DISEASE CONTROL Chancroid

Name: ERIL EMIRUL BIN MOHD RAPI Matrix No.: EH/DP/10-4/0002 Batch: 20

identification
An acute, sexually transmitted bacterial infection usually localized in the genital area and characterized clinically by a single or multiple painful, necrotic ulcers that bleed on contact. Chancroid ulcers are more frequently found in uncircumcised men, on the foreskin or in the coronal sulcus, and may cause a phimosis. These primary lesions are frequently accompanied by painful, swollen and suppurating regional lymph nodes Sign & Symptom Within 1 day - 2 weeks after getting chancroid, a person will get a small bump in the genitals. The bump becomes an ulcer within a day of its appearance. The ulcer: Ranges in size from 1/8 inch to 2 inches across Is painful Is soft Has sharply defined borders Has a base that is covered with a grey or yellowish-grey material Has a base that bleeds easily if it is banged or scraped

About half of infected men have only a single ulcer. Women often have four or more ulcers. The ulcers appear in specific locations.

Contd..
Common locations in men are:

Foreskin
Groove behind the head of the penis Shaft of the penis Head of the penis Opening of the penis Scrotum

Contd..
In women the most common location for ulcers is the outer lips of the

vagina (labia majora). "Kissing ulcers" may develop. These are ulcers that occur on opposite surfaces of the labia.Other areas, such as the inner vagina lips (labia minora), the area between the genitals and the anus (perineal area), and the inner thighs may also be involved. The most common symptoms in women are pain with urination and intercourse. The ulcer may look like a chancre, the typical sore of primary syphilis. About half of the people who are infected with a chancroid will develop enlarged inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen. In half of people who have swelling of the inguinal lymph nodes, the nodes will break through the skin and cause draining abscesses. The swollen lymph nodes and abscesses are often called buboes.

Infectious agent
Chancroid is caused by Haemophilus ducreyi a, a small,

gram-negative, facultative anaerobic bacillus. It produces a cytocidal distending toxin that appears to be responsible for its toxic effects.

Occurrence
It is a disease found primarily in developing countries,

most prevalent in low socioeconomic groups, associated with commercial sex workers. Infection levels are low in the Western world, typically around one case per two million of the population (Canada, France, Australia, UK and US).[citation needed] Most individuals diagnosed with chancroid have visited countries or areas where the disease is known to occur frequently, although outbreaks have been observed in association with crack cocaine use and prostitution.[ Chancroid is prevalent in Africa, the Caribbean basin, and Southwest Asia. It is thought to be the most common cause of genital ulceration in Kenya, Gambia, and Zimbabwe.

reservoir
Human

Mode of transmission
Chancroid can be sexually transmitted if there is skin-to-

skin contact with the open sores. Non-sexual transmission is also possible if a person comes into contact with the pus-like fluid oozing from the ulcer.

Incubation period
The organism has an incubation period from 1 day to 2

weeks, with a median time of 5-7 days.

Isolation & quarantine measure

Isolation or quarantine is not required for chancroid, but

patients must avoid sexual contact until all lesions, including discharging regional lymph nodes, are healed.

Period of communicability
Until the original ulcer and/or discharging lymph nodes

are healed.

Method of control & prevention

The prevention and control of STDs are based on the following five major strategies: 1) education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors; 2) identification of asymptomatically infected persons and of symptomatic persons unlikely to seek diagnostic and treatment services; 3) effective diagnosis and treatment of infected persons; 4) evaluation, treatment, and counseling of sex partners of persons who are infected with an STD; and 5) pre-exposure vaccination of persons at risk for vaccinepreventable STD.

Treatment
The CDC recommendation for chancroid is a single oral

dose (1 gram) of Azithromycin or a single IM dose of Ceftriaxone or oral Erythromycin for seven days.

References
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001659/

http://en.wikipedia.org/wiki/Chancroid
http://www.stdsincolor.com/chancroid.php http://emedicine.medscape.com/article/214737-

overview#a0199 www.gov.mb.ca/health/publichealth/cdc/protocol/chancroi d.pdf http://emedicine.medscape.com/article/1052141-followup http://www.cdc.gov/std/treatment/2006/clinical.htm