Background In 2012 the Essex Health Protection Unit of the Health Protection Agency(HPA) was alerted to a significant rise in syphilis in Southend. 27 cases were diagnosed in 2011 and 15 in the first half of 2012, compared to just 10 in 2010, indicating a greater than 50% rise. All were in men who have sex with men. In England as a whole, in 2011, 2915 syphilis cases were diagnosed, reflecting a less modest 10% rise compared to 2010.
Importantly, Southend is a high prevalence UK area of HIV, with a population prevalence of 2.76 per 1000. 6 of 27 individuals diagnosed with syphilis in Southend in 2011 were HIV-infected.
Aim A multidisciplinary incident management team (MDT) was established to investigate and establish measures to control the outbreak. The MDT includes members of the local health authority, public health department, HPA and genitourinary medicine(GUM) department. The MDT agreed to monitor GUM and diagnostic laboratory activity to inform testing and prevention strategies.
Interventions Local media press releases alerting the public of the syphilis outbreak were produced. Such information advised on sexual health promotion, irrespective of age or perceived risk. The Gay Essex Men’s Support Group, Terrence Higgins Trust, and local contraception services were also alerted and encouraged to use existing networks to raise awareness.
Annual use of one of 6 pharmacy campaigns to raise STI awareness was implemented. Dissemination (verbally and written-intranet) of information on STI trends and management was well received by local general practitioners.
Conclusions Firstly, local accurate reporting confirmed the increase in syphilis diagnoses, and enabled timely review and public health action. Secondly, good interagency and multidisciplinary working resulted in productive collaborative responses. And finally, the use of existing sexual health and MSM social/support networks enabled access to ‘harder to reach’ populations with regards to STI health promotion.
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