Chlamydia trachomatis Agent Information Sheet

Research Occupational Health Program (ROHP)
Boston University
617-358-7647

Agent

Chlamydiae are small obligate intracellular parasites and were once considered to be viruses. However, they contain DNA, RNA and ribosomes and make their own proteins and nucleic acids and are now considered to be true bacteria. They possess an inner and outer membrane similar gram-negative bacteria and a lipopolysaccharide but do not have a peptidoglycan layer.

Disease/Infection

Strains of C. trachomatis can cause urogenital infections, trachoma, pneumonia and lymphogranuloma venereum (LGV), infant pneumonia, pelvic inflammatory diseases (PID), Reiter’s syndrome (oligoarthritis) and neonatal conjunctivitis.

Pathogenicity

If untreated, chlamydial infections can progress to serious reproductive and other health problems with both short-term and long-term consequences such as pelvic inflammatory disease (PID), chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). In laboratory accident settings, infections are usually manifested as conjunctivitis, however severe cases of pneumonia have occurred through exposure to aerosols. There have been six reported       cases of infection with C. trachomatis up to 1987.

Biosafety Information

Risk Group/BSL
Risk Group 2
Biosafety Level 2 Practices
Biosafety level 2 (enhanced or BSL-3 based on a full risk)

Modes of Transmission
Direct contact with discharges from infected persons, or materials soiled there with;

Host Range/Reservoir
Humans

Symptoms
C. trachomatis can cause a spectrum of clinical manifestations including genital tract infections, inclusion conjunctivitis, trachoma, pneumonia in infants, and LGV.

Some laboratory workers exposed to C. trachomatis via aerosolized mode have developed conditions including mediastinal and supraclavicular lymphadenitis, pneumonitis,

Conjunctivitis and keratitis will usually present as eye pain, photophobia, eye discharge, and impact to vision.

Meningitis occurs in association with one of the other diseases.

Incubation Period
The incubation period for the infection is 6 to 19 days for adult conjunctivitis; 5 to 12 days for trachoma.

Viability
Susceptible to 1% sodium hypochlorite, 70% ethanol, 2% glutaraldehyde, formaldehyde.

Survival Outside Host
Carcass and organs – 1 to 7 days; glass – 30 min; water (50°C) – 30 min

Information for Lab Workers

Laboratory PPE

Lab coat, gloves and eye protection must be work when direct skin contact with infected materials or animals is unavoidable. Additional PPE and practices may be recommended based on rick assessment.

All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC).

Containment

Biosafety Level 3 practices, equipment, and facility design are recommended for work with high concentration cultures, screening BSL-2 practices, containment equipment, and facilities are recommended for personnel working with clinical specimens and cultures. BSL-3 practices, containment equipment and facilities are recommended for activities involving work with culture specimens or clinical isolates known to contain or potentially be infected with LGV serovars. Laboratory work with LGV serovars can be conducted in a BSL-2 facility as long as BSL-3 practices are followed when handling potentially infectious materials including but not limited to use of primary containment such as BSC’s.

ABSL-2 practices, containment equipment, and facilities are recommended for activities with experimentally infected animals.

In Case of Exposure/Disease

• For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc…):
  • Medical Campus: call or have a coworker call the Control Center at 617-414–4144.
  • Charles River Campus: call or have a coworker call campus security at 617-353-2121.
    You will be referred to or transported to the appropriate health care location by the emergency response team.
• For lab exposures (needle sticks, bite, cut, scratch, splash, etc…) involving animals or infectious agents, or for unexplained symptoms or illness call the ROHP 24/7 hour number (1-617-358-ROHP (7647); or, 8-ROHP (7647) if calling from an on-campus location) to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.
• Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.
• Provide the wallet-size agent ID card to the physician.

Vaccination

No vaccine available

Information for First Responders/Medical Personnel

Public Health Issues

Person to person transmission is possible through direct contact with discharges from infected persons, or materials soiled therewith. Standard precautions are recommended for both conjunctivitis and pneumonia. Health care providers should immediately report to local board of health (BPHC) where the diagnosis was made.

Diagnosis/Surveillance

Diagnosis is made based on syndromic presentation and laboratory confirmation. Diagnosis of suspected site can be made by PCR based methods or culture on clinical tissue. EIA and serologies are also available.

First Aid/Post Exposure Prophylaxis

Perform one of the following actions:

Antibiotics can be given for prophylaxis with the agents listed below.

Treatment

Sensitive to doxycycline, tetracycline, erythromycin, and azithromycin. They are usually prescribed orally. Chlamydial conjunctivitis can be treated topically with tetracycline, erythromycin, and fluoroquinolones. In most cases, the infection resolves within one to two weeks.

References

Mayo Clinic; http://www.mayoclinic.com/health/chlamydia/DS00173/DSECTION=prevention

District of Columbia Fact Sheet: http://doh.dc.gov/page/chlamydia

Microbiology and Immunology, University of S. Carolina School of On-Line Medicine; http://pathmicro.med.sc.edu/mayer/chlamyd.htm

Biosafety in Microbiological and Biomedical Laboratories; Deborah E. Wilson, DrPH, CBSP Director Division of Occupational Health and Safety National Institutes of Health Bethesda, Maryland L. Casey Chosewood, M.D. Director Office of Health and Safety Centers for Disease Control and Prevention Atlanta, Georgia; US Government Printing Office, Washington DC. 5^th Edition; 2009

105 CMR: Department of Public Health, 105 CMR 300.000: Reportable Diseases, Surveillance, and Isolation and   Quarantine Requirements: https://www.mass.gov/regulations/105-CMR-30000-reportable-diseases-surveillance-and-isolation-and-quarantine-requirements

Revised: 10/30/13