Background: Partner notification (PN) services for early syphilis cases- primary, secondary (P&S) and early latent (EL)-are the cornerstone of public health control efforts. Due to decreasing funding, the CDC has encouraged states to limit PN services to P&S index cases only. We compared the yield of newly detected syphilis among contacts of EL and P&S syphilis index cases.
Methods: Recent sexual contacts (as defined by CDC) identified through PN services performed by Disease Intervention Specialists (DIS) for P&S and EL index cases were assessed from 2010- 2012. Using the STD-MIS database, we compared the number of new early syphilis infections among sexual contacts of P&S and EL cases and calculated the “contact brought-to-treatment” index (#contacts newly diagnosed with early syphilis per #index cases interviewed).
Results: DIS performed PN services for 98.0% of assigned index cases, 1083 P&S and 961 EL. EL interviews elicited 2500 sexual contacts; 1917 were contactable and 673 (35.1%) were infected. Of infected EL contacts, primary, secondary and EL infections were diagnosed in 57 (8.5%), 206 (30.6%) and 369 (54.8%) individuals, respectively. P&S interviews elicited 2516 sexual contacts; 1871 were contactable and 557 (29.8%) were infected. Of infected P&S contacts, primary, secondary and EL infections were diagnosed in 66 (11.8%), 193 (34.6%) and 265 (47.6%) individuals, respectively. The “contact brought-to-treatment” index was 0.66 (632 contacts with early syphilis per 961 index cases) for EL and 0.48 (524 contacts with early syphilis per 1083 index cases) for P&S cases.
Conclusions: In North Carolina, PN services for EL and P&S cases identified similar numbers of early syphilis contacts. Without routine PN services for EL index cases, half of P&S syphilis cases among contacts may have remained undetected. Our findings suggest that effective syphilis prevention and control efforts in North Carolina require the continuation of PN services for EL cases.