Mathematical modeling of epidemic syphilis transmission. Implications for syphilis control programs.
OBJECTIVE
The past 10 years' wave of syphilis epidemics has challenged syphilis control programs. Although apparently connected to drugs-for-sex trading of crack cocaine, the genesis and resolution of these epidemics is poorly understood.


OBJECTIVE
The goals of this study were to develop a mathematical model of epidemic syphilis transmission based on empiric data, to stimulate and ascertain behavioral and sociologic features necessary to produce epidemic transmission, and to explore mechanisms leading to resolution of epidemic transmission.


METHODS
The study used multi-compartment iterative computer simulation using empirically derived input data.


RESULTS
Epidemic transmission resulted from adding a small core group of individuals with very high levels of partner exchange (300-400 partners per year) to a population with levels of partner exchange seen in the general population. Epidemic resolution could result from immunity or subtle changes in the size or partner exchange rate of the core group.


CONCLUSIONS
There is a need for sexually transmitted disease control programs to reevaluate their approach to prevention and control of epidemic syphilis in light of data on transmission dynamics.
Oxman
G L
GL
Multnomah County Health Department, Portland, Oregon, USA.
Smolkowski
K
K
Noell
J
J
D000293:Adolescent; D000328:Adult; D003198:Computer Simulation; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D009922:Oregon / Q000453:epidemiology; D011156:Population Density; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology / Q000276:immunology / Q000635:transmission*