Gunn R A, Harper S L, Borntrager D E, Gonzales P E, St Louis M E
Centers for Disease Control and Prevention, Atlanta, Ga., USA.
Am J Public Health. 2000 Oct;90(10):1540-4. doi: 10.2105/ajph.90.10.1540.
This study assessed a strategy designed to contain imported cases of syphilis and prevent reestablishment of ongoing transmission.
Reported syphilis cases during an endemic period (1990-1992) and an elimination period (1997-1998) were compared in San Diego, Calif. The elimination strategy, which focuses on rapid reporting of infectious syphilis cases by clinicians, prompt partner and sexual network management, outreach to marginalized populations, and implementation of an outbreak containment plan, was evaluated.
Infectious syphilis incidence rates declined from 18.3 per 100,000 in 1998 to 1.0 per 100,000 in 1998. Of the 46 cases involving probable infection during 1997-1998, 19 (41%) were imported, mostly (79%) from Mexico. Outbreak containment procedures were implemented successfully for 2 small clusters. Outreach workers provided sexually transmitted disease information to a large number of individuals; however, no cases of infectious syphilis were identified, suggesting that syphilis transmission was not occurring among marginalized groups.
This syphilis elimination and importation control strategy will require monitoring and adjustments. Controlling syphilis along the US-Mexico border is a necessary component of syphilis elimination in the United States.
本研究评估了一项旨在控制梅毒输入病例并防止已存在的传播重新建立的策略。
对加利福尼亚州圣地亚哥在流行期（1990 - 1992年）和消除期（1997 - 1998年）报告的梅毒病例进行比较。评估了该消除策略，其重点是临床医生对感染性梅毒病例的快速报告、及时的性伴和性网络管理、对边缘化人群的外展服务以及实施疫情控制计划。
感染性梅毒发病率从1990年的每10万人18.3例下降到1998年的每10万人1.0例。在1997 - 1998年期间涉及可能感染的46例病例中，19例（41%）为输入病例，大部分（79%）来自墨西哥。成功对2个小聚集性病例实施了疫情控制程序。外展工作人员向大量个体提供了性传播疾病信息；然而，未发现感染性梅毒病例，这表明梅毒传播未在边缘化群体中发生。
这种梅毒消除和输入控制策略需要进行监测和调整。在美国-墨西哥边境控制梅毒是美国消除梅毒的必要组成部分。
