STD ‘not seen since the 1920s’ prompts health warning

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Public Health officials across the country have put physicians on watch for a sexually transmitted disease that hasn’t been commonly seen in the U.S. since the 1920s.

Lymphogranuloma venereum, or LGV, is a form of the common sexually transmitted infection Chlamydia, that can cause scarring of the genitals and colon, and can produce swelling and bursting of lymph glands near the groin.

While no cases have been reported in Nashville, cases have been reported in San Francisco, prompting the concern that the disease could quickly spread. The last know case of LGV in Davidson County was more than 20 years ago.

Dr. William Schaffner, chairman of Preventive Medicine at Vanderbilt University Medical Center School of Medicine, and a nationally known expert on infectious diseases, said it was important for local physicians to be aware of the possible signs and symptoms of LGV, because quick treatment with an antibiotic will stop the bacteria in its tracks.

“This is a reemergence of the disease,” he said. “It was widely recognized in the 1920s and 1930s, however good diagnosis and treatment have virtually eliminated it from the U.S. But with international travel as easy as it is now, we are seeing people get the disease and bring it back to the U.S.”

In The Netherlands, heath authorities this fall reported 92 cases of LGV over the past 12 months. The country usually sees fewer than five cases per year. Schaffner said the alert issued last October by the Centers for Disease Control that the bacteria may show up in this country proved to be true, as evidence by the new cases showing up in San Francisco.

While the disease can affect men and women equally, the most likely people to develop LGV practice receptive anal intercourse. Because LGV doesn’t have remarkable external signs, Schaffner said it was important for physicians to be alert to its reemergence.

“The average physician practicing today has probably never seen a case of LGV,” Schaffner said. “It’s such an obscure disease and based on some of the symptoms, it could be confused with Chron’s disease.”

Schaffner said the disease was slow to present symptoms. Approximately three weeks after exposure a person infected could begin having genital ulcers. Within a month after exposure, there could be pain and swelling in the lymph nodes in the groin area, along with fever and general complaints of not feeling well. Other symptoms could include itching anus, blood or mucus in the stool, straining and cramping when having a bowel movement, gastrointestinal bleeding, and inflammation of the rectum and colon.

Patients with LGV typically undergo a three-week course of antibiotics, instead of the single dose used to treat common strains of Chlamydia. Long term health problems can result from the disease due to the possible scarring of the colon.

Brad Beasley from the Metro Public Health Department said it was “just a matter of time” before Middle Tennessee saw its first case of LGV.

“Avoidance of LGV as well as the other STDs goes back to consistent latex/polypropylene condom use in all activities, as well as limiting the number of sex partners,” Beasley said. “This would provide an effective barrier for not transmitting LGV or the other STDs.”

For more information on LGV or any STD, contact your physician or call Beasley at 615-340-5676. “As always, our patient information is totally confidential and is not accessible by any outside person, agency or other entity,” he said.