SAS Urban Survival Handbook (125 page)

HERPES

Not necessarily an STD but the general name for a group of viruses, of which herpes zoster (see
Chicken pox
) and herpes simplex are the most significant. Herpes zoster is also the virus which causes shingles. Most people carry HSV1 (herpes simplex virus type 1) and may develop cold sores and, in some cases, genital herpes. HSV2 more commonly leads to genital herpes.

SYMPTOMS
Pain, burning or itching in the affected area, followed by the development of sore red skin eruptions or blisters, which burst to form small painful ulcers. In a severe attack, glands in the groin may become swollen and painful, and there may be a fever. There may be pain on passing urine if the tip of the penis or the vagina are affected. The sores may appear anywhere on the body, provoked (it is believed) by stress, poor health, illness with fever, even by overheating in the sun.

ACTION
Seek medical attention. There is little or no treatment, except to avoid disturbing the sores—the virus is highly contagious. If the sores become infected, antibiotic drugs may be prescribed. Anti-viral drugs may be prescribed in severe cases. Kissing or sexual contact should be avoided during an attack, and for a week afterwards.

WARNING A severe attack may be life-threatening, especially if the eyes or the brain become affected. Seek urgent medical attention. A baby might become infected, if the mother has an attack at the time of childbirth. People who are HIV positive should avoid all forms of herpes, if possible. The consequences could be severe.

GENITAL WARTS

Soft warts which grow in and around the anus or the vagina, or on the penis. Genital warts are caused by a virus and spread through sexual contact with an infected person. However, it may take as long as twelve months after the initial contact for the warts to appear.

ACTION
Seek medical attention. Genital warts are usually painless and can be removed by simple surgery or the application of ointment, but tend to recur. Some may spontaneously disappear. Sometimes, however, clusters of warts may develop, causing great discomfort.

REMEMBER
Links are suspected between genital warts and cervical cancer (see
Cancer
). This makes doubly important the need for cervival smear tests for any woman who has had genital warts.

GONORRHOEA

Also known as ‘the clap’, it is spread primarily by sexual intercourse (including vaginal, anal and oral sex) and from mother to baby during childbirth. It is one of the most common STDs and, once detected (incubation period is less than two weeks), can usually be ‘cured’ very quickly and simply. Current safe sex practices (using condoms) should reduce the incidence statistics—if they are followed!

SYMPTOMS
Discharge from vagina/penis and pain on passing urine. More than half of women infected have no symptoms. If the anus is infected, the rectum and anus may become inflamed and a discharge may be apparent on the faeces. After oral sex a ‘sore’ throat may develop. In babies it causes an inflammation of one or both eyes.

ACTION
Seek medical attention. Antibiotics, usually penicillin, are administered. After treatment, further tests confirm eradication of the infection. Sexual partners are normally traced confidentially through STD clinics and told they may have gonorrhoea to prevent reinfection or spreading of the disease.

WARNING Gonorrhoea must be treated as early as possible to prevent it from spreading to other parts of the body. In men, it may cause inflammation of the testes and prostate, affecting fertility. In women it can spread to the fallopian tubes and cause pelvic inflammatory disease, with a risk of a misplaced (ectopic) pregnancy. It can also affect female fertility. If untreated gonorrhoea is allowed to spread through the system, a form of arthritis may develop—leading to painful and swollen joints. There may also be chronic blood poisoning which (very rarely) can affect the major organs (brain and heart) and lead to death.

NONSPECIFIC URETHRITIS (NSU)

An inflammation of the urethra, which may not have an identifiable cause. Most cases are caused by bacteria or viruses. This is the most common type of STD worldwide, affecting men and women.

SYMPTOMS
In men, there may be a clear or pus-filled discharge and pain on passing urine. Symptoms are sometimes absent. In women, there are usually no symptoms unless there are complications.

ACTION
Tests are made to identify the cause of the infection, but this can be difficult as there are so many possible causes. For women, diagnosis often relies on the fact that a partner has the condition and may have passed it on. Both partners should be treated with antibiotics. Most cases can be ‘cured’, but infection/symptoms commonly recur. Follow the full course of medication and seek further attention if the problem persists.

PUBIC LICE

Also known as crab lice or ‘crabs’. An infestation of
Phthirus pubis
—a small insect that lives at the base of pubic hairs and feeds on the host’s blood. They are very easily transferred during sexual contact.

SYMPTOMS
Pubic lice are usually felt (as pinching or itching) and seen (as small dark ‘spots’). The females lay tiny eggs which are also visible to the naked eye. On hairy men they may also be found in body hair, on the legs, arms and even on the face or head. Parents may transmit lice to their children. It is said that, if exposed to cold air or water, one can feel the lice ‘tighten their grip’!

ACTION
Seek medical attention. Insecticide lotion containing benzyl benzoate or lindone (to kill eggs as well) should be applied. More than one treatment may be required to kill all the eggs. Sexual partners should also be treated. Clothes, sheets and blankets should be washed in very hot water.

REMEMBER
Other body parasites such as scabies, and fungi such as ringworm, may be spread by sexual contact.

