Listeriosis

Epidemiology Corner

July 15 , 2005

Lymphogranuloma Venereum (LGV)

What is Lymphogranuloma Venereum?
Lymphogranuloma Venereum (LGV) is a more severe form of chlamydia. It is a systemic sexually transmitted disease (STD) that can be caused by three different strains of the chlamydia trachomatis bacteria (serovars L1, L2 and L3).

Signs and Symptoms
According to the Centers for Disease Control and Prevention (CDC), LGV can manifest with genital ulcers and swollen or enlarged lymph nodes in the groin often followed by formation of pus, inflammation of the rectum and abnormal cell growth of intestinal and rectal lymphatic tissue. Both sets of symptoms can be accompanied by other systemic symptoms including anorexia, general body discomfort, muscle pain, chills, joint pain and fever. If LGV is not treated, it can lead to damage of internal organs and the skin in the groin region as well as lead to infertility. As with STDs that cause ulcers, LGV may facilitate the transmission of HIV.

Epidemiology and Surveillance
LGV occurs worldwide and is endemic in parts of Southeast Asia, Africa, Central and South America and Caribbean countries. This disease is typically considered rare in the United States and other industrialized countries. However, recent outbreaks have occurred in the Netherlands and cases have also been reported in Belgium, France, Britain and Sweden showing that LGV is occurring in several European countries. According to multiple ProMED reports, cases have also occurred within the last two years in Canada, New York, Atlanta, San Francisco and Texas. Since September of 2004, only one patient has been reported to HDHHS with a laboratory confirmed case of LGV in Houston. Cases occurring in Europe and the United States are predominately among men who have sex with men (MSM).

Treatment
When diagnosed early, LGV can be effectively treated with antibiotics. According to CDC treatment guidelines, individuals diagnosed with LGV should be treated with Doxycycline twice a day for 21 days. Alternative treatments are available especially for pregnant or lactating women for whom Doxycycline is not recommended. Currently there is no vaccine against LGV.

CDC Suggestions for Prevention and Control

The CDC provides the following prevention and control information:

The surest way to avoid transmission of STDs is to abstain from sexual contact or to be in a mutually monogamous relationship with a partner who has been tested, does not have symptoms and is uninfected.
Latex male condoms, when used consistently and correctly, may reduce the risk of LGV transmission. Infectious genital ulcers can however occur in male and female genital areas not protected by a condom.
Having had LGV and completing treatment does not prevent re-infection. It is recommended that persons suspected of having LGV be treated as if they have it. Individuals treated for LGV should avoid sex until they have completed treatment and symptoms have disappeared.

For more information on LGV visit the CDC website at: www.cdc.gov/std. Information on LGV case reports can be found in the ProMed mail archives at www.promedmail.org.

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