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Syphilis Outbreak Response in Southwest Oklahoma

Posted By Jan Fox and Kristy Bradley, Friday, January 23, 2015
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On July 28, 2014, a case of primary syphilis was identified at the Comanche County Health Department (CHD) in Oklahoma. Between July 28 and September 25, eight additional cases were diagnosed in that county. These numbers reflected a 300 percent increase in reported cases for Comanche County from 2013. Upon review of the cases, the Oklahoma State Department of Health (OSDH) HIV/STD Service and the Comanche CHD determined that an outbreak of syphilis was occurring and outbreak response efforts were initiated. The outbreak was found to be occurring among men who have sex with men (MSM) and included risk factors of multiple sex partners, new and/or anonymous sex partners, using drugs, and/or trading sex for money and/or drugs. It was also noted that some infected were on the ‘down-low’ (slang for men who identify as heterosexual, but who have sex with men and avoid sharing this information even if they have female sexual partners and/or are married).
Working in partnership, the HIV/STD Service and the Comanche CHD quickly implemented the following activities:
  • Conducted a ‘blitz’, in which a team of Disease Intervention Specialists was dispatched to Comanche County to quickly initiate contact tracing (partner services) for all reported cases in an effort to get in front of the outbreak. Contact tracing is the cornerstone of public health response efforts for infectious diseases and involves face-to-face interviewing of infected persons to elicit reporting of sexual partners in order to subsequently locate, test, and treat persons who have been exposed to the disease. To date, a total of 110 sexual partners were identified as a contact to at least one of the 11 cases, with 73 in need of treatment. Among these, 81 have been located and tested, 52 have received treatment, and 8 required interstate assistance for follow-up.
  • A health alert went out to local clinicians and a syphilis educational meeting was held at the Comanche CHD in order to make local clinicians aware of the syphilis problem and to ask for assistance in testing and treating their at-risk patients. The meeting was well attended with 35-40 clinicians present.
  • A media news release was utilized to disseminate facts about syphilis to the public and included prevention, testing, and treatment information. The release resulted in wide distribution of information, including a live interview with KFOR, in-person on-camera interviews for KSWO-TV 7 News in Lawton, Telemundo, and Fox25 as well as a phone interview with the Daily Oklahoman and the Cameron Collegian Weekly. Additionally, the online story was shared more than 12,000 times on social media.
  • Posters and other print material were created and distributed in the Lawton area to raise awareness of syphilis and the outbreak. A quick response (QR) code was created and added to the print material; when scanned, this code would lead the person to a website that provided information about the health alert and basic syphilis information.
To date, 17 syphilis cases have been identified that are associated with this outbreak. Disease prevention and control efforts continue in order to ensure that the outbreak is brought to an end.
Jan Fox, RN, MPH, is the Director of the HIV/STD Service at the Oklahoma State Department of Health. Kristy K. Bradley, DVM, MPH is State Epidemiologist and State Public Health Veterinarian at the Oklahoma State Department of Health. She also serves as CSTE Executive Board Chair for Infectious Disease. For more information about STIs, visit CSTE’s National Notifiable Diseases Surveillance System NNDSS Modernization Initiative page and the Infectious Disease overview page.

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