Obama to remove infectious STDs from the list of diseases preventing admission of immigrants into the U.S. – Please HELP!


I am seriously concerned by the agenda this Administration has embarked upon
which evidences a total disregard for the health advancements accomplished in
America and the hard work of scientists and doctors of all disciplines towards
elimination of diseases in America.

The Obama Administration will announce on Tuesday, May 3, 2016 that the
following three (3) sexually transmitted diseases, common in third-world
countries, will no longer be considered as cause for denying immigrants entry
into the United States.

Considering the huge influx of immigrants and refugees into the U.S. from
third-world countries rift with these diseases and the fact that those immigrants
will congregate in communities of those with similar backgrounds and origins
as their own plus the low sexual mores of those from third-world
countries and the poor quality and availability of medical care in those
countries and we have the makings of a massive resurgence of STDs in America.

That in its self is bad enough, but, add to that the very poor record this Admin-
istration has for funding and enforcement of laws, edicts, demands, etc. and we
have the makings of a pandemic of sexually transmitted disease running wild
here in the U.S.

Those diseases won’t stay in the immigrant/refugee neighborhoods because
of the “welcome and accept” attitudes of most young Americans who will
surely have promiscuous relations with infected persons without protection
and end up helping to spread these diseases throughout the United States.

We must insist that these diseases continue to be cause for barring immigrants
from entry into the U.S. I think Hepatitis should be added to the list as well as
Tuberculosis.

PLEASE contact all three of your members of Congress and warn them that if
they refuse to block this horrendous move by Obama you will never vote for
them again. This is an election years and every single on of them is scared to
death they won’t be reelected (unconstitutionally) and will do things now to
insure they do get reelected that the would not do at other time.

Act now and be forceful in your demands. Surely you don’t want to risk having
members of your family becoming infected with these STDs!

Joseph D. Hollinger
God Bless Ameirca
Protect the Constitution at any cost!

Chancroid

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/chancroid

Chancroid at a Glance

  • A sexually transmitted disease (STD)
  • Common symptoms include sores on the genitals
  • Treatment is available
  • Easily spread
  • Condoms reduce your risk of infection

– See more at: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/chancroid#sthash.cxkqy5Yl.dpuf

Granuloma Inguinale (Donovanosis)

http://www.cdc.gov/std/tg2015/donovanosis.htm

Granuloma inguinale is a genital ulcerative disease caused by the intracellular
gram-negative bacterium Klebsiella granulomatis (formerly known as
Calymmatobacterium granulomatis
). The disease occurs rarely in the United
States, although it is endemic in some tropical and developing areas, including
India; Papua, New Guinea; the Caribbean; central Australia; and southern
Africa (383-385). Clinically, the disease is commonly characterized as painless,
slowly progressive ulcerative lesions on the genitals or perineum without
regional lymphadenopathy; subcutaneous granulomas (pseudobuboes) also
might occur. The lesions are highly vascular (i.e., beefy red appearance) and
bleed. Extragenital infection can occur with extension of infection to the pelvis,
or it can disseminate to intra-abdominal organs, bones, or the mouth. The
lesions also can develop secondary bacterial infection and can coexist with
other sexually transmitted pathogens.

Follow-up

Patients should be followed clinically until signs and symptoms resolve.

Management of Sex Partners

Persons who have had sexual contact with a patient who has granuloma
inguinale within the 60 days before onset of the patient’s symptoms should
be examined and offered therapy. However, the value of empiric therapy in
the absence of clinical signs and symptoms has not been established.

Lymphogranuloma Venereum (LGV)

http://www.cdc.gov/std/tg2015/lgv.htm

Lymphogranuloma venereum (LGV) is caused by C. trachomatis serovars L1,
L2, or L3 (386,387). The most common clinical manifestation of LGV among
heterosexuals is tender inguinal and/or femoral lymphadenopathy that is
typically unilateral. A self-limited genital ulcer or papule sometimes occurs
at the site of inoculation. However, by the time patients seek care, the lesions
have often disappeared. Rectal exposure in women or MSM can result in
proctocolitis mimicking inflammatory bowel disease, and clinical findings may
include mucoid and/or hemorrhagic rectal discharge, anal pain, constipation,
fever, and/or tenesmus (388,389). Outbreaks of LGV protocolitis have been
reported among MSM (390-392). LGV can be an invasive, systemic infection,
and if it is not treated early, LGV proctocolitis can lead to chronic colorectal
fistulas and strictures; reactive arthropathy has also been reported. However,
reports indicate that rectal LGV can be asymptomatic (393). Persons with
genital and colorectal LGV lesions can also develop secondary bacterial
infection or can be coinfected with other sexually and nonsexually
transmitted pathogens.

