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Vol 16 no 51 |
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Final Issue: Volume 16 Number 51 |
Published on: 21 December 2006 |
Final Issue in PDF |
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News Archives
Last updated: Volume 14, No.4 (PDF file, 184 KB)
Archives | News Archives 2004: Page 1| News 22 January 2004
News Archives: | 2006 | 2005 | 2004 | 2003
Update on avian influenza A (H5N1) in humans in Vietnam
A cluster of lymphogranuloma venereum (LGV) among men who have sex with men (MSM) has been reported from Rotterdam in the Netherlands. Between April and December 2003, ten confirmed, two probable, and one possible, cases were reported as infected with C. trachomatis serovar L2 (LGV2), as well as one confirmed LGV1 case. Cases presented with proctitis or constipation. Rectal swabs from all cases tested positive for chlamydia by PCR, although urethral swabs were negative. All cases were white males aged from 26 to 48 years. Thirteen were HIV positive (and already aware of their HIV status), and eight had a concomitant sexually transmitted infection (STI). One is hepatitis C (HCV) positive, and sexual transmission was the likely route of infection. All men reported unprotected insertive and receptive anal sexual contact. Fisting (insertive and receptive) was reported commonly. Many sexual contacts were anonymous, hampering individual contact tracing. Sexual contacts were reported in Germany, Belgium, United Kingdom, and France. Three further suspect cases of LGV have been identified in the past week following intensified contact tracing in The Netherlands.
LGV is an STI caused by Chlamydia trachomatis serovars L1, L2, and L3. The incidence of LGV in the developed world is low, and incidental cases are normally considered to be imports from areas where LGV is endemic, such as west and east Africa, India, southeast Asia, south and central America, and some Caribbean islands (1 ,2 ). The ulcerous character of LGV favours transmission and acquisition of HIV and other STIs as well as other bloodborne diseases (3). Recommended treatment is 100 mg doxycycline twice daily for 21 days (4).
Notification of the outbreak has been cascaded to genitourinary medicine physicians in the UK via the British Association of Sexual Health and HIV (BASHH) Newsletter. European Union STI surveillance and microbiological collaborators in the European Surveillance of STI (ESSTI) Network have also been informed though the ESSTI_ALERT early warning system, as well as the official European Early Warning System.
In view of the international distribution of the sexual contacts healthcare providers should be aware of this ongoing incident and have a high index of suspicion for associated cases among MSM.
References
1.Engelkens HJH, Stolz E. Genital ulcer disease. Int J Dermatol 1993; 32: 169-81.
2.Perine P L, Stamm W E. Lymphogranuloma venereum. In: Holmes KK, Mårdh PA, Sparling PF, et al, eds. Sexually Transmitted Diseases. New York: McGraw-Hill, 1999:423-32.
3.Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Inf 1999; 75: 3-17.
4.Roest RW, van der Meijden WI. European guideline for the management of tropical genito-ulcerative diseases. Int J STD AIDS 2001; 12 (Suppl 3): S78-83.
A cluster of lymphogranuloma venereum in The Netherlands with connections to the UK
A cluster of lymphogranuloma venereum (LGV) among men who have sex with men (MSM) has been reported from Rotterdam in the Netherlands. Between April and December 2003, ten confirmed, two probable, and one possible, cases were reported as infected with C. trachomatis serovar L2 (LGV2), as well as one confirmed LGV1 case. Cases presented with proctitis or constipation. Rectal swabs from all cases tested positive for chlamydia by PCR, although urethral swabs were negative. All cases were white males aged from 26 to 48 years. Thirteen were HIV positive (and already aware of their HIV status), and eight had a concomitant sexually transmitted infection (STI). One is hepatitis C (HCV) positive, and sexual transmission was the likely route of infection. All men reported unprotected insertive and receptive anal sexual contact. Fisting (insertive and receptive) was reported commonly. Many sexual contacts were anonymous, hampering individual contact tracing. Sexual contacts were reported in Germany, Belgium, United Kingdom, and France. Three further suspect cases of LGV have been identified in the past week following intensified contact tracing in The Netherlands.
