title: Syphilis outbreak at a California men's prison, 2007-2008: propagation by lapses in clinical management, case management, and public health surveillance.
abstract: This field report describes an investigation to identify cases to control a syphilis outbreak in a prison and determine whether clinical, case management, and surveillance practices influenced the outbreak occurrence, detection, or management. Key performance measures were assessed to evaluate timeliness and quality of clinical and case management activities and surveillance practices. Thirty cases were found. Prior to the investigation, median times for clinical and reporting/surveillance measures were 15 days from primary and secondary (P&S) symptom onset to exam, 7 days from P&S exam to treatment, and 63 days from serologic test to the state's receipt of case. After the investigation, these measures improved to 8, 4.5, and 28 days, respectively. Lack of adherence to surveillance and clinical management protocols likely contributed to this outbreak, which was curtailed by aggressive control measures.
authors.affiliation: Sexually Transmitted Disease Control Branch, California Department of Public Health, Richmond, CA 94804, USA. Jennifer.Brodsky@gmail.com
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brodsky
authors.forename: Michael C
authors.initials: MC
authors.lastname: Samuel
authors.forename: Janet C
authors.initials: JC
authors.lastname: Mohle-Boetani
authors.forename: Rilene Chew
authors.initials: RC
authors.lastname: Ng
authors.forename: Jamie
authors.initials: J
authors.lastname: Miller
authors.forename: Janelle M
authors.initials: JM
authors.lastname: Gorman
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Espain
authors.forename: Gail
authors.initials: G
authors.lastname: Bolan
mesh_terms: D002140:California / Q000453:epidemiology; D002985:Clinical Protocols; D018563:Disease Notification / Q000379:methods; D004196:Disease Outbreaks; D006298:Health Services Administration; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008403:Mass Screening; D062486:Public Health Surveillance / Q000379:methods; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology