Skip to main content

Military Health System

Surveillance Snapshot: Donovanosis Among Active Component Service Members, U.S. Armed Forces, 2011–2020

Image of 3_Surveillance snapshot_Donovanosis. 3_Surveillance snapshot_Donovanosis

Recommended Content:

Medical Surveillance Monthly Report

Donovanosis, or granuloma inguinale, is an uncommon sexually transmitted infection (STI) that is much rarer than chlamydia, gonorrhea, and syphilis. Donovanosis is found mainly in tropical regions, and is highly correlated with populations affected by poverty and lack of access to hygiene and public health infrastructure. However, recent news reports have described donovanosis as a "flesh-eating" STI that may be increasing in incidence in developed countries.1–3

Donovanosis is a bacterial infection of the skin and mucous membranes in the genital region.4–5 Early lesions are small, painless nodules that grow into characteristic "beefy red" highly vascular ulcers and progressively expand. Untreated cases can result in tissue destruction and scarring. Although clinical diagnosis is possible, ulcers may be hard to differentiate from those associated with syphilis, chancroid, HIV-associated herpes, amoebiasis, and carcinoma. For this reason, confirmation via staining of tissue or biopsies is recommended. The causative agent is Klebsiella granulomatis, a gram-negative intracellular bacillus, which produces characteristic Donovan bodies within mononuclear cells upon staining. Antibiotics such as azithromycin, doxycycline, erythromycin, ciprofloxacin, and trimethoprim-sulfamethoxazole are curative over a 3-week course or until sores have healed.

For this analysis, the Defense Medical Surveillance System was searched for records of inpatient and outpatient care for diagnoses of donovanosis. A case was defined by the recording of 1 inpatient or outpatient diagnosis of donovanosis (International Classification of Diseases, 9th Revision Clinical Modification [ICD-9-CM]: 099.2; ICD-10-CM: A58) in the primary diagnostic position. An individual could be counted as an incident case only once during the surveillance period (2011–2020). The surveillance population included all individuals who served in the active component of the Army, Navy, Air Force, or Marine Corps at any time during this period. During the 10-year period, there were 50 incident cases of donovanosis. Cases were split relatively evenly by sex (female service members: 54%; male service members: 46%) and most cases occurred in those aged 20–29 (56%) (data not shown). The annual numbers of cases ranged from 3 to 10 with no discernable trend over time (Figure).

Although the incidence of donovanosis has been very low among service members, it is important for health care providers to be aware of trends of emerging STIs particularly among young, sexually active individuals who may travel to endemic areas. As with other STIs, the best prevention of donovanosis is protected sex.

Author Affiliations: Defense Health Agency, Armed Force Health Surveillance Division (Ms. Daniele and Mr. Wilkerson).

References

  1. Purves R. Doctors warning as 'flesh-eating' STI hits UK. Birmingham Live. 21 Oct. 2021. Accessed 22 Nov. 2021. https://www.birminghammail.co.uk/news/health/what-donovanosis-flesh-eating-sti-21924441
  2. Lee B. Donovanosis: Why this is called a 'flesh eating' sexually transmitted infection. Forbes. 24 Oct. 2021. Accessed 22 No. 2021. https://www.forbes.com/sites/brucelee/2021/10/24/donovanosis-why-this-is-called-a-flesh-eating-sexually-transmitted-infection/?sh=423fc60112b4
  3. Gardiner, Alistair. Should doctors be concerned over this 'flesh-eating' STD? MDLinx. 4 Nov. 2021. Accessed 22 Nov,r 2021. https://www.mdlinx.com/article/should-doctors-be-concerned-over-this-flesh-eating-std/yKQ59ow980YmcCNPqVxiR
  4. Satter EK. Granuloma inguinale (donovanosis). Mescape. Updated 25 Oct. 2021. Accessed 22 Nov. 2021. https://emedicine.medscape.com/article/1052617
  5. O'Farrell N. Donovanosis. Sex Transm Infect. 2002;78(6):452–457.

FIGURE. Cases of donovanosis among active component service members, U.S. Armed Forces, 2011–2020

You also may be interested in...

Heat Illness, Active Component, U.S. Armed Forces, 2021

Article
4/1/2022
Cover 2

From 2020 to 2021, the rate of incident heat stroke was relatively stable while the rate of heat exhaustion increased slightly

Recommended Content:

Medical Surveillance Monthly Report

Brief report: Using syndromic surveillance to monitor MIS-C associated with COVID-19 in Military Health System beneficiaries

Article
3/1/2022
Cover 4

SARS CoV-2 and the illness it causes, COVID-19, have exacted a heavy toll on the global community. Most of the identified disease has been in the elderly and adults. The goal of this analysis was to ascertain if user-built ESSENCE queries applied to records of outpatient MHS health care encounters are capable of detecting MIS-C cases that have not been identified or reported by local public health departments.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Medical Separation from Service Among Incident Cases of Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
3/1/2022
Cover 5

Osteoarthritis (OA) is the most common adult joint disease and predominantly involves the weight-bearing joints. This condition, including spondylosis (OA of the spine), results in significant disability and resource utilization and is a leading cause of medical separation from military service.

