Outbreak of syphilis in men who have sex with men living in rural North Wales (UK) associated with the use of social media.

OBJECTIVES: To describe an outbreak of infectious syphilis in rural North Wales and the control measures implemented. METHODS: Following reports of an increase of syphilis in North Wales, a multidisciplinary Outbreak Control Team (OCT) was established. A multilevel prevention and control response was initiated, including: active case surveillance, partner notification and treatment, sexual network analysis, awareness raising with professionals and affected communities, point-of-care syphilis testing at a sauna and a health promotion campaign targeting users of men who have sex with men (MSM) social network mobile phone applications (apps). RESULTS: Four cases of infectious syphilis were diagnosed in clinics in North Wales per 100 000 population in 2013 compared with a mean of one case per 100 000 in the preceding decade. Diagnosed cases peaked in January 2014, declining in the first half of 2014. Initial cases were clustered in the westerly rural counties of North Wales and were predominantly white men, self-reporting as MSM (median age: 34 years, range: 17-61). Point-of-care testing at a sauna did not identity further new infections, suggesting that the cluster was relatively focused and had probably been detected early. The use of apps to find sexual partners was a feature of the network affected. A health promotion campaign, initiated by the OCT, targeting men using MSM apps reached 92% of the 755 men messaged. CONCLUSIONS: The outbreak was successfully controlled. However, it is difficult to determine which of the interventions implemented were most effective. Future outbreaks should be used as an opportunity to evaluate interventions using apps.

Teenage booster vaccine: factors affecting uptake.

BACKGROUND: The teenage booster of tetanus/diphtheria/polio vaccine is the final dose in the routine UK childhood schedule. It has the lowest uptake of all childhood vaccines in Wales and no Health Board (HB) has achieved 95% uptake. We examined the services used to deliver this vaccine across Wales in order to determine how to improve the national uptake rate. METHODS: A cross-sectional survey of the systems used to deliver the vaccine in the 7 HBs in Wales and their 22 constituent local authorities. Routinely published quarterly and annual COVER report uptake data for each HB were used to compare system effectiveness. RESULTS: The vaccine was either offered in school, in general practice or in both settings. Higher uptake rates were achieved with greater consistency in schools (76-81%) compared with general practice (5-74%), and when coordinated by the HB. When an option was available, most parents chose for their child to be vaccinated in school. CONCLUSIONS: Higher uptake rates of the teenage booster were observed when it was given in school compared with general practice. The findings suggest that offering the teenage booster in schools in all areas of Wales may improve vaccine uptake.