Sexually transmitted diseases - Chancroid

Chancroid is a common sexually transmitted disease (STD) caused by infection with the Gram negative bacterium Haemophilus ducreyi, a fastidious organism primarily located in the extra cellular spaces. It is highly infectious but curable and is characterized by painful sores on the genitalia, swollen, painful lymph glands or inguinal buboes in the groin and if it’s left unattended may facilitate HIV transmission.

Transmission and origin
Chancroid can be transmitted in two ways: sexually through skin-to-skin contact with open sore or sores; and non-sexually if a pus-like fluid from the ulcer is in contact with other areas of the body. If ulcers are already present then the person is deemed infectious.
Research claims that the disease is found mostly in third world and developing nations. Occurrences in the United States ranges from fair to rare and most people diagnosed with such have traveled to countries where the disease has occurred frequently. Further, uncircumcised men have three times greater risks of being infected and for contracting the disease to another person.

The most common cases of Chancroid can be attributed to unsafe and unhygienic intercourse mostly manifested in areas where commercial sex is associated and in boom thus it affects both the workers and the clientele. It is widely accepted that prostitutes constitute an important reservoir of this kind of infection.

Incubation
It takes about 1 to 7 days for Chancroid to fully develop and eventually the lesion appears 2-3 days after the first exposure however it may also be up to a month before it the pores finally erupt. A preliminary macule or papule will first appear at the area surrounding the inoculation and rapidly spreads through vesicular and pustular stages forming a very well circumscribed painful ulcer which can then take into different forms that can be single or multiple. In most men, the main lacerations are usually located on the preputial orifice, frenulum, coronal sulcus and rarely on the glans penis and the shaft. In women on the other hand, the sites of predilection are the labia, clitoris and fourchette though the perineum and anus are affected, only in less common situations.

Treatment and Prevention
The infection can be treated with antibiotics that can usually cure and resolve the symptoms within 3 days to 7 days and prevents transmission to others as well. This includes azithromycin, ceftriaxone, ciprofloxacin, and erythromycin.

The treatment is also available in multi-dose and single dose therapy that requires strict diligence and should also continue even after the wounds are healed to prevent the infection from recurring and to make certain the complete eradication of such disease. Although sometimes recovery may take longer, it really depends on the size of the ulcer and the person. Some people would suffer pain for more than a few months.

Scientists from the Chapel Hill's School of Medicine of the North Carolina University and North Carolina State University's College of Veterinary Medicine are currently working on different vaccines for treating Chancroid and they are investigating the antibodies formed by pigs and swine when immunized against the said disease. The recent study and other studies suggest that formulating a chancroid vaccine would be a quite simple task.