“Putting on the blitz: An intensive outreach and screening drive in response to a cluster of syphilis cases in Milwaukee, WI"

During August of 2013, a cluster of seven (7) confirmed syphilis cases in close geographic proximity were reported to the City of Milwaukee Health Department (MHD) Sexually Transmitted Disease (STD) Program.  A subsequent epidemiological investigation by the MHD revealed suspected heterosexual transmission between individuals at two rental housing units in a neighborhood noted for high drug traffic and saleable sex.  The MHD initiated a “blitz” at each complex during a single day period that entailed intensive educational outreach and testing offered to building occupants.  The intent of the “blitz” was to provide effective and targeted education, screening, and Field Delivered Therapy to identified symptomatic cases for purposes of interrupting continued transmission in this setting and disease spread within the larger community. MHD field staff conducted in a single evening field interviews of approximately 200 persons residing or visiting each building complex.  Each person contacted received STD educational material and condoms. Fifty-three (53)  of two-hundred (200) contacts (26.5%) were tested for syphilis resulting in 5.6% positivity  Approximately 92% of those tested were African American and 55% male with an age range of 13-64 years.   As a result of the initial syphilis cluster identification, the MHD strategically mobilized to prevent potential additional exposure and cases of syphilis infection in a high-risk setting.  The  MHD syphilis “blitz” required significant coordination between public health authoriteis, law enforcement and the property owner to ensure safety of the community and department staff.  Furthermore, this type of intervention required close calibration of outreach, screening, testing and laboratory resources for efficient use of potential STD contact interaction opportunities.