A rare sexually transmitted disease never before confirmed in laboratory tests in New York City has been diagnosed in two men, leading health officials to remind the public about practicing safe sex and to encourage doctors to be on the lookout for signs of the disease.
The cases are among the first reported in the United States and match a strain of the disease that only began to surface in Europe in recent years.
The disease, lymphogranuloma venereum, known as LGV, is a rare form of chlamydia that can cause acute illness, lifelong disability and disfigurement as well as fuel the spread of H.I.V./AIDS through open sores. A majority of those infected, both in Europe and the United States, have been gay men who engage in anal intercourse.
Health officials would not go into detail about the two infected men in New York except to say the cases appeared unrelated.
Some of the symptoms may have showed up in doctors' examinations, but they were not connected to the disease until further lab tests were performed by health officials on the federal and local levels.
Officials said that the disease is treatable, and that wearing a condom during sex can reduce the risk of transmission.
"LGV is a serious condition and its emergence in New York City reflects continuing high levels of unsafe sexual activity among men who have sex with men," said Thomas R. Frieden, commissioner of the New York City Department of Health and Mental Hygiene.
Dr. Frieden added, "It is also critical for gay and bisexual men to minimize risky sexual behaviors and practice safer sex - including limiting the number of sex partners and using condoms every time you have sex - to help prevent the spread of this illness and H.I.V./AIDS."
City health officials have been worried for some time that residents, particularly gay men, are growing lax in their attitudes about safe sex. In the past four years, the number of new syphilis cases in the city has slowly increased, with gay men accounting for most of them.
According to a survey conducted by the Health Department in 2003, only 45 percent of gay men reported using a condom.
The LGV disease has been prevalent in less-developed countries in Africa, Southeast Asia and the Caribbean. When officials in Europe noticed a significant rise in cases of LGV in the Netherlands, to 62 cases in 2004 from an average of fewer than five cases in previous years, they sent a warning to all nations in the European Union. The Centers for Disease Control in Atlanta issued an alert to health authorities in the United States in October.
How the disease made its way to Europe is still under investigation. One health official suggested that the disease's spread is related to "international sexual networks." The networks, the official said, could be anything from prostitution to overseas sex holidays.
So far, there have been six cases of the disease reported in the United States. In addition to the two New York cases, there have been three in San Francisco and one in Atlanta.
Dr. Frieden said the disease was hard to diagnose, often confused with inflammatory bowel syndrome. The symptoms for LGV include a painful, bloody rectal infection, genital ulcers and the draining of the lymph nodes in the groin area.
Making the disease even harder to detect is that it can have a gestation period of up to six months, Dr. Frieden said. During this time, an infected person would have no symptoms but can still pass on the disease.
Once the disease is diagnosed, a three-week course of antibiotics is usually effective treatment, Dr. Frieden said.
The city has sent an alert to physicians warning them to be on the lookout for the disease and is working closely with leaders in the gay community to better inform the public