Lomax N, Wheeler H, Anaraki S, Anderson H, Goh B
Ambrose King Centre, Royal London Hospital, Whitechapel, London E1 1BB, UK.
Sex Transm Infect. 2006 Dec;82(6):437-8. doi: 10.1136/sti.2006.020461. Epub 2006 Jun 28.
To describe the control and management of a syphilis outbreak in female street sex workers (SSWs) in east London.
Following the identification of several cases of infectious syphilis in SSWs in east London, a targeted service for screening and treatment of syphilis and other sexually transmitted infections was developed. A multidisciplinary team (MDT) joined an existing outreach service to facilitate this. Once it became apparent that this was not an isolated case, an outbreak control team (OCT) was established.
Between April and December 2004 a total of 14 (58%) women with 15 cases of infectious syphilis were identified in 24 SSWs: 14/15 (93%) received treatment. Epidemiological treatment for syphilis was also given to the rest of SSWs at the initial visit. Several coexistent STIs were identified in this cohort. As part of the enhanced outbreak surveillance in north east London, 21 cases of infectious syphilis were reported in SSWs between April 2004 and December 2005.
Outbreak management in this population was challenging: an MDT approach was crucial in identifying and treating syphilis to prevent onward transmission. There was a high prevalence of syphilis and other STIs in this cohort, and we treated the majority of cases. The formation of an OCT enabled us to monitor the outbreak and implement control measures more effectively. The novel intervention we describe has proved valuable in helping to control this syphilis outbreak.
描述伦敦东部女性街头性工作者梅毒暴发的控制与管理情况。
在伦敦东部的街头性工作者中发现数例感染性梅毒病例后，开展了一项针对梅毒及其他性传播感染筛查与治疗的专项服务。一个多学科团队（MDT）加入了现有的外展服务以推动此项工作。一旦发现这并非孤立病例，便成立了疫情控制小组（OCT）。
2004年4月至12月期间，在24名街头性工作者中总共确认了14名（58%）女性患有15例感染性梅毒：14/15（93%）接受了治疗。在初次就诊时，其余街头性工作者也接受了梅毒的预防性治疗。在该队列中还发现了几种并存的性传播感染。作为伦敦东北部强化疫情监测的一部分，2004年4月至2005年12月期间，街头性工作者中报告了21例感染性梅毒病例。
对这一人群的疫情管理具有挑战性：多学科团队方法对于识别和治疗梅毒以防止进一步传播至关重要。该队列中梅毒及其他性传播感染的患病率很高，我们对大多数病例进行了治疗。疫情控制小组的组建使我们能够更有效地监测疫情并实施控制措施。我们所描述的新型干预措施已证明在帮助控制此次梅毒暴发方面具有价值。
