A previously rare disease has been reported for the first time in the UK, Lymphograunuloma venereum (LGV) is a genital/anogenital bacterial infection caused by a particularly invasive strain of Chlamydia trachomatis.
An editorial in the journal Sexually Transmitted Infections has revealed that in January 2005, the first 24 cases were reported in the UK, mostly from sexual health clinics in London. All were in gay men, 17 of whom were HIV positive, four also had hepatitis C infection.
Five thought they had caught the infection in mainland Europe, others said they had become infected in the UK. By mid February, a total of 34 cases had been reported.
The infection, which can be treated with a three week course of antibiotics, usually manifests as an ulcer or papule, and symptoms usually include rectal inflammation (proctitis), rectal pain and bleeding, straining, constipation and abdominal pain, it may also be accompanied by fever and malaise.
If the primary ulcer goes unnoticed, and is left untreated, it can progress to chronic infection with the formation of skin pouches (fistulas), abscesses, and narrowing of the anus as well as problems with the lymphatic system, surgery is often necessary.
The disease was considered rare until 2003, when 100 cases were reported in gay men in Rotterdam in the Netherlands, most of whom were HIV positive or had other sexually transmitted infections, including hepatitis C. Outbreaks have since been reported in Antwerp, Belgium, Hamburg, Germany, and Paris, France. Cases have also been reported in Sweden, and most recently in several US cities, including New York, San Francisco, and Atlanta. The UK's leading HIV charity, The Terrence Higgins Trust, and the Health Protection Agency, which monitors cases of the disease, last year alerted clinics and those most at risk to the spread of the infection.
The authors suspect that the problem has been present for some time in the UK, but many cases are not diagnosed.
Dr Patrick French, Mortimer Market Centre, University College London, UK
Tel: +44 (0)207 530 5055
Email: [email protected]
Press Office, Health Protection Agency, London, UK
Tel: +44 (0)208 327 6055