Public health intervention in a cocaine-related syphilis outbreak

Am J Public Health. 1991 Oct;81(10):1259-62. doi: 10.2105/ajph.81.10.1259.


Background: Cocaine users and prostitutes are at high risk for syphilis, but disease control is difficult among these populations. During a cocaine-related syphilis outbreak in Chester, Pennsylvania, in 1989, we conducted a control program at sites where sex and drugs were sold.

Methods: During a 2-week period, investigators recruited persons from these sites for interview, serologic testing, and empiric treatment.

Results: Among 136 persons screened, 25 (18%) had early syphilis and 26 others (19%) had recent sexual contact with early syphilis patients. All were treated at initial screening at a cost of $402 and 12 investigator hours per case, compared to $470 and 20 hours per case when treated during routine investigator activities. This program may have contributed to a short-term decline in syphilis incidence in Chester by reducing the period of infectivity of these patients.

Conclusions: Screening and empiric treatment of persons at sites where sex and drugs are sold can be useful in short-term control of cocaine-related syphilis outbreaks.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cocaine*
  • Disease Outbreaks*
  • Female
  • Humans
  • Male
  • Mass Screening / economics
  • Middle Aged
  • Pennsylvania
  • Sex Work*
  • Substance-Related Disorders / complications*
  • Syphilis / epidemiology*
  • Syphilis / etiology*
  • Syphilis / prevention & control


  • Cocaine