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Background: In 2008, Genesee County, Michigan experienced an increase in primary and secondary syphilis of almost 500% (82 cases in 2008 versus 14 cases in 2007). The majority of cases were among heterosexuals in the African American community within the City of Flint.
Objectives: Outbreak response objectives included to reduce the rate of infectious syphilis among the sexually active community, to educate the public about the outbreak, and to maximize public health resources using targeted interventions.
Methods: In 2008 the Genesee County Health Department (GCHD) began collaborating with Michigan Department of Community Health (MDCH) to address the outbreak. A cross-divisional team within the GCHD was assigned to work with the STD unit and partners from MDCH. An overall strategy was formulated and weekly meetings were held to review case data and plan interventions. The strategy utilized the expertise of MDCH personnel as well as other divisions within the GCHD who routinely worked with the affected populations. Partnerships with the private medical community and community-based organizations were forged as well. A targeted public health information campaign included the use of billboard and bus advertising and radio announcements. Multiple screening interventions were performed based on information obtained from case interviews and geographic analysis of case data.
Results: As of July 2009, cases have decreased over 50%. Evaluation of at-risk individuals indicates that awareness of the outbreak and knowledge of syphilis increased subsequent to public health interventions. Screening of individuals at risk increased.
Conclusions: New partnerships were established that will continue to facilitate STD intervention efforts. The use of data to target public health messages to those at risk and those serving at-risk populations led to enhanced screening and detection of cases.
Implications for Programs, Policy, and/or Research: Collaboration among health department divisions as well as between local and state agencies and public and private partners is critical to manage a syphilis outbreak successfully.