Tropical Sex Disease Surfaces in Toronto

An outbreak of a sexually transmitted disease usually seen only in the tropics has public health officials worried it is yet another signal that HIV infections are about to rise.

Lymphogranuloma venereum (LGV), caused by a bacteria that is part of the chlamydia family, is normally confined to the tropics of Africa, South America, Asia and the Caribbean. By the end of 2005 there were 30 recorded cases of LGV in Toronto.

"This is a new thing," said Dr. Robert Remis, a University of Toronto HIV/AIDS researcher. "It's hard to diagnose and it's a rather painful condition."

The city is already in the grip of a syphilis outbreak, and both diseases are associated with an increased risk for HIV and AIDS.

Dr. Kelly MacDonald, chair of the Ontario HIV Treatment Network, said the two outbreaks are a serious concern.

"It's a marker for high-risk sex and partner change," she said. "In every study with explosive rates of HIV you see syphilis."

And LGV is a "tropical disease we shouldn't see" in Toronto, she added. "It means the rate of partner change is extremely high. Things like syphilis and LGV should be the first things we get under control," said MacDonald, a microbiologist at Mount Sinai Hospital.

LGV symptoms appear three to 30 days after exposure. It starts with a painless sore on the vagina, penis, rectum or oral cavity. The condition can be cured with three weeks of antibiotics, but left untreated it can cause scarring, deformity and, in rare cases, hepatitis and meningoencephalitis (infection of the brain and spinal cord tissues).

In Toronto, all but one of the 30 cases were found in gay or bisexual men, said Dr. Rita Shahin, associate medical officer of health. Cases of LGV have been recently reported in gay men in the Netherlands and other European countries.

The current syphilis outbreak started in May 2002, mostly in gay or bisexual men, and peaked in 2004 with 368 cases. Last year there were 241.
(Keep Reading:TorontoStar)