Follow-up

Patients should be followed clinically until signs and symptoms resolve.

Management of Sex Partners

Persons who have had sexual contact with a patient who has LGV within the
60 days before onset of the patient’s symptoms should be examined and
tested for urethral, cervical, or rectal chlamydial infection depending on
anatomic site of exposure. They should be presumptively treated with a
chlamydia regimen (azithromycin 1 g orally single dose or doxycycline 100
mg orally twice a day for 7 days).

Chancroid at a Glance

  • A sexually transmitted disease (STD)
  • Common symptoms include sores on the genitals
  • Treatment is available
  • Easily spread
  • Condoms reduce your risk of infection

– See more at: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/chancroid#sthash.cxkqy5Yl.dpuf

Chancroid at a Glance

  • A sexually transmitted disease (STD)
  • Common symptoms include sores on the genitals
  • Treatment is available
  • Easily spread
  • Condoms reduce your risk of infection

– See more at: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/chancroid#sthash.cxkqy5Yl.dpuf

Chancroid at a Glance

  • A sexually transmitted disease (STD)
  • Common symptoms include sores on the genitals
  • Treatment is available
  • Easily spread
  • Condoms reduce your risk of infection

– See more at: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/chancroid#sthash.cxkqy5Yl.dpuf
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Chancroid

Planned Parenthood STD Chancroid

STDs

Chancroid at a Glance

  • A sexually transmitted disease (STD)
  • Common symptoms include sores on the genitals
  • Treatment is available
  • Easily spread
  • Condoms reduce your risk of infection

Want to get tested for chancroid?Find a Health Center

STDs are very common. But we can protect ourselves and each other from STDs like chancroid. Learning more about chancroid is an important first step.

Here are some of the most common questions we hear people ask about chancroid. We hope you find the answers helpful, whether you think you may have chancroid, have been diagnosed with it, or are just curious about it.

Expand All

What Is Chancroid?

Because chancroid is not common, many people are not sure what it is. Chancroid (SHANG-kroid) is a type of bacteria that is transmitted through sexual contact. It causes sores on the genitals.

Chancroid was once common in the United States, but now it is rare. It is more common in men than in women.

What Are the Symptoms of Chancroid?

Chancroid symptoms usually appear about 4–10 days after infection. Chancroid symptoms may include

  • Open sores, usually on the penis, rectum, and vulva — especially around the opening to the vagina. Sores may produce pus and be painful.
  • Swollen glands in the groin.

How Can I Know If I Have Chancroid?

Only a health care provider can diagnose chancroid. Chancroid symptoms can be confused with other infections, such as herpes and syphilis. Your health care provider will examine the discharge from the sore with a microscope to make a diagnosis.

Is There a Treatment for Chancroid?

Chancroid is easily treated with antibiotics. Both you and your partner should be treated at the same time.

Where Can I Get a Test or Treatment for Chancroid?

Staff at your local Planned Parenthood health center, many other clinics, health departments, and private health care providers can diagnose chancroid and help you get any treatment you may need.

Want to get tested for chancroid?Find a Health Center

How Is Chancroid Spread?

Chancroid is spread through skin-to-skin contact during sex play. People can also spread chancroid from one place to another on their bodies if they touch the sores.

How Can I Prevent Getting or Spreading Chancroid?

There are several ways to help prevent getting chancroid or spreading it to other people:

  • You can abstain from vaginal and anal intercourse, and oral sex.
  • If you choose to have vaginal or anal intercourse, use female or latex condoms every time.
  • If you choose to have oral sex, use a condom, Glyde dam, or dental dam.
  • Avoid touching the chancroid sores. If you do touch one, carefully wash your hands to reduce the risk that you spread the infection to another part of your body.

