On Thursday, CDC alerted US doctors and clinics to be prepared to diagnose and treat gay and bisexual men who could be infected with the rare STD Lymphogranuloma venereum (LGV).

CDC issued the warning following reports of a recent outbreak of the disease among gay and bisexual men in the Netherlands, which uncovered 92 LGV cases dating back to 2003. The nation usually sees less than five cases a year. Belgium, France, Sweden, and Britain have also reported infections. It is unknown whether a similar LGV surge affects the United States, because doctors are not required to report the infections to local health departments.

Caused by specific strains of the STD chlamydia, LGV is usually marked by genital ulcers, swollen lymph glands and flu-like symptoms. However, the men recently infected in the Netherlands developed gastrointestinal bleeding, inflammation of the rectum and colon, and other problems not typically associated with LGV or other STDs.

LGV can be cured with a three-week course of antibiotics; however, it could be difficult to contain since it is uncommon in industrialized nations and is easily misdiagnosed. Control efforts could be complicated by some gay and bisexual men's high-risk sexual behavior. A large number of the men recently LGV-infected in the Netherlands had engaged in unprotected anal intercourse and taken part in sex parties in the year before getting sick, Dutch authorities found. Many were also HIV-infected.

"We expect it's a question of time before we see cases appearing here," said Dr. Stuart Berman, chief of epidemiology surveillance in CDC's division of STD prevention. "This is an early warning."

The full report, "Lymphogranuloma Venereum Among Men Who Have Sex With Men -- Netherlands, 2003-2004," was published in CDC's Morbidity and Mortality Weekly Report (2004;53(42):985-988).

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