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Outbreaks of sexually transmitted infections (STIs) are a continued public health concern. In this issue, for example, Foster and colleagues describe an outbreak of gonorrhoea that affected over 300 people in a discrete population in England, predominantly young heterosexual adults.1 Outbreaks of other emerging, or re-emerging, infections such as shigella2 and syphilis3 have also been detected with increased regularity, while the recent evolution of a ‘highly resistant’ strain of gonorrhoea in the north of England generated considerable media coverage due to the threat of spread of antimicrobial resistance.4 Social networking apps that use geographical locations to find sexual partners are thought to have contributed to the spread of some of these infections, partly because they can increase the size and connectivity of sexual networks. Consideration of geographical information is therefore important when investigating STI outbreaks.
In a previous editorial in Sexually Transmitted Infections, Simms and colleagues outlined the potential for geospatial methods to be applied across sexual health research.5 They identified examples of researchers using these tools to map geographical distributions of infection; plan, improve and evaluate services, and identify clusters of STIs in space and time. Here, we focus specifically on methods that can be used to enhance outbreak investigations. Many geospatial tools are available and can be used to assist with detection of the outbreak; describing cases; testing hypotheses; targeting interventions and communicating findings. These approaches are summarised in table 1 and described in detail in a recent systematic review.6 However, only one of the reports identified in this review described an investigation of an STI outbreak, indicating an opportunity for expansion of their use in this field.
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