Orange County NC Website
7 <br />^•. remaining cases. Consistent with these similarities between the syphilis and HIV epidemics in <br />North Carolina, the five-county tazget area accounted for 2T% of the state's 1997 HIV cases,. <br />with Guilford, Forsyth and Durham Counties ranking 3rd, 4th and 6th, respectively, among the <br />100 counties. <br />1 <br />Outbreaks of syphilis continue to occur in some localities within North Cazolina, despite the <br />noted decline in overall morbidity. Several counties in central North Cazolina--Forsyth, <br />Guilford, Alamance, and Orange--recently experienced or aze currently experiencing outbreaks <br />of syphilis. Forsyth County, the farthest west of the group, reported increasing numbers of <br />syphilis cases in the latter part of 1993, with the outbreak peaking in 1995. Shortly thereafter, <br />syphilis morbidity began to increase in Guilford County, immediately east of Forsyth County. <br />Rates in Guilford County appeaz to have peaked in late 1997, though rates remain well above <br />baseline levels. In late 1997 and early 1998, small clusters of early syphilis cases began to appear <br />in azeas of Alamance and Orange Counties-the next counties to the east--where syphilis had <br />previously been uncommon. East of Orange County lies Durham County, an area that has <br />traditionally had high levels of STDs but recently has had modest primazy and secondary syphilis <br />rates (11.2 cases/100,000 in 1997). However, very recent data show that primary and secondary <br />syphilis is increasing in Durham County, with more cases in May, 1998 than in the previous four <br />months combined. <br />In response to the high syphilis morbidity in Guilford County, the North Cazolina HIV/STD <br />Prevention. and Care Section worked with Guilford County during August 1997 to implement a <br />Rapid Intervention Outreach Team (R.I.O.T.) effort. The North Cazolina RI.O.T. was onQinally <br />developed in 1993 as an outbreak response t,.am. The primary function of the R.I.O.T. is to <br />coorainate efforts among local health departments, community based organizations and the state <br />HIV/STD Prevention and Caze Section to rapidly increase outreach education, screening, <br />diagnostic services, treatment, and partner notification activities in areas that have documented <br />exceptionally high eazly syphilis morbidity. During a R.I.O.T. effort, outreach workers from <br />community-based organizations and disease intervention specialists (DIS) from azound the state <br />go into an area of high morbidity to work together as prevention partners. This enables the local <br />community to offer one-on-one street and community outreach, community-based risk reduction <br />education, HIV/STD counseling, testing, and referral during non-traditional hours to people who <br />aze infected, exposed or have questions about HIVIAIDS-and STDs. Amore detailed description <br />of RI.O.T. caa be found in North Carolina's 1996 and 1997 Sexually Transmitted Disease (STD) <br />Accelerated Prevention Campaign Cc:ntinuation applications. <br />_ During the Guilford County RI.O.T., a statewide network of community based organizations <br />and DIS participated in door-to-door outrcach, cotmseling, screening and health fairs. The door- <br />to-door outreach allowed outreach workers, local health department staff and DIS from across <br />the state to work together as partners in prevention, sharing techniques for engaging at-risk <br />individuals in conversations about HIV/STDs. The RI.O.T. resulted in distribution of 1998 . <br />packets of syphilis risk reduction information and on-the-spot syphilis counseling and testing to <br />104 individuals, of whom 13 (12.5%) were positive.. <br />2 <br />