Chancroid and HIV

Chancroid sores may make it easier to contract HIV. If you are at risk for HIV and have a chancroid sore, it is especially important to abstain from sex play. If you do have sex, you can reduce your risk of getting HIV and other STDs by using latex or female condoms.

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Find Dr. Cullins’ Answers to Common Sexual Health Questions

Q&A with Dr. Cullins

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Treatment Sexually Transmitted Diseases

Granuloma Inguinale (Donovanosis)

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Granuloma inguinale is a genital ulcerative disease caused by the intracellular gram-negative bacterium Klebsiella granulomatis (formerly known as Calymmatobacterium granulomatis). The disease occurs rarely in the United States, although it is endemic in some tropical and developing areas, including India; Papua, New Guinea; the Caribbean; central Australia; and southern Africa (383-385). Clinically, the disease is commonly characterized as painless, slowly progressive ulcerative lesions on the genitals or perineum without regional lymphadenopathy; subcutaneous granulomas (pseudobuboes) also might occur. The lesions are highly vascular (i.e., beefy red appearance) and bleed. Extragenital infection can occur with extension of infection to the pelvis, or it can disseminate to intra-abdominal organs, bones, or the mouth. The lesions also can develop secondary bacterial infection and can coexist with other sexually transmitted pathogens.

Diagnostic Considerations

The causative organism of granuloma inguinale is difficult to culture, and diagnosis requires visualization of dark-staining Donovan bodies on tissue crush preparation or biopsy. No FDA-cleared molecular tests for the detection of K. granulomatis DNA exist, but such an assay might be useful when undertaken by laboratories that have conducted a CLIA verification study.

Treatment

Several antimicrobial regimens have been effective, but only a limited number of controlled trials have been published (383). Treatment has been shown to halt progression of lesions, and healing typically proceeds inward from the ulcer margins; prolonged therapy is usually required to permit granulation and re-epithelialization of the ulcers. Relapse can occur 6–18 months after apparently effective therapy.

Recommended Regimen

  • Azithromycin 1 g orally once per week or 500 mg daily for at least 3 weeks and until all lesions have completely healed

Alternative Regimens

  • Doxycycline 100 mg orally twice a day for at least 3 weeks and until all lesions have completely healed
    OR
  • Ciprofloxacin 750 mg orally twice a day for at least 3 weeks and until all lesions have completely healed
    OR
  • Erythromycin base 500 mg orally four times a day for at least 3 weeks and until all lesions have completely healed
    OR
  • Trimethoprim-sulfamethoxazole one double-strength (160 mg/800 mg) tablet orally twice a day for at least 3 weeks and until all lesions have completely healed

The addition of another antibiotic to these regimens can be considered if improvement is not evident within the first few days of therapy. Addition of an aminoglycoside to these regimens is an option (gentamicin 1 mg/kg IV every 8 hours).

Other Management Considerations

Persons should be followed clinically until signs and symptoms have resolved. All persons who receive a diagnosis of granuloma inguinale should be tested for HIV.

Follow-up

Patients should be followed clinically until signs and symptoms resolve.

Management of Sex Partners

Persons who have had sexual contact with a patient who has granuloma inguinale within the 60 days before onset of the patient’s symptoms should be examined and offered therapy. However, the value of empiric therapy in the absence of clinical signs and symptoms has not been established.

Special Considerations

Pregnancy

Doxycycline should be avoided in the second and third trimester of pregnancy because of the risk for discoloration of teeth and bones, but is compatible with breastfeeding (317). Data suggest that ciprofloxacin presents a low risk to the fetus during pregnancy (317). Sulfonamides are associated with rare but serious kernicterus in those with G6PD deficiency and should be avoided in third trimester and during breastfeeding (317). For these reasons, pregnant and lactating women should be treated with a macrolide regimen (erythromycin or azithromycin). The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.

HIV Infection

Persons with both granuloma inguinale and HIV infection should receive the same regimens as those who do not have HIV infection. The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.

