- A rare sexually transmitted disease some are calling
the "new AIDS" has made its way to Canada.
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- 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.
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- 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.
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- 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.
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- "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.
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- 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.
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- "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.
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- 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.
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- 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.
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- 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.
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- 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.
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- 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.
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- Virtually all the men engaged in "Internet partnering,"
frequented bath houses, or had sex at rave parties, according to the study.
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- 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.
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- 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."
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- (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.)
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- 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.
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