An Outbreak of Early Syphilis in Patients Registered at the City Institute for Skin and Venereal Diseases in Belgrade from 2010 to 2012: a Case Series of 86 Patients

The purpose of this study was to analyze the characteristics of an outbreak of early syphilis registered at the City Institute for Skin and Venereal Diseases in Belgrade, during the period from 2010 to 2012. The study was designed as a case-note review. In a three-year-long period, a total of 86 patients with early syphilis were registered: 33 cases of primary, 31 of secondary and 22 cases of early latent syphilis. Sixty-five (76.5%) of all patients were men who have sex with men, 15 were heterosexual men and 6 were women. The majority of patients were infected in Belgrade, and in 51/86 cases oral sex was the only risk factor. There were 13 HIV-positive patients, all men who have sex with men. Thus, 20% of men who had sex with men in this study were co-infected with HIV. In conclusion, this outbreak of early syphilis in Belgrade, in which more than two thirds of all patients were men who have sex with men, of whom 20% were HIV-infected, shows the need for: 1) enhanced prevention efforts targeting this group more important than ever, with education and condom use for oral sex as an important part of patient counseling; 2) coordinated and expeditious surveillance, partner services, screening among population at-risk, as well as early diagnosis and treatment.