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Lymphogranuloma Venereum (LGV)

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Lymphogranuloma venereum (LGV) is caused by C. trachomatis serovars L1, L2, or L3 (386,387). The most common clinical manifestation of LGV among heterosexuals is tender inguinal and/or femoral lymphadenopathy that is typically unilateral. A self-limited genital ulcer or papule sometimes occurs at the site of inoculation. However, by the time patients seek care, the lesions have often disappeared. Rectal exposure in women or MSM can result in proctocolitis mimicking inflammatory bowel disease, and clinical findings may include mucoid and/or hemorrhagic rectal discharge, anal pain, constipation, fever, and/or tenesmus (388,389). Outbreaks of LGV protocolitis have been reported among MSM (390-392). LGV can be an invasive, systemic infection, and if it is not treated early, LGV proctocolitis can lead to chronic colorectal fistulas and strictures; reactive arthropathy has also been reported. However, reports indicate that rectal LGV can be asymptomatic (393). Persons with genital and colorectal LGV lesions can also develop secondary bacterial infection or can be coinfected with other sexually and nonsexually transmitted pathogens.

Diagnostic Considerations

Diagnosis is based on clinical suspicion, epidemiologic information, and the exclusion of other etiologies for proctocolitis, inguinal lymphadenopathy, or genital or rectal ulcers. Genital lesions, rectal specimens, and lymph node specimens (i.e., lesion swab or bubo aspirate) can be tested for C. trachomatis by culture, direct immunofluorescence, or nucleic acid detection (394). NAATs for C. trachomatis perform well on rectal specimens, but are not FDA-cleared for this purpose. Many laboratories have performed the CLIA validation studies needed to provide results from rectal specimens for clinical management. MSM presenting with protocolitis should be tested for chlamydia; NAAT performed on rectal specimens is the preferred approach to testing.

Additional molecular procedures (e.g., PCR-based genotyping) can be used to differentiate LGV from non-LGV C. trachomatis in rectal specimens. However, they are not widely available, and results are not available in a timeframe that would influence clinical management.

Chlamydia serology (complement fixation titers >1:64 or microimmunofluorescence titers >1:256) might support the diagnosis of LGV in the appropriate clinical context. Comparative data between types of serologic tests are lacking, and the diagnostic utility of these older serologic methods has not been established. Serologic test interpretation for LGV is not standardized, tests have not been validated for clinical proctitis presentations, and C. trachomatis serovar-specific serologic tests are not widely available.

Treatment

At the time of the initial visit (before diagnostic tests for chlamydia are available), persons with a clinical syndrome consistent with LGV, including proctocolitis or genital ulcer disease with lymphadenopathy, should be presumptively treated for LGV. As required by state law, these cases should be reported to the health department.

Treatment cures infection and prevents ongoing tissue damage, although tissue reaction to the infection can result in scarring. Buboes might require aspiration through intact skin or incision and drainage to prevent the formation of inguinal/femoral ulcerations.

Recommended Regimen

  • Doxycycline 100 mg orally twice a day for 21 days

Alternative Regimen

  • Erythromycin base 500 mg orally four times a day for 21 days

Although clinical data are lacking, azithromycin 1 g orally once weekly for 3 weeks is probably effective based on its chlamydial antimicrobial activity. Fluoroquinolone-based treatments also might be effective, but the optimal duration of treatment has not been evaluated.

Other Management Considerations

Patients should be followed clinically until signs and symptoms have resolved. Persons who receive an LGV diagnosis should be tested for other STDs, especially HIV, gonorrhea, and syphilis. Those who test positive for another infection should be referred for or provided with appropriate care and treatment.

Follow-up

Patients should be followed clinically until signs and symptoms resolve.

Management of Sex Partners

Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined and tested for urethral, cervical, or rectal chlamydial infection depending on anatomic site of exposure. They should be presumptively treated with a chlamydia regimen (azithromycin 1 g orally single dose or doxycycline 100 mg orally twice a day for 7 days).

Special Considerations

Pregnancy

Pregnant and lactating women should be treated with erythromycin. Doxycycline should be avoided in the second and third trimester of pregnancy because of risk for discoloration of teeth and bones, but is compatible with breastfeeding (317). Azithromycin might prove useful for treatment of LGV in pregnancy, but no published data are available regarding an effective dose and duration of treatment.

HIV Infection

Persons with both LGV and HIV infection should receive the same regimens as those who are HIV negative. Prolonged therapy might be required, and delay in resolution of symptoms might occur.

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