What is that ‘flesh-eating’ STI becoming more common in the UK?

For a few days, a ‘flesh-eating’ STI apparently spreading in the UK has been scarying people on social media. What is it about? Should we be afraid? How can we protect ourselves?

A TikTok video in which a British physician listed the gory symptoms of a 'flesh-eating' sexually transmitted disease and described it as 'terrifying'. That’s all it took for it to gather more than 1.5 millions views in about 24 hours. And when a London doctor who added the “infection is more common on these shores” was quoted in the media, followed by other doctors in Britain, a sort of panic has emerged. These doctors are worried about an apparent rise in the number of cases of donovanosis, a sexually transmitted infection described as 'flesh-eating' because of the damaging nature of its genital ulcers and sores.

An infection which does not actually ‘eat’ the skin

Donovanosis is caused by the bacterium Klebsiella granulomatis. The condition does not actually eat the skin, but it has been dubbed 'flesh-eating' ulcers that damage the tissue of a person’s genitals. If left untreated, it can spread to other parts of the body. The initial symptoms are relatively painless, as the lesions form slowly on the genitals and perineum, the area between the genitals and the anus. Things come worst if it is left untreated with serious tissue damage in the genital area and beyond.

Picture (EXPLICIT CONTENT): female genitals damages
Picture (EXPLICIT CONTENT): male genitals damages
Credits: SOA-AIDS Amsterdam, CC

A STI which can be cured

Donovanosis can be cured as antibiotic treatments are available, including azithromycin, doxycycline, erythromycin and trimethoprim-sulfamethoxazole. Patients must be aware  that a relapse might occur from 6 to 18 months after completing treatment. People who have been diagnosed with donovanosis must also know that fragilized mucous membranes also increase the likelihood of HIV transmission. However, unlike gonorrhea or syphilis, which can be asymptomatic, people with donovanosis almost always have detectable symptoms so that they can’t miss it.

Should people in Britain worry about donovanosis?

Not on the basis of current numbers. Donovanosis infections are rare in developed countries. The disease is mostly found in tropical areas, including Papua New Guinea, parts of Central America, southern Africa and southern India. British government figures indicate it is nowhere near as prevalent as more common STIs such as chlamydia and gonorrhea.  From 2016 to 2020, there were between 18 and 30 cases detected in England each year, according to Public Health England. Eighteen infections were logged in 2020, down from 30 in 2019, as widespread social distancing curbed its spread, along with the spread of other STIs.

Even though there a few cases, research is still needed to find out who is affected. For instance, if widespread transmission is occurring in a particular part of the country, or a particular community, it might be classified as a localized outbreak, and therefore it could help to tackle it.

Doctors warn: looking after our sexual health is especially important as we’re able to enjoy a more normal life without COVID-19 restrictions. But still: as the disease is most commonly spread through vaginal or anal sex, the best way to prevent the STI is and remains through condom use.