Army begins tests to stem spread of sexually transmitted diseases
December 16, 2007
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YONGSAN GARRISON South Korea — All female U.S. soldiers coming into South Korea are being tested for chlamydia under a new Army policy, according to the Army’s top medical officer in the country.
The policy, which was instituted Nov. 19, is intended to stem the disease’s spread and to catch infections in women who show no symptoms, according to Col. Greg Jolissaint, the commander of the 18th Medical Command.
In January, the testing will expand to a sampling of incoming male soldiers. By spring, Jolissaint plans to test all incoming soldiers assigned to South Korea, an effort he hopes will lower the rate among troops of America’s most common sexually transmitted disease.
“We wanted to create a program to eradicate chlamydia when they get here,” said Jolissaint, a family medicine doctor who has been in South Korea for 18 months. “We wanted to start people out on the right foot.”
Jolissaint also hopes the policy will serve as a model for increased testing across the Army. Unlike the Navy and the Air Force, the Army does not test incoming recruits for chlamydia, Jolissaint said.
“When you first come in, you’re not tested for STDs,” Jolissaint said. “That’s part of the problem. The only people who get tested are the ones who go in” voluntarily.
Across all services, new troops are tested for HIV and syphilis, Jolissaint and other medical officials say. Military medical units also encourage annual chlamydia tests for female servicemembers, usually during a yearly exam. Some military health officials say they require all women under 25 to get the yearly screening.
Addressing a problem
When it comes to chlamydia, women are tested more regularly than men, who typically are the carriers of the infection but suffer little from it. If left untreated in women, chlamydia can cause problems with pregnancies and even result in infertility, said Tanya Jacobsmuhlen, a registered nurse contracted by Jolissaint’s medical unit for the chlamydia project.
Since mid-November, Jacobsmuhlen has met each morning with the Army’s jet-lagged arrivals at Yongsan, the headquarters base in Seoul.
“Welcome to Korea,” Jacobsmuhlen said at 9:15 a.m. on a recent morning, during the first round of briefings for about 100 soldiers who had arrived in Seoul the previous night. “We have a problem. Our problem is chlamydia.”
Last year, 630 people in the military community in South Korea tested positive for chlamydia at Army facilities, according to the medical command’s preventive health office. That was a spike compared with previous years, which saw 450 to 500 cases each year. There are about 19,000 soldiers in South Korea.
Jolissaint said he’s unsure what caused last year’s increase. This year’s numbers are more in line with those of previous years, he said.
About 10,000 patients, including troops, family members and civilian workers, tested positive for chlamydia at Army facilities worldwide.
Jolissaint said he doesn’t think South Korea’s numbers are alarmingly high, but he’s worried that young men and women in the Army have the infection, don’t know it and are spreading it to each other.
“Most people get it from other soldiers,” he said. “They don’t get it downtown.”
South Korean health officials only recently began tracking the disease, according to Kim Yong-ho, a urologist who directs an South Korean association that tracks genital infections. In 2006, the country, with a population of 49 million, reported 2,144 cases through a sampling process, he said.
That tracking method gives a less accurate count than the one used in the States, where each case is reported to the federal Centers for Disease Control and Prevention. In America, health experts estimate 2.8 million people out of a population of 301 million are infected.
It won’t kill you, but …
In the first three weeks of Jolissaint’s new testing policy, about 100 female soldiers were checked.
“They always think they are clean,” said Lt. Col. Marie Price, the 18th Medical Command’s chief public health promotion coordinator. “Last week, we had four come back positive.”
During her daily briefings, Jacobsmuhlen gives soldiers a 15-minute talk about the infection, how it can spread easily through unprotected sex, and how untreated symptoms can lead to ectopic pregnancies, which occur outside the uterus.
“It’s not going to kill you,” she said of chlamydia. “But it’s going to make you feel really bad when you’re trying to have kids.”
The treatment, if caught early, usually involves a routine dose of antibiotics. But people can be reinfected, and generally the symptoms and lingering side effects are worse with each new infection, Jacobsmuhlen said.
When Jacobsmuhlen’s briefing ends, the men leave the room for a short break. Twenty women move to the front and get a quick lesson in peeing in a cup and labeling tubes. They also are asked to fill out a survey that records their last duty station, any previous chlamydia diagnoses and any current symptoms they might have.
Then Price and Jacobsmuhlen lead the group to a public bathroom with four stalls. A line forms outside, in the same room occupied by some of their male counterparts who are watching football on flat-screen televisions.
Price acknowledged the testing area isn’t perfect, and she knows it will only get more complicated as they begin testing men next year.
“We almost need a new building just to do this,” she said.
Price shepherds the women in and out as quickly and professionally as possible in the cramped space. She doesn’t miss the opportunity to pull rank — as an officer and a public health nurse.
“Don’t get a boyfriend,” she says as the women leave, “not until we get the results.”
The samples are sent each day to Tripler Army Medical Center in Hawaii, and it takes about seven days to get the results, Price said. As of Dec. 3, five women tested positive.
The chlamydia testing is estimated to cost about $400,000 a year, according to 18th Medical Command spokesman Master Sgt. Desmond Smith.
Jolissaint said the costs are worth it, especially when compared with treating the disease’s complications down the road. He also hopes a year of data from South Korea will help him persuade others throughout the Army to implement similar testing.
“This is a big deal,” he said. “And I think this is a reasonable painless service that we can provide that fits into the wellness category. I have no problem making this a long-term commitment.”
Stars and Stripes reporter Hwang Hae-rym contributed to this story.