ABSTRACT
Anogential warts are much less common in children than in adults. In children the presence of anogenital warts have been suggested as an indicator for sexual abuse because of the association of genital warts with sexual activity. Difficulties of establishing mode of transmission arise because of the long latency of human papillomavirus and possibility of vertical and non-sexual transmission. A multidisciplinary approach is advised for the proper care of children with anogenital warts.
ABSTRACT
OBJECTIVE: To establish the prevalence of sexually transmitted organisms and other genital organisms in potentially sexually abused children. DESIGN: Prospective study of children attending an inner London department of community paediatrics for evaluation of possible sexual abuse. SUBJECTS: Children under 16 referred for evaluation of possible sexual abuse. OUTCOME MEASURES: Prevalence of sexually transmitted organisms in relation to age, symptoms, and type of abuse. RESULTS: Swabs were taken from 159 of 242 girls evaluated. The overall prevalence of sexually transmitted organisms was 3.7%: three girls were infected with gonorrhoea, four with Trichomonas vaginalis, and two with Chlamydia trachomatis. One girl had all three infections plus mycoplasmas. Mycoplasmas were identified in 22% of girls swabbed. Of 30 boys swabbed, none yielded a sexually transmitted organism. CONCLUSIONS: There is a low prevalence of definitely sexually transmitted organisms in children who might have been abused. Other organisms possibly associated with sexual activity can be identified in this population. Screening for infection should be mandatory in presumed sexually abused girls with vaginal discharge and ideally should be undertaken in all children attending for evaluation of sexual abuse.
Subject(s)
Child Abuse, Sexual , Chlamydia trachomatis/isolation & purification , Mycoplasma/isolation & purification , Neisseria gonorrhoeae/isolation & purification , Sexually Transmitted Diseases/microbiology , Trichomonas vaginalis/isolation & purification , Vaginal Discharge/microbiology , Adolescent , Anal Canal/microbiology , Animals , Child , Child, Preschool , Chlamydia Infections/diagnosis , Female , Gonorrhea/diagnosis , Humans , Infant , Male , Mycoplasma Infections/diagnosis , Pharynx/microbiology , Prevalence , Sexually Transmitted Diseases/diagnosis , Trichomonas Infections/diagnosis , Urethra/microbiology , Vagina/microbiologyABSTRACT
An outbreak of Salmonella typhimurium DT9 food poisoning due to contaminated chicken pieces affected at least 196 delegates at a medical conference. Twelve per cent of the cases reported suffering parasthaesiae. Nine reported serious complications of infection which included rectal prolapse and perianal abscess. Antibiotic therapy did not measurably reduce the duration or severity of diarrhoea. Over 1,600 doctor-days were lost to the NHS. Most doctors sought expert infection control advice before returning to work but the advice given differed between hospitals.