LGV is an STI caused by Chlamydia trachomatis serovars L1, L2, and L3. The incidence of LGV in the developed world is low, and incidental cases are normally considered to be imports from areas where LGV is endemic, such as west and east Africa, India, southeast Asia, south and central America, and some Caribbean islands (1 ,2 ). The ulcerous character of LGV favours transmission and acquisition of HIV and other STIs as well as other bloodborne diseases (3). Recommended treatment is 100 mg doxycycline twice daily for 21 days (4).
Notification of the outbreak has been cascaded to genitourinary medicine physicians in the UK via the British Association of Sexual Health and HIV (BASHH) Newsletter. European Union STI surveillance and microbiological collaborators in the European Surveillance of STI (ESSTI) Network have also been informed though the ESSTI_ALERT early warning system, as well as the official European Early Warning System.
In view of the international distribution of the sexual contacts healthcare providers should be aware of this ongoing incident and have a high index of suspicion for associated cases among MSM.
Refences
1.Engelkens HJH, Stolz E. Genital ulcer disease. Int J Dermatol 1993; 32: 169-81.
2.Perine P L, Stamm W E. Lymphogranuloma venereum. In: Holmes KK, Mårdh PA, Sparling PF, et al, eds. Sexually Transmitted Diseases. New York: McGraw-Hill, 1999:423-32.
3.Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Inf 1999; 75: 3-17.
4.Roest RW, van der Meijden WI. European guideline for the management of tropical genito-ulcerative diseases. Int J STD AIDS 2001; 12 (Suppl 3): S78-83.
Erratum: COVER programme: July to September 2003
(Commun Dis Rep CDR Wkly 25 September 2003; 13(39): immunisation. Available at
<http://wwww.hpa.org.uk/cdr/archives/2003/cdr3903.pdf>.
On 25 September 2003, table 3 was published with incorrect data. These data have now been corrected.
Table 3 Completed primary immunisations (all antigens) by 5 years: April to June 2003
| Region/Country | PCT/HB/AR* (total) |
DTPol3 % | P3 % | Hib3 % | MenC % | MMR1 % | MMR2 % | DTPol4 % | |
| Regions of England | |||||||||
| North East |
16 (16) |
95.7 |
95 |
95.3 |
91.6 |
93.9 |
82.5 |
82.4 |
|
| North West |
42 (42) |
95.6 |
94.3 |
94.7 |
90.8 |
92.2 |
77.2 |
82.8 |
|
| Yorkshire & Humber |
33 (34) |
95.3 |
94.5 |
94.6 |
86.7 |
92.9 |
78.6 |
82.2 |
|
| East Midlands |
28 (28) |
97.1 |
96.4 |
96.5 |
92.7 |
94.6 |
79.6 |
86.1 |
|
| West Midlands |
30 (30) |
96.0 |
95.1 |
95 |
91.2 |
93.8 |
79.1 |
83.9 |
|
| East of England |
41(41) |
95.5 |
94.7 |
95 |
90 |
91.6 |
79.9 |
85.6 |
|
| London |
32 (32) |
87 |
86.3 |
86.4 |
72.7 |
78.9 |
56.2 |
61.7 |
|
| South East |
49(49) |
94.4 |
93.5 |
93.7 |
88.5 |
91.2 |
75.6 |
83.4 |
|
| South West |
32 (32) |
96.8 |
95.8 |
96.1 |
91.2 |
92.8 |
79.6 |
86.9 |
|
| England (Total) |
303 (304) |
94.2 |
93.4 |
93.6 |
87.3 |
90.4 |
75.0 |
80.6 |
|
| Wales |
3 (3) |
94.7 |
92.5 |
94.2 |
90.5 |
90.2 |
74 |
81.8 |
|
| Northern Ireland |
4 (4) |
98 |
97.9 |
97.3 |
95.6 |
97 |
87.9 |
90.6 |
|
| Scotland 6 years† |
15 (15) |
– |
– |
– |
– |
– |
90.4 |
94.9 |
|
| England, Wales & Northern Ireland |
325 (326) |
94.4 |
93.5 |
93.7 |
87.8 |
90.6 |
75.4 |
81.0
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