By Andre Picard
The Globe and Mail
6-2-5
A rare sexually transmitted disease some are calling the "new AIDS" has made its way to Canada.
There have been 22 cases of lymphogranuloma venereum (LGV) reported in Canada in recent months, all in homosexual and bisexual men with high-risk sexual practices, according to a report published yesterday in the on-line edition of the Canadian Medical Association Journal.
In fact, the way LGV is spreading -- among men who have anonymous sex in bath houses (and the latest variation, encounters arranged via Internet chat groups) -- is eerily similar to the beginnings of the HIV-AIDS epidemic.
Unlike HIV-AIDS, however, LGV, a bacterial infection, is easily treatable with antibiotics. But the symptoms -- small painless lesions on the genitals and swollen glands -- are probably not familiar to most doctors. What's more, an infection with LGV increases the risk of contracting and spreading HIV-AIDS and hepatitis, partly because it creates sores, making it easier for viruses to enter the bloodstream.
"This is an important public-health and clinical challenge," Dr. Thomas Wong, director of the community-acquired-infections division of the Public Health Agency of Canada said yesterday.
He said the arrival of a new sexually transmitted disease reflects an upsurge in risky sexual behaviour that stems from "safer-sex fatigue," the popularity of party drugs that strip away inhibitions (and often common sense), and the increasingly common practice of anonymous sex.
"LGV isn't the only sexually transmitted disease we're seeing. The number of cases of syphilis, gonorrhea, chlamydia are all increasing," Dr. Wong said.
LGV is a form of chlamydia, a common sexually transmitted disease that can cause infertility in women. But LGV is more invasive. Left untreated, it can cause destructive swelling of the genitals and rectum, and even lead to meningitis (swelling of the lining of the brain), encephalitis (swelling of the brain) and death.
LGV is common in the tropics, including Africa, Asia, South America and the Caribbean. Until recently, it was virtually unknown in industrialized countries. That changed, perhaps forever, in 2003, when a cluster of cases sprang up in the Netherlands among sex tourists. The disease then spread to Belgium, France, Germany, Sweden, Britain, and now the United States and Canada.
Dr. Wong said the rapid spread reflects the increasing globalization of infectious diseases in an era of easy air travel and frequent trips for work and pleasure.
According to the new study, none of the men infected with LGV in Canada had travelled abroad recently, but all had the same strain of the disease that is circulating in the Netherlands.
What distinguishes those who have been infected with LGV is that few of them could identify their recent sexual partners, and their propensity for high-risk sexual activity.
Virtually all the men engaged in "Internet partnering," frequented bath houses, or had sex at rave parties, according to the study.
Half of the infected practised "barebacking" -- anal sex without a condom. They also engaged in "booty bumping" -- ingesting the drug crystal meth anally -- and in "fisting".
Dr. Wong said the Public Health Agency of Canada is stepping up surveillance for LGV and will try to educate physicians to spot symptoms early. "This infection could spread to more people," he said. "We're concerned that it could have an impact on the HIV and hepatitis epidemics in the future."
(In all Canadian provinces, chlamydia is a reportable disease, but most jurisdictions do not distinguish between LGV and non-LGV types because the lab tests are expensive.)
The U.S. Centers for Disease Control and Prevention has expressed similar concerns. In particular, the CDC has warned gay and bisexual men who practise unprotected sex to look out for symptoms of LGV, and cautioned that these symptoms, in particular inflammation and bleeding of the rectum and colon, can be misdiagnosed as colitis and Crohn's disease.
A rare sexually transmitted disease some are calling the "new AIDS" has made its way to Canada.
There have been 22 cases of lymphogranuloma venereum (LGV) reported in Canada in recent months, all in homosexual and bisexual men with high-risk sexual practices, according to a report published yesterday in the on-line edition of the Canadian Medical Association Journal.
In fact, the way LGV is spreading -- among men who have anonymous sex in bath houses (and the latest variation, encounters arranged via Internet chat groups) -- is eerily similar to the beginnings of the HIV-AIDS epidemic.
Unlike HIV-AIDS, however, LGV, a bacterial infection, is easily treatable with antibiotics. But the symptoms -- small painless lesions on the genitals and swollen glands -- are probably not familiar to most doctors. What's more, an infection with LGV increases the risk of contracting and spreading HIV-AIDS and hepatitis, partly because it creates sores, making it easier for viruses to enter the bloodstream.
"This is an important public-health and clinical challenge," Dr. Thomas Wong, director of the community-acquired-infections division of the Public Health Agency of Canada said yesterday.
He said the arrival of a new sexually transmitted disease reflects an upsurge in risky sexual behaviour that stems from "safer-sex fatigue," the popularity of party drugs that strip away inhibitions (and often common sense), and the increasingly common practice of anonymous sex.
"LGV isn't the only sexually transmitted disease we're seeing. The number of cases of syphilis, gonorrhea, chlamydia are all increasing," Dr. Wong said.
LGV is a form of chlamydia, a common sexually transmitted disease that can cause infertility in women. But LGV is more invasive. Left untreated, it can cause destructive swelling of the genitals and rectum, and even lead to meningitis (swelling of the lining of the brain), encephalitis (swelling of the brain) and death.
LGV is common in the tropics, including Africa, Asia, South America and the Caribbean. Until recently, it was virtually unknown in industrialized countries. That changed, perhaps forever, in 2003, when a cluster of cases sprang up in the Netherlands among sex tourists. The disease then spread to Belgium, France, Germany, Sweden, Britain, and now the United States and Canada.
Dr. Wong said the rapid spread reflects the increasing globalization of infectious diseases in an era of easy air travel and frequent trips for work and pleasure.
According to the new study, none of the men infected with LGV in Canada had travelled abroad recently, but all had the same strain of the disease that is circulating in the Netherlands.
What distinguishes those who have been infected with LGV is that few of them could identify their recent sexual partners, and their propensity for high-risk sexual activity.
Virtually all the men engaged in "Internet partnering," frequented bath houses, or had sex at rave parties, according to the study.
Half of the infected practised "barebacking" -- anal sex without a condom. They also engaged in "booty bumping" -- ingesting the drug crystal meth anally -- and in "fisting".
Dr. Wong said the Public Health Agency of Canada is stepping up surveillance for LGV and will try to educate physicians to spot symptoms early. "This infection could spread to more people," he said. "We're concerned that it could have an impact on the HIV and hepatitis epidemics in the future."
(In all Canadian provinces, chlamydia is a reportable disease, but most jurisdictions do not distinguish between LGV and non-LGV types because the lab tests are expensive.)
The U.S. Centers for Disease Control and Prevention has expressed similar concerns. In particular, the CDC has warned gay and bisexual men who practise unprotected sex to look out for symptoms of LGV, and cautioned that these symptoms, in particular inflammation and bleeding of the rectum and colon, can be misdiagnosed as colitis and Crohn's disease.
No comments:
Post a Comment