extremities. About one-half of the infections occur without an obvious rash.
Congenital rubella causes defects of the developing fetus of pregnant women with rubella. Approximately 25 percent of infants born to women with rubella during the first trimester of pregnancy are affected.
Rubella occurs worldwide and is endemic almost everywhere except in remote isolated communities. This disease occurs most often in the winter and spring. It is a disease of childhood in unvaccinated populations and of adolescents and adults in populations where children are immunized.
The infectious agent is the rubella virus. The reservoir is man. Rubella is transmitted when susceptible persons contact nasopharyngeal discharges from infected persons. When susceptible persons live under crowded conditions, e.g., military recruits, all susceptible unimmunized persons will probably be infected if the virus is introduced.
The average incubation period is about 18 days. Rubella is communicable from about a week prior to the appearance of a rash until about 4 days after the appearance. There is no specific medical treatment for rubella.
Preventive measures are primarily concerned with the immunization of susceptible persons. Immunization with one dose of live attenuated rubella virus vaccine produces a long-lasting immunity in about 95 percent of all susceptible persons. It is recommended that all children receive a vaccine of combined rubella/measles at about 15 months of age. Emphasis should also be placed on immunizing susceptible adolescent and adult females, because rubella continues to occur in women of childbearing age. However, pregnant women should not be vaccinated.
In hospitals or institutions, when a patient is suspected of having rubella, isolation in a private room is recommended. Every attempt should be made to prevent exposing nonimmune pregnant women to rubella. Children should be kept home from school and adults should not go to work for 7 days after the onset of a rash.
Sexually Transmitted Diseases
Sexually transmitted diseases (STDs) are among the most common communicable diseases. Because of embarrassment or lack of education, a great many cases go unreported and untreated. Changes in sexual behavior, and the fact that many people are asymptomatic carriers, have added to the problems of control.
A hospital corpsman will havre the responsibility of recognizing cases of sexually transmitted disease in the sickcall environment, initiating laboratory procedures to confirm the diagnosis, and educating personnel in recognizing the signs of sexually transmitted disease and the best way to avoid infection.
This section will deal with the most common types of sexually transmitted diseases: gonorrhea, nongonnococcal urethritis, syphilis, and genital herpes. There are many other less common sexually transmitted diseases that are not covered here. Current medical journals and books are a good source of information, in addition to current Naval texts and Instructions.
Each STD case should be interviewed by a contact interviewer trained by preventive medicine personnel. Information gained from the interviewer should be recorded on the Venereal Disease Epidemiologic Report Form, CDC Form 9.2936A, and be forwarded to the appropriate agency. The Interviewer ’s Aid for VD Contact Investigation, NAVMED P-5036, contains guidance for conducting interviews. NAVMEDCOMNOTE 6222 series contains specific treatment requirements for sexually transmitted diseases.
Chlamydial Genital Infections
This infection causes urethritis in males and cervicitis in females. Clinically, in males the urethritis produces an opaque discharge of scanty or moderate quantity and urethral burning or itching on urination. Asymptomatic infections occur in 1 to 10 percent of sexually active men. In females, clinical symptoms similar to gonorrhea include inflammation and infection of the uterine cervix. Complications are infections of tube/ ovaries with risk of infertility. Diagnosis of nongonnococcal urethritis or cervicitis is usually based on the failure to denlonstrate Neisseriu gonorrhoeae on culture.
The infectious agent is Chlamidia trachomatis. The reservoir is man. The incubation period is 5 to 10 days or longer. Chlamydial genital in feetions are transmitted through sexual contact. The period of communicability is unknown. The specific treatment is tetracycline, doxycycline, or erythromycin, as directed by medical officer,
Preventive measures concerning health and sex education for this infection are the same for all sexually transmitted diseases. Emphasis sould be