Chlamydia and LGV: Etiology and epidemiology

Etiology and epidemiology of Chlamydia trachomatis infections (including lymphogranuloma venereum (LGV)).

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Etiology

Chlamydia is a bacterial infection caused by C. trachomatis genotypes D to K.

LGV is a bacterial infection caused by C. trachomatis genotypes L1, L2 or L3.

Epidemiology

Chlamydia

Chlamydia is the most common reportable sexually transmitted infection (STI) in Canada. Rates have been increasing steadily since 1997.Footnote 1 Chlamydia may be under-detected because the majority of people with an infection are asymptomaticFootnote 2Footnote 3 and empiric treatment may be given without laboratory testing.

Males may be under screened due to infrequent health visits.Footnote 3Footnote 4Footnote 5 High-risk people may also be under screened.

Sexually active youth and young adults are disproportionately represented in case reports for chlamydia. The 15–29 age group has the highest infection rate. Females accounted for two-thirds of chlamydia infections reported between 2010 and 2015. While increased rates were observed in most age groups, adults over 40 years had the greatest increase.Footnote 1

LGV

LGV is relatively rare. LGV is thought to account for 2–10% of genital ulcer disease in India and Africa.Footnote 6  Prior to 2004, most Canadian cases were identified in travellers returning from endemic regions of Africa, Southeast Asia, the Caribbean and Latin America.Footnote 7 Since 2004, there have been LGV outbreaks in Canada, mainly in gay, bisexual and other men who have sex with men (gbMSM).

National enhanced surveillance of LGV was carried out from 2004-2012. During this time, 104 confirmed and 66 probable cases were reported to the Public Health Agency of Canada (PHAC) by provinces and territories. Confirmed cases were reported from Quebec, Ontario, British Columbia and Alberta; probable cases were reported from these provinces as well as from Nova Scotia.

More information

Local epidemiological information: Consult with your public health unit.

National epidemiological information:

Global epidemiological information: World Health Organization Report on global sexually transmitted infection surveillance

References

Footnote 1

Choudhri Y, Miller J, Sandhu J, Leon A, Aho J. Chlamydia in Canada, 2010-2015. Can Commun Dis Rep 2018 Feb 1;44(2):49-54.

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Footnote 2

Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: the case for screening. Prev Med 2003 Apr;36(4):502-509.

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Footnote 3

Marrazzo JM, Whittington WL, Celum CL, Handsfield HH, Clark A, Cles L, et al. Urine-based screening for Chlamydia trachomatis in men attending sexually transmitted disease clinics. Sex Transm Dis 2001 Apr;28(4):219-225.

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Footnote 4

Chen MY, Donovan B. Screening for genital Chlamydia trachomatis infection: are men the forgotten reservoir? Med J Aust 2003 Aug 4;179(3):124-125.

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Footnote 5

Andersen B, Olesen F, Moller JK, Ostergaard L. Population-based strategies for outreach screening of urogenital Chlamydia trachomatis infections: a randomized, controlled trial. J Infect Dis 2002 Jan 15;185(2):252-258.

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Footnote 6

Roest R, Van der Meijden W. European guideline for the management of tropical genito-ulcerative diseases. Int J STD AIDS 2001;12(2_suppl):78-83.

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Footnote 7

Mabey D PR. Lymphogranuloma venereum. Sex Transm Infect 2002;78:90-92.

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