contact, although it also is commonly transmitted by contact
with skin, infested sheets, towels, or even furniture.
Symptoms. Scabies causes intense itching, which often becomes
worse at night. Small red bumps or lines appear on the body at sites
where the female scabies mite has burrowed into the skin to lay her
eggs. The areas most commonly affected include the hands (especially
between the fingers), wrists, elbows, lower abdomen, and genitals.
The skin reaction may not develop until a month or more after
infestation. During this time, a person may pass the disease
unknowingly to a sex partner or to another person with whom he or she
has close contact.
Diagnosis. Scabies may be confused with other skin irritations
such as poison ivy or eczema. To make an accurate diagnosis, a doctor
takes a scraping of the irritated area and examines it under a
microscope, to reveal the presence of the mite.
Treatment. As with pubic lice, lindane is an effective treatment
for scabies. Pregnant women should consult a doctor before using this
product. Nonprescription remedies such as sulfur ointment also are
available. Sulfur is fairly effective but may be objectionable
because of its odor and messiness. Itching can persist even after the
infestation has been eliminated because of lingering skin irritation.
A hydrocortisone cream or ointment or a soothing lotion may provide
relief from itching.
Prevention. Family members and sex partners of a person with
scabies are advised to undergo treatment. Twenty-four hours after
drug therapy, a person with scabies infestation is no longer
contagious to others, even though the skin irritation may persist for
some time. As with pubic lice, special care must be taken to rid
clothing and bedding of any mites.
Human T-Cell Lymphotropic Virus
The human T-cell lymphotropic viruses (retroviruses), HTLV-I and
HTLV-II, are uncommon in the general U.S. population. They appear to
be most prevalent among IV drug users and persons who have multiple
sex partners, genital ulcers, or a history of syphilis. The virus can
be transmitted by blood or intimate sexual contact, and can be passed
from mother to child during pregnancy and through breast milk.
Most infected persons remain healthy carriers of the virus. In
rare cases, however, HTLV-I can cause adult T-cell leukemia/lymphoma
(ATL), a rare and aggressive cancer of the blood. Infected persons
also may develop myelopathy, a neurologic disorder that affects the
muscles in the legs. In addition, researchers think that HTLV-I plays
a role in the development of B-cell chronic lymphocytic leukemia.
HTLV-II can cause another rare cancer called hairy-cell leukemia.
Because the chances of curing ATL rely on early detection, scientists
are studying protein in the blood of HTLV-I-infected persons that may
help predict who will develop the disease.
Blood donations are screened routinely for HTLV-I. Because lab
tests cannot easily distinguish between HTLV-I and HTLV-II, experts
believe many cases of HTLV-II are eliminated from the blood supply as
Note: All information is based upon materials published by the National
Institute of Allergy and Infectious Diseases (NIAD).