Public health priority: Routine.
PHU response time: Enter probable and confirmed cases on NCIMS within 5 working days of notification.
Case management: Responsibility of treating doctor.
To monitor the epidemiology and so inform the development of better prevention strategies.
A probable case requires clinical evidence and epidemiological evidence.
Clinically compatible illness involving genital ulceration.
A confirmed case requires laboratory definitive evidence and clinical evidence.
Donovanosis is to be notified by laboratories on microbiological confirmation (ideal reporting by routine mail).
Confirmed and probable cases should be entered onto NCIMS.
The Gram-negative bacillus Klebsiella granulomatis (previously named Calymmatobacterium granulomatis) is the presumed aetiological agent.
Presumed to be by direct contact with lesions during sexual activity, but not all sexual partners become infected. It occurs mainly in remote areas of Northern Australia, Papua New Guinea, India and Southern Africa.
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.
The usual clinical presentation is characterised by indurated nodules of the external genitalia, inguinal and anal areas which become exuberant, beefy red ulcerated lesions.
Within 5 working days of notification enter confirmed and probable cases on NCIMS.
In general, the attending medical practitioner is responsible for treatment.
Refer to: Therapeutic Guidelines: Antibiotic
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.
Regular sexual contacts of the patient, the previous weeks and months are at most risk of infection.
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.
Case clustering, for example among clients of a sex industry establishment, may indicate the need to initiate an education and/or screening program.