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29 Oct 2004

CDC warns gay men of rare STD

Most gay men have never heard of Lymphogranuloma venereum, or LGV, but the CDC warns that the rare STD is heading to North America from Europe.

A rare sexually transmitted disease that is spreading among gay and bisexual men in Europe could be poised to surface in the United States, the US Centers for Disease Control and Prevention (CDC) said on Thursday.

Credit: University of Louvain, Faculty of Medicine. In the primary stage, the initial lesion may be a painless papule, shallow erosion, ulcer, or grouping of lesions (herpetiform in appearance); and may progress to the formation of a solitary, large, tender lymphoid nodule, or bubonulus. These bubonuli may rupture to form sinuses and/or fistulas.
The US federal agency that monitors epidemics and other health threats, urged doctors and clinics across the US to be prepared to diagnose and treat men infected with the disease after receiving reports of recent outbreaks in the Netherlands, Belgium, France, Sweden and the UK. According to the CDC report, the prevalence of LGV is greatest in Africa, Southeast Asia, Central and South America, and Caribbean countries.

Dutch health authorities have reported 92 cases of LGV in the past 12 months. It typically sees fewer than five cases per year.

The infection is caused by specific strains of chlamydia, a sexually transmitted disease, and usually marked by genital ulcers, swollen lymph glands and flu-like symptoms. The CDC however said that this new strain, showing up in men who have sex with men, is marked by gastrointestinal bleeding, inflammation of the rectum and colon, and other problems not often associated with the infection or other sexually transmitted diseases. LGV also occurs in men up to six times more frequently than in women.

Health authorities in the Netherlands found that a large number of the men recently infected with LGV had participated in sex parties and unprotected anal intercourse in the year before getting sick. Many also were infected with HIV, the virus that causes AIDS.

CDC says that it is not known whether America is seeing a similar surge because US doctors are not required to report the infections to local health departments although it warns that the US might see a similar increase among MSM.

"We expect it's a question of time before we see cases appearing here," said Dr Stuart Berman, chief of the epidemiology and surveillance branch in the CDC's division of STD prevention. "This is an early warning."

Health officials in the US could be hard pressed to keep a lid on the spread of the infection because it is uncommon in industrialised nations and easily misdiagnosed.

Although LGV can be cured by a three-week course of antibiotics, untreated infections could be fatal.

Safe sex advocates added that efforts to combat the disease are complicated by the tendency of some gay and bisexual men to engage in high-risk sexual behaviour.

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