Subject: JAMA: SF syphilis rate at "lowest number ever reported," 40 in 98, 41 in 99
From: [email-masked]
Date: Thu, 27 Jul 2000 12:40:27 EDT

Pull quotes: 
"Case subjects were early-stage syphilis cases among gay men reported to 
SFDPH in July and August 1999 and were not necessarily part of the outbreak 
cluster."

"Following news reports of the syphilis cyberspace outbreak,(7, 8) the SFM4M 
chat room was deluged by online antigay hate messages.(9)"

"In San Francisco, there were only 40 cases of early-stage syphilis reported 
in 1998 the lowest number ever reported and 41 cases in 1999."
                 
                 *    *   *
Web link: <A HREF="http://jama.ama-assn.org/issues/v284n4/full/joc00896.html">
Click here: Tracing a Syphilis Outbreak Through Cyberspace</A> 
http://jama.ama-assn.org/issues/v284n4/full/joc00896.html

JAMA. 2000;284:447-449
Journal of American Medical Association
July 26, 2000
 
Tracing a Syphilis Outbreak Through Cyberspace  
 
by Jeffrey D. Klausner, MD, MPH; Wendy Wolf, MPA; Lyn Fischer-Ponce, MPA; 
Ilene Zolt, BA; Mitchell H. Katz, MD 

Context:  A recent outbreak of syphilis among users of an Internet chat room 
challenged traditional methods of partner notification and community 
education because locating information on sexual partners was limited to 
screen names and privacy concerns precluded identifying sexual partners 
through the Internet service provider.

Objectives:  To determine the association of Internet use and acquisition of 
syphilis and to describe innovative methods of partner notification in 
cyberspace.

Design, Setting, and Patients:  Outbreak investigation conducted at the San 
Francisco (Calif) Department of Public Health (SFDPH) in June-August 1999 of 
7 cases of early syphilis among gay men linked to an online chat room; 
case-control study of 6 gay men with syphilis reported to SFDPH in 
July-August 1999 (cases) and 32 gay men without syphilis who presented to a 
city clinic in April-July 1999 (controls).

Main Outcome Measures:  Association of syphilis infection with Internet use, 
Internet use among cases vs controls, and partner notification methods and 
partner evaluation indexes.

Results:  During the outbreak, cases were significantly more likely than 
controls to have met their sexual partners through use of the Internet (67% 
vs 19%; odds ratio, 8.7; P = .03). We notified and confirmed testing for 42% 
of named partners; the mean number of sexual partners medically evaluated per 
index case was 5.9.

Conclusions:  In this study, meeting sexual partners through the Internet was 
associated with acquisition of syphilis among gay men. Public health efforts 
must continually adapt disease control procedures to new venues, carefully 
weighing the rights to privacy vs the need to protect public health.

JAMA. 2000;284:447-449

[Deleted article.  [email-masked]]

To eliminate syphilis it is crucial for public health departments to respond 
rapidly in innovative ways to clusters of disease and newly identified 
social-sexual networks. This outbreak indicates that the Internet is a 
technology that may facilitate transmission of syphilis but may also provide 
targeted awareness and enhance control of STDs.

Author/Article Information --
Author Affiliations: San Francisco Department of Public Health (Drs Klausner 
and Katz and Mss Wolf, Fischer-Ponce, and Zolt) and Department of Medicine, 
Division of AIDS and Oncology, University of California, San Francisco (Drs 
Klausner and Katz); and the National Center for HIV, STD, and TB Prevention, 
Centers for Disease Control and Prevention, Atlanta, Ga (Ms Wolf). 
 
Corresponding Author and Reprints: Jeffrey D. Klausner, MD, MPH, STD 
Services, 1360 Mission St, Suite 401, San Francisco, CA 94103 (e-mail: 
[email-masked]). 

Acknowledgment: We thank the San Francisco Department of Public Health 
Syphilis Elimination Team: Veronica Davila, John Tambis, Rosito Bartolini, 
Tony Tran, Joseph Engelman, MD, and Robert Kohn, MPH, for their innovative 
and tireless efforts during this investigation; and Charlotte Kent, MPH, for 
her helpful comments in the preparation of the manuscript.

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