Identifying outbreaks of sexually transmitted infection: who cares?

We conducted a cross-sectional survey in Wales in June 2005, and sent a questionnaire to consultants of genitourinary medicine (GUM, n = 11), a consultant microbiologist from each laboratory (n = 14), all consultants in communicable disease control (n = 5), and to epidemiologists of the National Public Health Service (n = 4).26 (76%) of 34 survey recipients responded. Of these, 17 (65%) ranked the investigation of STI outbreaks as important or very important, and 19 (73%) perceived participation in the investigation of an STI outbreak as part of their responsibility. Only six (25%) respondents had actively searched their computer system or patient records for a possible STI outbreak in the previous twelve months, and 15 (63%) had never looked for an outbreak. Of seven GUM physicians who said they had identified at least one STI outbreak, three had never informed public health authorities.Prompt identification and coordinated investigation of outbreaks, usually through a multidisciplinary outbreak control team, is central to the control of many infectious diseases. This does not appear to be the case for STIs, which we believe represents a lost opportunity to reduce transmission. Besides improved surveillance methods, a change in culture towards STI outbreaks is needed among health professionals in Wales.The Health Protection Agency (HPA) ranked sexually transmitted infections (STIs), including HIV, among the greatest infectious disease threats facing the United Kingdom (UK) [1]. A network of genitourinary medicine (GUM) clinics, created after the 1916 Veneral Disease Regulations, exists to diagnose, treat and control STIs in the UK. Each year more than 1.5 million new episodes of STIs are seen in GUM clinics[1], although an increasing number are diagnosed in primary care in the UK [2].STI outbreaks often signify a failure in routine control measures such as partner notification and treatment and warrant an effective public health response. To do so, outbreaks must f