The enigma of granuloma inguinale in South Africa

Granuloma inguinale (donovanosis) was well described in South Africa in the early part of this century. After 1927 no further reports appeared and with the passage of time, the belief grew that the disease did not occur in this country. This belief held until the 1980s, when several reports of cases of the disease appeared. What happened to the disease in the intervening half century? Did it disappear spontaneously? Or was it just not being recognised even when cases were being reported from 1950 onwards in neighbouring Zimbabwe? How is it that a disease can remain unrecognised when, untreated, it can relentlessly progress to cause severe disfigurement?