Targeted mass treatment for syphilis with oral azithromycin.
From mid 1997 to end of 1999, there was a sexually-transmitted infectious syphilis outbreak mainly in heterosexual people in British Columbia, Canada, that was concentrated in Vancouver. The rate across the province increased from less than 0.5 to 3.4 per 100000, and the rate in Vancouver reached 12.9 per 100000. We aimed to eliminate the syphillis outbreak by treating people at risk of infection. In 2000, a targeted mass treatment programme provided azithromycin (1.8 g orally) to 4384 at-risk residents in this city. After the programme, syphilis frequency fell significantly for 6 months (p=0.016), but rose again in 2001. Results from curve fitting analyses showed that the number of cases in 2001 (177) was higher than expected (0.0001<p<0.0044). This rate rebound and the absence of a sustained effect suggest that targeted mass treatment for syphilis, even though feasible, should not be done routinely.
Rekart
Michael L
ML
University of British Columbia Centre for Disease Control, Canada. michael.rekart@bccdc.ca
Patrick
David M
DM
Chakraborty
Bubli
B
Maginley
Juanita J L
JJ
Jones
H D
HD
Bajdik
Chris D
CD
Pourbohloul
Babak
B
Brunham
Robert C
RC
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017963:Azithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D001955:British Columbia / Q000453:epidemiology; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration*; D013587:Syphilis / Q000453:epidemiology* / Q000517:prevention & control; D014505:Urban Population
D000900:Anti-Bacterial Agents; D017963:Azithromycin