Human papillomavirus: transmission, symptoms, and health effects

Microorganisms are very tiny living beings, about .04 mm in size, so small that they are not as yet visible to the naked eye (Health Hype 2010). They are classified into bacteria, viruses, fungi and protozoa or pathogens. Bacteria are one-celled microorganisms called prokarotes. Fungi are non-motile and many-celled eukaryotes. Protozoa or pathogens are disease-causing biological agents. And viruses are simple microorganisms with only one DNA or RNA and cause systemic infections in the living host. Microorganisms are either beneficial or harmful. Viruses are harmful microorganisms (Health Hype).

Genital Human Papillomavirus or HPV is a particular scourge. With more than 40 types, which are transmissible through the genitals, mouth and throat, HPV is the most common sexually transmitted infection or STI (CDC 2010). Most of those with the infection are not aware of it. HPV is different from herpes and HIV, which causes AIDS. The HPV is transmitted during sex and has different symptoms and health conditions from herpes and HIV. In most cases, it does not develop symptoms or health conditions as the body's immune system removes the virus naturally within two years (CDC).

Signs and Symptoms

Some HPV types develop genital warts in either sex or wars in the throat (CDC 2010). HPV warts in the throat cause the condition called recurrent respiratory papillomatosis or RRP. Other HPV types can cause cancer of the cervix or other cancer types, such as of the vulva, vagina, penis, anus, and the head and neck. The tongue, tonsils and throat may also be infected. HPV types that can cause genital warts are different from those that can cause cancer. HPV can be contracted by anyone of either sex and at any age or race (CDC).

Genital warts are small or large bumps in the genital area (CDC 2010). They may be flat or raised and shaped like a cauliflower. A genital wart is visible to health care professionals during a check-up. These warts can appear within weeks or months after transmission even if the infected partner has no sign of the wart. If they are not treated, they may disappear, remain unchanged, multiply or enlarge. However, they will not turn into cervical cancer. In comparison, cervical cancer has no symptoms until quite advanced. This is why regular screening is quite important so as to detect the early signs of the disease and treatment can be instituted before cancer develops. Similarly, other HPV-related cancers may be asymptomatic or have no signs or symptoms until advanced. At that point, they are difficult to treat. These include cancers of the vulva, vagina, pens, anus, head and neck. RRP warts in the throat can obstruct the airway and disturb breathing or make the voice hoarse (CDC).

Pathogenesis

HPV can make normal cells on infected skin to turn abnormal without the person feeling the change (CDC 2010). Fortunately, the body's immune system fights the virus naturally and the abnormal cells turn back to normal. But when this does not happen,

HPV creates visible on the skin in the form of warts or cancer. Warts become visible within weeks or months after infection but cancer takes years to develop after contracting HPV (CDC).

Diagnosis and Therapy

Available tests only screen for cervical cancer and not overall HPV status (CDC 2010). There are no tests to determine HPV in the genitals, mouth or throat. Because the body's immune system most of the time clears the virus, an HPV found today is very likely to disappear within the next two years. Neither is there a treatment for the virus itself, The person can, however, treat his or her own visible genital wart with medications given by the healthcare professional. But they will often advise to just observe if the warts disappear without treatment. On the other hand, cervical cancer is treatable when diagnosed early. Medicines or surgery can treat RRP (CDC).

Vaccines

Prevention is always the better option. Vaccines given in three shots provide the best protection (CDC 2010). It is also most effective when obtained after the first sexual contact or exposure to possible HPV. The vaccines Cervarix and Gardasil are the most available for girls and women as protection against HPV types, which can cause cervical cancer. They are recommended for girls aged 9 upward. Gardasil protects boys and men against most genital warts at ages 9 to 26. Condoms may also be used to reduce the risk of HPV. Infection may also be reduced by keeping a monogamous relationship or by limiting the number of sexual partners. A monogamous relationship, however, is not an absolute guarantee. It may not be possible to determine if a sexual partner is currently infected or not. The only sure way to prevent HPV is sexual abstinence. The same protection and prevention hold for HPV-related diseases. Pap tests are recommended for detecting anal and penile cancers (CDC).

HPV Incidence in Florida

The incidence rate was 9.6 per 100,000 people in this State with almost 1,000 new cases reported in the year of review (Bureau of Epidemiology 2005). It was higher among females aged 40-64 than the 15-39 and 65 and older. Race was not a significant factor. In 2005, 291 succumbed to cervical cancer, which HPV often causes, at a mortality rate of 2.8 per 1,000 people. Those who die are under than age 65 than older. Fatalities lose a potential of 25.4 years of productive life, the highest in all the categories of cancer. Mortality is higher among Black females at 4.4% per 1,000 than white females at only 2.6%. Both the incidence and mortality rates were lower than those of 1981. Prognosis depends significantly on the stage of diagnosis with the five-year survival rate at 96-99% at early diagnosis. The survival rate drops to 15-20% at late-stage diagnosis. Advanced diagnosis is higher among Blacks at 51.7% than whites at 44.3%. It also increased by 57% in 2005 from 44% in 1981. Screening for cancer in 2004 for females 18 and older was by Pap smear within the past two years. Again, race was not a factor. Screening was lower among females aged 65 years and older, with annual household incomes lower than $25,000 and without health insurance (Bureau of Epidemiology).

Incidence in Hillsborough County

Incidence of sexually transmitted disease has reached 70% in the Tampa Bay area, especially among 15-19-year-olds (Peterson 2009). From this number, at least 3% came from Hillsborough and Pinellas Counties in 2007. This was more than twice the low rates of the 90s, as reported by the Department of Health. The Hillsborough County Health Department revealed that cases increased from 7,350 in 2007 to approximately 8,500 in 2008. The rise in detection can be the result of both better testing methods and the increase in the number of children engaging in unprotected sex. The Department asked schools to inform teens about condom use rather than bank on abstinence (Peterson).

Hillsborough had the highest incidence rate of Chlamydia, gonorrhea and syphilis in Florida in 2007 (Peterson 2009). Public schools in Florida teach abstinence as the standard, according to Florida law. Some of these schools teach abstinence only, but those in Hillsborough County mention the use of condoms as prevention. Sex education starts in the 6th grade and continues to high school. Legislators filed a bill, which emphasizes abstinence as the only sure prevention. It also calls for comprehensive, accurate and factual information. The Florida Catholic Conference strongly opposed the legislation. The U.S. Government Accountability Office, however, found that abstinence-based sex education was not too successful. The programs were not implemented scientifically and the information provided was not accurate. But school authorities commented that they can only do so much and need parents' assistance through the value system set at home (Peterson).

Incidence in Riverview, Florida

Anal cancer is highest among men having sex with men at 35 in every 100,000 of them in this locality (Health Communities 2010). The rate is lower among 100,000 heterosexual men. Anal cancers are located in the peri-anal skin around the anus in men, equivalent to tumors in the anal canal in women. These are typically squamous cell carcinomas, which may spread to deeper layers of tissue. Their exact cause is unknown but associated with HPV. Aside from smoking and alcohol consumption, HPV and ano-genital warts are associated with anal cancer both from past and current infections. Most men who get infected are more than 50 years old and may be also be infected with HIV. They have no visible symptoms, except a probable history of ano-genital warts. They may also have lesions, often benign, a possible sore or bump, abnormal discharge or bleeding from the anus or rectum (Health Communities). #