West Virginia
Infectious Disease Epidemiology Program

Public Health Action

1. Report all cases to the West Virginia Bureau for Public Health within one week of diagnosis using the VD91. (See attached.)
   
2. For all questions on sexually transmitted diseases, please call 304 558-2950 or toll-free in the state at 1-800 -642-8244.

Chancroid, caused by Haemophilus ducreyi, is one of the genital ulcerative STDs; others include syphilis and herpes simplex virus (HSV). Chancroid is prevalent in Africa and parts of Asia and has been shown to be a risk factor in the transmission of HIV. It is likely that chancroid is underreported in the United States because laboratory diagnosis of chancroid is difficult and most laboratories are incapable of culturing H. ducreyi. H. ducreyi may be identified in a gram-stained smear based on cell morphology, staining, and arrangement or by isolating and identifying the organism by its biochemical reaction patterns. Neither method of identification is very sensitive. Thus, improved methods for the identification of H. ducreyi in specimens has become a priority.

Antimicrobial resistance has emerged in H. ducreyi. The detection of high-level tetracycline resistance due to the acquisition of the TetM determinant by H. ducreyi as well as plasmids encoding resistance to beta-lactams, aminoglycosides, and other antimicrobial agents has renewed interest in the antimicrobial susceptibilities of this organism.

Azithromycin 1 gm orally

or

Ceftriaxone 250 mg IM in a single dose

or

Ciprofloxacin 500 mg twice daily x 3 days

or

Erythromycin base 500 mg tid x 7 days