Non-Sexual Transmission of Chlamydia
Yes, chlamydia can be transmitted without sexual intercourse, but this is rare in adults and occurs primarily through perinatal (mother-to-infant) transmission during childbirth. 1, 2
Primary Transmission Route
- Sexual intercourse remains the overwhelmingly dominant mode of transmission for Chlamydia trachomatis in adolescents and adults, with the cervix being the most common initial site of infection in women. 3
- A woman's exposure to chlamydia is "usually a result of sexual intercourse," according to CDC guidelines. 3
Non-Sexual Transmission Routes
Perinatal Transmission (Mother-to-Infant)
- Infants can acquire chlamydia during passage through an infected birth canal, leading to neonatal conjunctivitis or pneumonia. 3, 1
- Perinatally transmitted infections can persist in the nasopharynx, urogenital tract, and rectum for more than 1 year in infants. 1
- Some infants with chlamydial pneumonia show abnormal pulmonary function tests later in childhood, indicating long-term consequences. 1
Trachoma (Eye Infection)
- Serovars A, B, and C are transmitted primarily through infectious eye discharge rather than sexual contact, causing trachoma under poor hygienic conditions. 4
- This represents a distinct epidemiologic pattern from genital chlamydia (serovars D-K). 4
Critical Clinical Context
In Prepubertal Children
- When sexually transmitted diseases including chlamydia are found in prepubertal children, sexual abuse must be highly suspected, as nonsexual transmission is an infrequent occurrence in this age group. 2
- The tendency to assume asexual transmission in children is often misguided. 2
In Adults
- Nonsexual transmission of chlamydia is rarely an issue in adults. 2
- The infection occurs primarily among sexually active adolescents and young adults. 3
Important Caveats
- Asymptomatic infection is extremely common (over 80% of cases), which contributes to ongoing transmission through unrecognized sexual contact. 5, 6
- Patients may not recall or report sexual contact, but this does not mean transmission occurred through non-sexual means. 7
- Treatment of pregnant women prevents transmission to infants during birth, making prenatal screening critical. 3