The infection is extremely rare in the United States and in England. But that doesn't mean you shouldn't still be careful.
If you’ve managed to escape any mentions in your news feed of the “flesh-eating” sexually transmitted disease recently reported in England, well, we’re sorry for bringing it up. But the horrifying headlines seem to be everywhere: As first reported by the Liverpool Echo, an unidentified woman in Southport, UK, was diagnosed in the last 12 months with donovanosis—a sexually transmitted infection (STI) that can cause genital ulcers and, if not treated, can literally cause tissue to rot away.
Donovanosis is extremely rare in both the United Kingdom and the United States, but its description is graphic enough to both captivate and terrify us, nonetheless. To learn more about donovanosis—and how freaked out we should really be—we spoke with Jeanne Marrazzo, MD, MPH, chair of the division of infectious diseases at the University of Alabama at Birmingham. Here’s what she thinks are the important facts behind the viral story.
What is donovanosis, and how common is it?
Also called granuloma inguinale, donovanosis is a bacterial infection that’s transmitted through vaginal or anal intercourse, or, rarely, through oral sex. According to the Centers for Disease Control and Prevention (CDC), the infection is common in tropical and developing parts of the world, including India, Guyana, New Guinea, Central Australia, and Southern Africa.
It’s much, much less common in developed countries. In the United States, only about 100 cases are reported every year, most or all of which are acquired abroad. “Even among STD experts, I would wager to say that most doctors in the United States have not seen a case of this,” says Dr. Marrazzo. (She has, once, in a Caribbean native who’d recently relocated to the United States.)
The case in the news this week was reported as part of a survey of UK hospitals conducted by the online pharmacist Chemist 4 U. Some news outlets have reported that there have “been no prior cases” of donovanosis in the UK, and that this disease had been identified there “for the first time.”
But the British Association for Sexual Health and HIV (BASHH) told Health via email that there’s no basis to those statements. According to Public Health England, donovanosis is found in the UK, although it's “rarely diagnosed and reported.”
Is it really flesh-eating?
Medical descriptions of donovanosis often refer to ulcers or raised bumps that form one to 12 weeks after exposure. “It’s known for causing these really nasty-looking ulcers—they look like raw meat, beefy and really red, and they have a lot of blood supply so they bleed easily,” says Dr. Marrazzo.
“If they’re left untreated, they really can cause destruction of the tissue around them, which is why people say it’s ‘flesh-eating’ or that it causes skin to ‘rot away,’” Dr. Marrazzo adds. In advanced cases, according to the CDC, the ulcers can spread to the groin, lower abdomen, and upper thighs, and can develop secondary infections of their own.
However, Dr. Marrazzo adds, that shouldn’t happen with a timely diagnosis and proper treatment. When caught early, antibiotics can clear a donovanosis infection. It can sometimes reappear, however, and the sores can sometimes cause scarring or long-term damage.
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So, should you worry?
If you’re not traveling to and having unprotected sex in countries where this disease is prevalent, the chances you’d be exposed to it are extremely slim, says Dr. Marrazzo. But that doesn’t mean this can’t serve as a reminder to practice safer sex with casual partners: Use a condom or another barrier method (for all forms of sexual contact, not just intercourse), and avoid contact with open wounds.
If you do notice strange ulcers or sores on your genitals, get them checked out right away. “Odds are, if you have something that is giving you this kind of complaint, it’s probably something much more common like syphilis or herpes,” says Dr. Marrazzo. (Regardless of the cause, you’ll need prompt treatment to keep it from getting worse.)
In fact, rates of syphilis have been soaring in the U.S. and the UK. “If there is a big public-health message here, it’s that we’ve seen a huge resurgence of syphilis,” says Dr. Marrazzo. “That’s definitely one thing we really should be looking out for.”