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Last updated:
06 September 2004
1. Reason for surveillance
- To monitor the epidemiology of the disease and so inform prevention strategies.
2. Case definition
A confirmed case requires:
- Demonstration of Chlamydia trachomatis sero vars L1 to L3 in fluid aspirated from a fluctuant bubo or from a genital lesion by immunoflourescence (IF), EIA, DNA probe, PCR, culture or by specific micro-IF serological tests.
Factors to be considered in case identification
Diagnosis is made by demonstration of C. trachomatis from bubonic fluid. Complement fixation testing is of diagnostic value if there is a four-fold rise or a single titre of ≥1:64.
3. Notification criteria and procedure
Lymphogranuloma venereum is to be notified by:
- Laboratories on diagnosis (ideal reporting by routine mail).
Only confirmed cases should be entered onto NDD.
4. The disease
Infectious agent
The bacterium Chlamydia trachomatis (serovars L1-3). Mode of transmission
Direct contact with open lesions of infected people, usually during sexual intercourse. Timeline
The typical incubation period is variable, with a range or 3 to 30 days of the primary lesion. If a bubo is the first manifestation, the range is from 10 to 30 days up to several months. The period of communicability is variable, from weeks to years, during the presence of active lesions. Clinical presentation
The usual clinical presentation begins with a small painless lesion on the genital area followed some weeks later by lymphadenopathy. Affected lymph nodes, which in males are usually inguinal and in females pelvic, may progress to fluctuant buboes. Proctitis may result from rectal intercourse. Other symptoms which are usually present include fever, headache and joint pains.
5. Managing single notifications
Response time
Data entry
Within 5 working days of notification enter confirmed cases on NDD. Response procedure
Where a case is reported in a child <16 years old, the PHU must send a letter to the treating doctor outlining his/her obligation to notify the Department of Community Services. Case management
Investigation and treatment
In general, the attending medical practitioner is responsible for treatment. Specialist advice is usually required. Refer to Therapeutic Guidelines: Antibiotic. Education
In general, the case's doctor provides education and counselling. 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
Sexual contacts in the 2 weeks before the ulcer appeared or since arrival from an endemic area. Investigation and treatment
The treating doctor is responsible for contact tracing. PHUs should work with Sexual Health Service staff to assist if requested. Contacts require counselling, examination, and culture and treatment of any lesion.
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 to meet local requirements.
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