Background:
Syphilis screening in community venues may have poor yield, even in communities with high morbidity.

Objective:
To describe the success and cost of community-based screening in finding new syphilis cases during a “Syphilis Blitz” in Baltimore.

Method:
In Fall 2004, in response to a rapidly escalating outbreak with a broad epidemiologic profile (women engaging in prostitution and their clients, drug users, men having sex with men [MSM], recent Latino immigrants), the Baltimore City Health Department and Maryland Department of Health and Mental Hygiene launched a “Syphilis Blitz.” CDC supported this effort by deploying field investigators to augment local efforts. New information on social hangouts and sex partner meeting places arising from case-cluster interviews was provided to outreach staff daily to redirect screening activities. Screening continued at venues until no longer productive in reaching those with targeted risk behaviors. We calculated the total cost of the Blitz by summing costs of local staff overtime, support for deployment of federal workers, and the laboratory costs of Blitz-related testing.

Result:
From September 1, 2004 to October 31, 2004, 1335 persons were screened for syphilis in 39 distinct community venues. Of those screened, 387 (29%) reported heroin or cocaine use, 200 (15%) reported exchanging sex for drugs/money, 51 (3.8%) were MSM, and 184 (14%) were Hispanic. One hundred and five (7.9%) were serologic reactors and 17 (1.3%) represented new cases of early syphilis. Each new case of early syphilis detected through Blitz activities cost $7,700.

Conclusion:
A Syphilis Blitz using community-based syphilis screening directed by case-cluster based interview methods during an outbreak can be effective in identifying cases of early syphilis.

Implications:
A Syphilis Blitz using community-based syphilis screening directed by case-cluster based interview methods during an outbreak can be effective in identifying cases of early syphilis.