An unusually virulent form of chlamydia has emerged in the United States primarily among gay males following an outbreak in Europe two years ago, federal researchers said Wednesday.
The number of confirmed cases is still small – fewer than 80 – but infectious disease experts fear the actual number is substantially larger because the disorder is difficult to diagnose and many physicians are not aware of its existence.
Officials are concerned because, like many other sexually transmitted diseases, the disease can accelerate the spread of HIV infections and perhaps even enhance replication of HIV in people who are co-infected.
Lymphogranuloma venereum, commonly known as LGV, is caused by three strains of the bacterium Chlamydia trachomatis – strains that are different from those that cause regular chlamydia infections or eye diseases.
Symptoms include bleeding, inflammation of the rectum and colon, abdominal cramping and severe pain. Infections can be fatal if left untreated. They can be cured with antibiotics including doxycycline, but three weeks of treatment are required, substantially longer than required for common genital chlamydia.
The disease is most common in parts of Asia, Africa and South America along the equator, but it made an unexpected appearance in Europe in 2004. The Netherlands, which normally saw four or five cases per year, suddenly began to see two cases per week, and other countries reported similar experiences.
Since then, it has begun to show up in the United States and Canada, generally in cities with a high prevalence of other sexually transmitted diseases. Dr. Preeti Pathela of the New York City Department of Health and Mental Hygiene said at a sexually transmitted diseases meeting in Florida that her laboratory has confirmed 31 cases of the disease in the last year, 30 of them in gay males.
Testing has been a problem because it requires sequencing part of the genome of the bacterium, a task that requires several days and a sophisticated laboratory.
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