Last updated:
06 September 2004
1. Reason for surveillance
- To monitor the epidemiology and so inform the development of better prevention strategies.
2. Case definitions
Probable case
A probable case requires clinical evidence and epidemiological evidence. Laboratory evidence
Not applicable. Clinical evidence
Clinically compatible illness involving genital ulceration. Epidemiological evidence
- A compatible sexual history in a person from a endemic area, or
- A compatible sexual risk history involving sexual contact with someone from an endemic area.
Confirmed case
A confirmed case requires laboratory definitive evidence AND clinical evidence. Laboratory definitive evidence
- Demonstration of intracellular Donovan bodies on smears or biopsy specimens taken from a lesion, or
- Detection of Calymmatobacterium granulomatis by nucleic acid testing of a specimen taken from a lesion.
Clinical evidence
Clinically compatible illness involving genital ulceration. Epidemiological evidence
Not applicable.
3. Notification criteria and procedure
Donovanosis is to be notified by:
- Laboratories on microbiological confirmation (ideal reporting by routine mail).
Confirmed and probable cases should be entered onto NDD.
4. The diseases
Infectious agent
The Gram-negative bacillus Calymmatobacterium granulomatis (Klebsiella granulomatis) is the presumed aetiological agent. Mode of transmission
Presumed to be by direct contact with lesions during sexual activity, but not all sexual partners become infected. It occurs mainly in Northern Australia, Papua New Guinea, India and Southern Africa. Timeline
The typical incubation period is unknown, but probably between 7 and 112 days. The period of communicability is unknown, but is probably for the duration of the open lesions on the skin or mucous membranes. Clinical presentation
The usual clinical presentation is characterised by indurated nodules of the external genitalia, inguinal and anal areas which become exuberant, beefy red ulcerated lesions.
5. Managing single notifications
Response times
Data entry
Within 5 working days of notification enter confirmed and probable cases on NDD. Response procedure
Where a case is reported in a child <16 years old, the PHU must send a letter to the caring doctor outlining his/her obligation to notify the Department of Community Services. Case management
Treatment
In general, the attending medical practitioner is responsible for treatment. Refer to: Therapeutic Guidelines: Antibiotic Education
In general, the case's doctor provides counselling and education. PHU or Sexual Health Service staff should provide additional assistance, if required. The medical practitioner should provide information to the case about the nature of the infection and the mode of transmission. Contact management
Identification of contacts
Regular sexual contacts of the patient, the previous weeks and months are at most risk of infection. Investigation and treatment
The treating doctor is responsible for contact tracing. PHUs should work with SHC staff to provide assistance where requested by the doctor. Contacts require counselling and examination. Most infected contacts will be symptomatic and lesions should be treated.
6. Managing Special Situations
Case clustering
Case clustering, for example among clients of a sex industry establishment, may indicate the need to initiate an education and/or screening program.
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