So-called ‘carnivorous’ STI donovanosis raises fears in Britain

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Some doctors in Britain are concerned about an apparent increase in the number of cases of donovanosis, a sexually transmitted infection described as “carnivorous” due to the damaging nature of their genital sores and ulcers.

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Donovanosis infections are rare in developed countries. It is found primarily in tropical areas, including Papua New Guinea, parts of Central America, southern Africa, and southern India. Figures from the British government indicate that it is not as common as the more common STIs, such as chlamydia and gonorrhea.

But that hasn’t stopped the alarm on social media after local media quoted a London doctor as saying the infection “is becoming more common on these shores.” A TikTok video in which another British doctor listed his bloody symptoms and described it as “scary” garnered more than 1.5 million views in about 24 hours.

Q: What is donovanosis?

A: Donovanosis is caused by the bacteria Klebsiella granulomatis. The condition does not actually eat the skin, but has been dubbed “carnivorous” because of what the Centers for Disease Control and Prevention describe as “fleshy red” sores that damage a person’s genital tissue. If left untreated, it can spread to other parts of the body.

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The disease is most often transmitted through vaginal or anal sex.

Q: What are the symptoms of donovanosis?

A: Initial symptoms are relatively painless, as lesions slowly form on the genitals and perineum. But if left untreated, it becomes a “debilitating and stigmatizing” condition that can cause “severe tissue damage” in the genital area and beyond, according to John Kaldor, a professor at the Kirby Institute at the University of New South Wales in Australia. , which investigates infectious diseases.

Frank Bowden, a doctor who helped eliminate an outbreak in Aboriginal communities in northern Australia, said people would disappear into the bush, rather than seek treatment, with disastrous results.

“I am a doctor specializing in infectious diseases and I have never seen anything like it in my life. Without treatment it’s terrible, ”said the retired Australian National University professor of medicine.

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Q: Is there a cure for donovanosis?

A: There are antibiotic treatments available, including azithromycin, doxycycline, erythromycin, and trimethoprim-sulfamethoxazole. But the CDC says patients and their doctors should be on the lookout for possible relapse six to 18 months after completing treatment. Infections that cause ulcers around the genitals also increase the likelihood of HIV transmission, public health officials say.

Unlike gonorrhea or syphilis, which can be asymptomatic, people with donovanosis almost always have detectable symptoms. “Western-educated people don’t like things on their genitals, so they seek treatment,” Bowden said.

Q: Should people in Britain be concerned about donovanosis?

A: No, based on current numbers. Between 2016 and 2020, between 18 and 30 cases were detected in England each year, according to Public Health England. In 2020, 18 infections were recorded, compared to 30 in 2019, as widespread social distancing slowed their spread, along with that of other STIs.

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“With totals in teens and 20s over the past few years, I don’t think we can say it’s clearly increasing as there will inevitably be some random fluctuations,” said Kaldor of the Kirby Institute.

But he says more research is needed to find out who is affected. For example, if widespread transmission occurs in a particular part of the country, or a particular community, it could be classified as a localized outbreak.

Q: Who is most at risk for donovanosis?

A: Most infected people are in their 20s and 40s, according to the US National Library of Medicine, and the condition is more common in men than women. In the United States, the small number of cases each year typically occurs in people who have traveled to or come from places where the disease is common.

The best way to prevent STIs is by using condoms.

Q: Is donovanosis a problem in the United States?

A: Donovanosis was once endemic in the United States, but disappeared in the 1950s and 1960s as antibiotic use increased, Bowden said. It is rarely seen today, especially when compared to other STIs. About 100 cases are reported each year in the United States, according to the National Library of Medicine.