SYPHILIS

Usually transmitted sexually during intercourse, less commonly by kissing, mutual masturbation or by contact with items soiled by an infected person. Traditionally viewed as life-threatening, syphilis responds well to antibiotics—although the sooner it is recognized, the better. Syphilis is caused by the bacterium
Treponema pallidum,
which has access through breaks in the skin or through membranous tissues of the genitals, anus or mouth. Since mothers-to-be are now screened, congenital syphilis is rare.

There is a 30 per cent chance of contracting the disease after contact with an infected person.

SYMPTOMS
Three to four weeks after contact, a painless ulcer with a wet base, up to 1 cm (1/2 in) across, appears on the site of the infection—genitals, anus, rectum, lips, throat, and sometimes on the fingers. This heals within four to eight weeks. At six to twelve weeks, there may be a skin rash. In white people this takes the form of noticeable crops of pinkish round spots. In black people, the rash is pigmented and appears darker than the surrounding skin. Other symptoms include fever, fatigue, headaches, ‘aching bones’ and loss of appetite. Scalp hair may fall out. Infectious pinky-grey patches can develop on moist skin areas.

Latent syphilis:
This stage of the disease may persist for years or even indefinitely. The infected person appears to be quite ‘healthy’, but a few cases (if untreated) may lead in time to tertiary syphilis.

Tertiary syphilis:
This stage can take as many as 25 years to develop—perhaps as few as three. The effects will vary from one individual to another. Tissue death or breakdown of any parts of the body may occur. Other effects of tertiary syphilis include cardiovascular syphilis (which can lead to heart valve disease) and neurosyphilis (with progressive brain/spinal cord damage and general paralysis).

ACTION
Seek medical attention. All stages of the disease respond to treatment with penicillin, but any organ damage (which only occurs in the later stages) is irreversible. As treatment begins, there may be flu-like symptoms and tender lymph nodes. Regular check-ups should follow to confirm that the infection has been dealt with. It will show up (harmlessly) in the blood for many years.

REMEMBER
The first and second stages of the disease are infectious, the latent and tertiary stages are not. Measures to avoid contracting syphilis include practising safe sex. Confidential contact tracing means that others who may have become infected can be informed and treated. Some may have no symptoms and may spread the disease, unwittingly, to others.

HEPATITIS B

Viral disease, resulting in inflammation of the liver. It may be extremely serious, with damage to or death of liver cells. People in obvious high-risk groups—those with many sexual partners, intravenous drug users and their partners, prostitutes and their clients, doctors and nurses—should seek advice. There is a vaccine available.

SYMPTOMS
Begins as a flu-like illness (which may be severe and debilitating) and leads eventually to jaundice—yellowing of the skin. In rare cases, if not treated, liver failure may occur, leading to death.

ACTION
Treat as a very serious illness. Seek urgent medical attention.

WARNING A baby born to a carrier mother may be at severe risk. Antenatal screening is advisable. There is no risk from contaminated blood products. Blood is screened and/or heat treated to remove the risk.

PARASITES

Numerous organisms may live in or on humans. Not all spend their entire life with the host—some are just ‘passing through’! Some bring serious diseases, whereas others may cause few noticeable symptoms.

About 30
protozoa
may ‘inhabit’ humans—many causing serious conditions such as amoebic dysentery, malaria and toxoplasmosis.
Fungi
are fairly simple parasites and may only cause simple skin infections, such as ringworm. Others may invade the lungs or other body tissues and leads to serious illness or even death.

Many
bacteria
are essential within the human body, others are ‘invaders’ causing diseases such as pneumonia, meningitis and skin disorders. Many are well-known and deadly—salmonella, for example.

Even
viruses
are parasites. There are many types of virus—the smallest known disease agents (about 100th the size of the smallest bacterium)—leading to some very well-known illnesses from the common cold to warts, from rabies to viral hepatitis, from AIDS to polio—and all the common childhood diseases from mumps to measles. Immunization programmes exist to combat many viruses.

WORMS

Many people are embarrassed by the very idea of having ‘worms’, but most humans have at least one type of worm in their lifetime. These may live in the gut, in bile ducts, or in blood vessels. Many produce eggs which are excreted by the host.

Liver flukes
infest the bile ducts of the liver and have a bizarre life cycle. They normally infest sheep and lay eggs which are excreted in the faeces. The eggs are then eaten by snails, hatch and emerge as immature flukes which are passed on to water flora—including watercress. In the Far East, liver flukes may be ingested by humans in raw or undercooked freshwater fish. In the early stages of infestation there may be rashes, night sweats, liver enlargement and tenderness. Later, jaundice may develop.

The largest types of
tapeworm
usually occur in regions where there is inadequate sewage disposal and unhygienic preparation of meat for food. Animals may play intermediate host, humans ingesting the larvae from undercooked meat. The largest tapeworms may be 9m (over 29 ft) long! They attach themselves to the wall of the intestine and trail throughout it.

The
dwarf tapeworm
is only 2.5 cm (1 in) long and found worldwide, especially in tropical regions, and is usually caught from an infested person or in insanitary conditions. The eggs pass out in faeces and may be ingested by hand-to-mouth contact. In central and Western Europe, Australia and New Zealand there is a rare but serious illness involving cyst formation in the lungs and other tissues. The cause is the larva of a small tapeworm, which relies on sheep and dogs to complete its life cycle.

Roundworms
such as threadworms and hookworms are fairly common worldwide. Many cases of infestation don’t cause any noticeable symptoms, unless there are large numbers of worms.