Agenda - 11-03-1999 - 9c - Laserfiche WebLink

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16 SYPHILIS ELINIINATION PROJECT SCOPE OF WORK Outbreaks of syphilis continue to occur in some localities within North Carolina, despite the noted decline in overall morbidity. Several counties in central North Carolina--Forsyth, Guilford, Alamance, and Orange--recently experienced or are currently experiencing outbreaks of syphilis. Forsyth County, the farthest west of the group, reported increasing numbers of syphilis cases in the latter part of 1993, with the outbreak peaking in 1995. Shortly thereafter, syphilis morbidity began to increase in Guilford County, immediately east of Forsyth County. ~ - Rates in Guilford County appear to have peaked in late 1997, though rates remain well above baseline levels. In late 1997 and early 1998, small clusters of early syphilis cases began to appear in areas of Alamance and Orange Counties--the next counties to the east--where syphilis. had previously been uncommon. East of Orange County lies Durham County, an area that has traditionally had high levels of STDs but recently has had modest primary and secondary syphilis rates (11.2 cases/100,000 in 1997). However, very recent data show that primary and secondary syphilis is increasing in Durham County, with more cases in May, 1998 than in the previous four months combined. . - The first year of this project, the Project Coordinator and the local Syphilis Elimination staff will Assess populations at high risk for syphilis, factors which promote syphilis transmission, and barriers to syphilis treatment and prevention in high morbidity areas of Forsyth, Alamance, Orange and Durham Counties. Develop and implement a~targeted syphilis elimination plan for the five-county area with individualized plans for each county based on the rapid community assessments. Each plan will. include the following components: outreach worker. educational and screening activities, clustering techniques by local DIS, screening for syphilis in jails and community-based organizations performing HIV counseling and testing, and contribution to the outbreak response team. Evaluate and document the appropriateness of the syphilis elimination plan targeting through quarterly assessment of the population affected by syphilis and their utilization of health services for syphilis, and revise specific targeting of plan as indicated by this assessment. All community-based organizations offering HIV counseling and testing in the five-county area will offer and encourage syphilis serologic testing to clients requesting HIV tests. Each outreach worker will provide weekly risk-reduction sessions at the.local jail, provide one-on-one outreach to individuals at risk for syphilis in the community for 8 hours per week and document the establishment of condom distribution sites which are accessible to at-risk persons.