How is trachoma treated?
Systemic or local, intracellularly effective antibiotics are used to treat trachoma. The WHO recommends local therapy with tetracyclines. Therapy with azithromycin is also possible, but is more expensive.
In the scar stage, surgery should be performed to remove the entropion and trichiasis. Surgical restoration of the cornea (keratoplasty) has little chance of success in the final stage of a severe trachoma. In most cases, however, the therapeutic options for trachoma are very limited due to the socioeconomic standards in the affected countries.
How can trachoma be prevented?
Transmission by smear infection can be largely prevented by appropriate hygiene measures, e.g. hygienic hand disinfection with 70% alcohol. Contact lens wearers must be informed about the possible dangers of contact lenses (corneal injuries with superinfection) and instructed in proper cleaning and storage. A lack of hygiene facilities in underdeveloped countries promotes the occurrence of trachoma. Only by improving the infrastructure, a sufficient water supply and improved hygienic conditions (e.g. washing the face once a day) can the incidence of trachoma be reduced.
How contagious is this?
Like many bacterial infections, trachoma is highly contagious. It is not yet clear whether patients are already infectious during the incubation period of 5-10 days or only when the first symptoms appear. However, transmission from person to person occurs via flies carrying the bacteria or via smear infection. Poor hygiene or sharing a towel can be a transmission route, for example.
What is the prognosis with trachoma?
The prognosis of trachoma depends on the stage of the disease. The prognosis is good if treatment is started at an early stage. Blindness only occurs if the disease has not been treated for years and there is a high incidence of re-infection.
What is the history of trachoma?
The term chlamydia is derived from chlamys (gr. the coat). A description of a trachoma-like disease of the human eye can already be found in ancient traditions.
The first description of Chlamydia trachomatis was made in 1907 by Ludwig Halberstadter (*1876 in Beuthen, Upper Silesia, † 1949 in New York City) and Stanislaus von Prowazek (*1875 Czech Republic, † 1915 in Cottbus). They were able to show that the clinical picture of trachoma can be transferred experimentally from humans to great apes: Using a specific staining technique, the Giemsa stain, they identified vacuoles in cells from smears of the conjunctiva, which they interpreted as the cause of trachoma. In subsequent years, similar inclusion bodies were found in conjunctival swabs of newborns with conjunctivitis, in cervical swabs of their mothers, and in urethral swabs of men.
Due to their lack of cultivability on artificial culture media, their small size, and their purely intracellular multiplication, the pathogens were then wrongly classified as viruses. Thanks to cell culture techniques and electromicroscopy, it became clear in the mid-1960s that chlamydia is not a virus but a bacterium. In 1966, they were recognized as a separate order of Chlamydiales of bacteria.
