Officials with New South Wales Health (NSW Health) reported a large increase of the sexually transmitted infection (STI), Lymphogranuloma venereum (LGV), among men who have sex with men (MSM) in the Sydney area in 2016.
A total of 52 LGV cases were notified to NSW Health from 1 January to 31 December 2016. This was more than three times the number of cases reported in the previous year (2015) and is the highest annual number of cases notified to NSW Health since 2010.
All cases notified to NSW Health in 2016 were male and the majority (81%) were residents of metropolitan Sydney.
LGV is caused by certain rare types of the bacterium Chlamydia trachomatis (L-1, L2 and L-3). Other types of Chlamydia trachomatis bacteria cause the more common chlamydia infection and trachoma, an eye disease. LGV causes a distinctly different illness to chlamydia.
LGV begins as a small painless ulcer at the site of infection. This is usually in the genital area, rectum or mouth. This heals by itself after a few days and most people are not aware of it. Over the next two to six weeks, the infection spreads to the local lymph glands usually in the groin or inside the pelvis. Symptoms at this stage may also include fever, tiredness, muscle and joint pain, loss of appetite and headaches.
Infected lymph nodes become swollen and filled with pus. These may open up and discharge the pus to the surface of the skin or to the inside of the rectum or vagina in women. The infected lymph nodes and adjacent infected tissues are called buboes. If untreated, the course of the disease is prolonged with scarring that may result in deformity in the affected area.
Rectal exposure in women or gay and bisexual men can result in proctocolitis with mucoid or bloody discharge, anal pain, constipation, fever and a constant urge to pass stools. Proctocolitis may be difficult to distinguish from other conditions such as inflammatory bowel disease, colorectal cancer and lymphoma. If left untreated it can lead to chronic colorectal fistulas and strictures.
LGV is spread through unprotected anal, vaginal or oral sex, especially if there is trauma to the skin or mucous membranes. Having ulcers due to LGV increases the risk of becoming infected with HIV.
Using condoms for anal and vaginal sex, and dental dams and condoms for oral sex, reduces the risk of spreading LGV. To avoid infection, sex partners should not share sex toys, or toys should be washed and protected with a fresh condom between partners.
Antibiotics are effective in treating LGV infection. People who have LGV should not have sex until they have completed a course of antibiotics to prevent spreading the infection to their partner. Sexual partners of people diagnosed with LGV should be tested.
- Sexually Transmitted Infections: Those common and those not so common, Part 1
- Sexually Transmitted Infections: Those common and those not so common, Part 2
- Sexually Transmitted infections in New Zealand 2014: Syphilis cases up, gonorrhea cases down