Twenty-four cases of the sexually transmitted infection lymphogranuloma venereum (LGV) have been diagnosed in England since October 2004, according to data published in the January 28th edition of Eurosurveillance Weekly.
Enhanced surveillance of LGV was started in England in October 2004 after clusters of the infection were diagnosed amongst gay men, many of whom were HIV-positive, across Europe.
Detailed information is available on 19 of the UK cases. All these 19 cases involve gay men, 17 of whom are HIV-positive. The men were aged between 24 – 52 years, with a median age of 40 years.
Anorectal symptoms were reported by 18 of the men, typically rectal pain, discharge and bloody stools. Systemic symptoms, typically general malaise, were reported by seven men. Two men had painful and swollen lymph glands in the groin.
Other sexually transmitted infections were present in eight of the men, and four men were also infected with hepatitis C virus.
Unprotected anal sex was reported by 13 men in the three months prior to the development of LGV symptoms, and four of these men also said that they had engaged in fisting, an activity associated with the European outbreaks. Two men also reported the use of shared sex toys.
Almost all the cases were in London, and genotyping suggests that LGV has been present in the UK since early 2004.
“The UK data are consistent with those reported elsewhere in Europe, with HIV-positive homosexual men presenting with LGV associated proctitis following unprotected anal sex with numerous sexual partners, often involving international sexual networks”, write the investigators, who conclude, “concerted action will be required to control the current outbreak of LGV in Europe and beyond.”
Macdonald N et al. Initial results of enhanced surveillance for lymphogranuloma venereum (LGV) in England. Eurosurveillance Weekly 10 (4): 10 - 12, 2005.