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• W14007562 abstract "Page 66 The California Journal of Emergency Medicine III:4,Oct-Dec 2002 ORIGINAL RESEARCH syphilis Testing in E~~~~~~~~ Department Patients Treated for Other STDs David A. Guss, MD, Sam S. Torbati, MD, Donna L. Kelly, RN other sexually active adults, asymptomatic disease presents a threat to the unborn child. During the last epidemic in the 1980's the incidence of con- genital syphilis increased 178 to 777 percent in different regions of the US 4 . The only means of syphilis detection in the latent stages is by serologic testing. As different STDs share common epidemiology and modes of trans- mission, the CDC recommends empiric syphilis serology testing for patients diagnosed with other STDs such as gonococcal urethritis 5-7. Previous studies of emergency department patients have reported prevalence rates of asymptomatic syphi- lis of three to eleven percent making the ED a pre- ferred site for screening 8-10. The objective of this study was to determine how well emergency phy- sicians comply with the CDC recommendation for syphilis serologic testing in patients diagnosed with STDs. Department of Emergency Medicine-UCSD Medical Center and Department of Emergency Medicine- Cedars-Sinai Medical Center INTRODUCTION: Syphilis remains a common sexually transmitted disease (STD) . In 1995, among individuals be- tween the ages of 15 to 49, there were 12 million cases of syphilis worldwide '. The number of cases reported in the United States, however, is relatively small, with only 6,993 cases reported to the Cen- ters for Disease Control in 1998 2. This figure is the lowest number of cases reported in the last thirty years, a dramatic 90% decline from the 50,233 cases reported in 1990 3. While this de- cline may appear reassuring, historically syphilis has been a disease of variable incidence with a pattern of epidemics emerging after periods of steady decline. A number of factors contribute to the variable rates of this disease. In the 1980s major contributing factors were the emergence of Human Immunodeficiency Virus (HIV) and the increased use of illicit drugs such as crack cocaine. METHODS: This study was reviewed and approved by the Medical Center Committee on Investigations In- volving Human Subjects. Study setting: University hospital ED with an an- nual census of 38,000 patient visits, staffed by resi- dents in emergency medicine and other speciali- ties and supervised by faculty board certified in emergency medicine. The ED population studied is multicultural and socio-economically diverse. Study design: A retrospective chart review of all patients diagnosed and treated in the ED with any of the following STDs: pelvic inflammatory dis- ease, cervicitis, urethritis, gonorrhea, chlamydia, genital herpes, genital warts, or STD unspecified. During the period of study all ED patient infor- A universal challenge to the control of syphilis relates to its tendency to persist in a clinically un- detectable, asymptomatic stage for an extended period of time. Beyond the spread of disease to" @default.
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• W14007562 title "Syphilis Testing in Emergency Department Patients Treated for Other STDs." @default.
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