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 U.S. Centers for Disease Control and Prevention announced in late October.
CDC officials urged doctors and clinics across the nation to be prepared to diagnose and treat gay and bisexual men infected with lymphogranuloma venereum.
They issued the advice after receiving reports of recent outbreaks in the Netherlands. That northern European nation has uncovered 92 cases of lymphogranuloma venereum dating back to 2003. It typically sees fewer than five cases a year.
Although lymphogranuloma venereum can be cured by a three-week course of antibiotics, U.S. health officials could be hard-pressed to keep a lid on the spread of the infection because it is uncommon in industrialized nations and is easily misdiagnosed. Efforts to combat the disease also are complicated, health officials say, by the tendency of some gay and bisexual men to engage in high-risk sexual behavior.
The infection is caused by specific strains of chlamydia, a sexually transmitted disease, and is usually marked by genital ulcers, swollen lymph glands, and flu-like symptoms. However, most of the men recently infected in the Netherlands developed gastrointestinal bleeding, inflammation of the rectum and colon, and other problems not often associated with the infection or other sexually transmitted diseases.
Belgium, France, Sweden, and the United Kingdom also have reported infections. It is not known whether the United States is seeing a similar surge because U.S. doctors are not required to report the infections to local health departments. 'We expect it is a question of time before we see cases appearing here,' says Stuart Berman, MD, chief of the epidemiology and surveillance branch in the CDC's division of STD prevention. 'This is an early warning.'
Dutch authorities found that a large number of the men recently infected with lymphogranuloma venereum had participated in sex parties and unprotected anal intercourse in the year before getting sick. Many also are HIV-positive.