Recommended Content:

Medical Surveillance Monthly Report

Obesity prevalence among active component service members prior to and during the COVID-19 pandemic, January 2018–July 2021

Article
3/1/2022
Cover 2

This study examined monthly prevalence of obesity and exercise in active component U.S. military members prior to and during the COVID-19 pandemic. These results suggest that the COVID-19 pandemic had a small effect on the trend of obesity in the active component U.S. military and that obesity prevalence continues to increase.

Recommended Content:

Medical Surveillance Monthly Report

Brief Report: Refractive Surgery Trends at Tri-Service Refractive Surgery Centers and the Impact of the COVID-19 Pandemic, Fiscal Years 2000–2020

Article
3/1/2022
Cover 3

Since the official introduction of laser refractive surgery into clinical practice throughout the Military Health System (MHS) in fiscal year 2000, these techniques have been heavily implemented in the tri-service community to better equip and improve the readiness of the U.S. military force.

Recommended Content:

Medical Surveillance Monthly Report

Update: Malaria, U.S. Armed Forces, 2021

Article
3/1/2022
Cover 1

Malaria infection remains an important health threat to U.S. service members who are located in endemic areas because of long-term duty assignments, participation in shorter-term contingency operations, or personal travel. In 2021, a total of 20 service members were diagnosed with or reported to have malaria.

Recommended Content:

Medical Surveillance Monthly Report

Diagnosis of hepatitis C infection and cascade of care in the active component, U.S. Armed Forces, 2020

Article
2/1/2022
Cover 1 a

Hepatitis C virus (HCV) infection rates are rising in the U.S. despite widely available tools to identify and effectively treat nearly all of these cases. This cross-sectional study aimed to use laboratory data to evaluate the prevalence of HCV diagnoses among active component U.S. military service members.

Recommended Content:

Medical Surveillance Monthly Report

A new approach to categorization of ocular injury among U.S. Armed Forces

Article
2/1/2022
Cover 2a

Ocular injuries present an ongoing threat to readiness and retention of service members. This report describes a new approach to categorizing ocular injury using Military Health System data, the application of an algorithm to a dataset, and the verification of the results using an audit of clinical data.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance snapshot: Health care burden attributable to osteoarthritis and spondylosis, active component, U.S. Armed Forces, 2016–2020

Article
2/1/2022
Cover 4

This snapshot summarizes the total numbers of inpatient and outpatient encounters with an OA or spondylosis diagnosis in the first diagnostic position and the total numbers of unique individuals affected by these conditions during the same 5-year surveillance period.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Lengths of Hospital Stays for Service Members Diagnosed with Sepsis, Active Component, U.S. Armed Forces, 2011–2020

Article
1/1/2022
Cover 4

Sepsis is a serious and life-threatening organ dysfunction caused by a dysregulated host response to infection. In the U.S., sepsis is a leading cause of in-hospital mortality and 1 of the most expensive conditions treated in U.S. hospitals.

Recommended Content:

Medical Surveillance Monthly Report

Description of a COVID-19 Beta Variant Outbreak, Joint Base Lewis-McChord, WA, Feb.–March 2021

Article
1/1/2022
Covid Beta

This report describes an outbreak of SARS-CoV-2, the causative agent of COVID-19, that peaked during 21–26 Feb. 2021 and was tied to a single military training event. A total of 143 laboratory-confirmed cases were identified.

Recommended Content:

Medical Surveillance Monthly Report

COVID-19 and Depressive Symptoms Among Active Component U.S. Service Members, January 2019–July 2021

Article
1/1/2022
Cover 3

This study examined the rates of depressive symptoms in active component U.S. service members prior to and during the COVID-19 pandemic and evaluated whether SARS-CoV-2 test results (positive or negative) were associated with self-reported depressive symptoms.

Recommended Content:

Medical Surveillance Monthly Report

Update: Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
12/1/2021
1_Update_Osteoarthritis

Osteoarthritis (OA), the most com­mon adult joint disease, is primarily a degenerative disorder of the entire joint organ, including the subchondral bone, synovium, and periarticular structures (e.g., tendons, ligaments, bursae). Spondylosis, often referred to as OA of the spine, is characterized by degenerative changes in the vertebral discs, joints, and vertebral bodies.

Recommended Content:

Medical Surveillance Monthly Report

Incident COVID-19 Infections, Active and Reserve Components, Jan. 1, 2020–Aug. 31, 2021

Article
12/1/2021
2_Incident COVID 19 infections

Incident COVID-19 Infections, Active and Reserve Components, 1 January 2020–31 August 2021

Recommended Content:

Medical Surveillance Monthly Report

Sepsis Hospitalizations Among Active Component Service Members, U.S. Armed Forces, 2011–2020

Article
11/1/2021
1_Sepsis

Recommended Content:

Medical Surveillance Monthly Report
<< < 1 2 3 4 5  ... > >> 
Showing results 46 - 60 Page 4 of 14
Refine your search
Last Updated: October 18, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery