British Journal of Venereal Diseases, 1977, 53, 68-71
Sexually transmitted diseases Extract from the Annual Report of the Chief Medical Officer of the Department of Health and Social Security.for the year 1975 infectious syphilis were believed to have been contracted abroad (14-2% in the first half of 1974); the corresponding figures for post-pubertal gonorrhoea were 2-8% and 2-7%.
The number of clinics for sexually transmitted diseases that have been renamed departments of genito-urinary medicine has increased, without causing problems for doctors or patients. The improvement this year in the recruiting of doctors to this specialty may in part be due to the change of name. Some of these doctors had started their training in gynaecology, obtained a higher qualification and then opted for a medical, rather than a surgical, career. Table 1 shows the numbers of cases of syphilis, gonorrhoea, and chancroid reported in the first six months of 1975, with comparable figures for the first six months of 1974. Although the slight fall in the figures for early infectious syphilis and gonorrhoea may seem encouraging, several years' results will be needed before firm conclusions can be drawn regarding the trends in the incidence of these diseases. Control measures must therefore not be relaxed, or the number of medical, nursing, and ancillary staff decreased.
Contacts In the first half of 1975, 951 contacts of cases of syphilis were approached to attend at a clinic. As a result, 468 males and 189 females attended; of these, 118 males and 61 females were found to have syphilis. The corresponding figures for gonorrhoea were 19 119, 4459 and 7628, and 2272 and 5601 respectively. Table 2 shows the numbers of cases of other sexually transmitted diseases reported in the first six months of 1975, with comparable figures for the first six months of 1974. The incidence of non-specific genital infection continues to rise, though from the figures (Table 2) it can be seen that the increase was mostly in females. Most of the other diseases on the list showed some increase, particularly genital herpes and genital
Imported cases In the first half of 1975, 15-3% of
cases
of early
warts.
Table 1 Cases of syphilis, gonorrhoea, and chancroid reported in the first six months of 1975 (incidence rates are given in Table 3) Numbers of cases Disease
Total
Males
Females
Syphilis Early
Primary and secondary only Late
Congenital Gonorrhoea All forms Post-pubertal All ages
Under 16
16-17 18-19
20-24 25 and over Chancroid
1083 771 586 89
(1101) (813) (541) (71)
926 677 395 34
(18)
157 (177) 94 (125) 191 (157) 55 (53)
27 241 (27 431)
17 195 (17 523)
10 046 (9908)
27 209 (27 396) 258 (267) 1665 (1667) 3695 (3572) 9207 (9343) 12 384 (12 547) 29 (26)
17 188 (17 513) 45 (52) 471 (510) 1681 (1665) 5600 (5759) 9391 (9527)
10 021 213 1194 2014 3607 2992 4
Figures for the second half of 1975 will be published in next year's Report. Figures for first six months of 1974 are shown in parentheses.
68
25
(924) (688) (384)
(23)
(9883) (215)
(1157) (1907) (3584) (3020) (3)
Annual Report of the Chief Medical Officer 1975
69
Table 2 Other sexually transmitted diseases reported in the first six months of 1975 (incidence rates are given in Table 4) Nuimbers of cases Disease
Total
Lymphogranuloma venereum Granuloma inguinale Non-specific genital infection (NSGI) NSGI with arthritis Trichomoniasis Candidiasis Scabies Pediculosis pubis Genital herpes Genital warts Genital molluscum Other treponemal diseases Other conditions requiring treatment in a centre Other conditions not requiring treatment in a centre
18 8 41 543 243 9516 16 694 1358 2456 2897 10 122 380 497 18 525 41 984
Males (17) (8) (40 663) (189) (9219) (15 959)
15 (13) 4 (5) 33 581 (33 486)
221 (179) 725 (694) 2688 (2563) 1116 (1049) 1784 (1731) 1967 (1691) 6615 (6272) 278 (229) 304 (296) 12 354 (11 897) 26 113 (25 935)
(1315) (2379) (2478) (9395) (348) (468) (17 169) (41 323)
Females 3 4
(4) (3) (7117) (10) (8525) (13 396)
7962 22 8791 14006 242 (266) 672 (648) 930 (787) 3507 (3123) 102 (119) 193 (172) 6171 (5272) 15 851 (15 388)
Figures for the second half of 1975 will be published in next year's Report. Figures for the first six months of 1974 are shown in parentheses.
The present position The appeal to raise money for an academic department in genito-urinary medicine at the Middlesex Hospital is making good progress and it is hoped that the first medical staff appointment may be made in 1976. Staff engaged in genito-urinary medicine in England and Wales in September totalled 206 (180 8 whole-time equivalents (WTE)) including 100 (91-1 WTE) consultants, 29 (27 9 WTE) senior registrars, and 37 (33 5 WTE) registrars compared with a total of 188 (161 8 WTE) in September 1974 with 95 (84-1 WTE) consultants, 23 (22 2 WTE) senior registrars, and 32 (30 5 WTE) registrars. In September 1974 70 out of 104 consultants in Great Britain were full-time. The recruitment of married women doctors (Department of Health and Social Security, 1969) continued. Some difficulty is being experienced in recruiting candidates for training courses in sexually transmitted diseases organised through the Joint Board of Clinical Nursing Studies. Physicians in charge of clinics are again reminded of these important facilities. It is also hoped that tutors at nurse training schools (SRN and SEN) will ensure that newly qualified nurses are informed of the courses. Research projects in sexually transmitted diseases continue to be supported by the Medical Research Council and by the Department of Health and Social Security. In addition the Department of Health and Social Security has provided financial support to enable 11 doctors, nurses and technicians to travel abroad for research purposes during the last two years. Their reports demonstrate the value of this activity.
A final report (World Health Organization) has been issued on the meeting, which was mentioned in last year's Report, on health education in the control of sexually transmitted diseases. It considers, in detail, the context and application of health education in this field. The progress made in the Health Education Council's project to develop a training programme for staff engaged in contact tracing was satisfactory. A standardised information system was introduced in a number of sexually transmitted diseases clinics, together with induction and inservice training, which included an experimental course on interviewing techniques. A British delegation attended and participated in the technical discussions on the 'Social and health aspects of the sexually transmitted diseases; need for a better approach' held during the Twenty-eighth World Health Assembly. A report (World Health Organization) at the end of the discussions considered several aspects of sexually transmitted diseases control: 1. Prevention of sexually transmitted diseases (policy, case finding, diagnosis and treatment, health education and research) 2. Organisation of health infrastructure 3. Training of medical and other health staff 4. Required international action. A resolution of the World Health Assembly at its twelfth plenary meeting on 28 May 1975 (World Health Organization) inter alia 'requested Governments to consider the need: (a) to make optimal use of existing services and health structures to strengthen the control of sexually transmitted diseases, (b) to encourage the appropriate training in this field of medical personnel and other health
70
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Annual Report of the Chief Medical Officer 19/) workers at all levels and the further training of existing personnel, (c) to promote information and health education to all concerned in order to develop the sense of responsibility and respect for the integrity of all human beings.' This country should play in important part in sexually transmitted diseases control by implementing these requests in close co-operation with the World Health Organisation.
71 Department of Health and Social Security (1969). Hospital Memorandum HM69/6. World Health Organisation. Report of Meeting on Health Education in Control of Sexually Transmitted Diseases (INTI VDT/75,364), WHO: Geneva. World Health Organisation, Twenty-Eighth World Health Assembly, (A28/Technical Discussions/6). WHO: Geneva. World Health Organisation, Twenty-Eighth World Health Assembly, Resolution (WHA 28.58), WHO: Geneva.
Sexually transmitted diseases Extract from the Annual Report of the Chief Medical Officer of the Department of Health and Social Security.for the year 1975 infectious syphilis were believed to have been contracted abroad (14-2% in the first half of 1974); the corresponding figures for post-pubertal gonorrhoea were 2-8% and 2-7%.
The number of clinics for sexually transmitted diseases that have been renamed departments of genito-urinary medicine has increased, without causing problems for doctors or patients. The improvement this year in the recruiting of doctors to this specialty may in part be due to the change of name. Some of these doctors had started their training in gynaecology, obtained a higher qualification and then opted for a medical, rather than a surgical, career. Table 1 shows the numbers of cases of syphilis, gonorrhoea, and chancroid reported in the first six months of 1975, with comparable figures for the first six months of 1974. Although the slight fall in the figures for early infectious syphilis and gonorrhoea may seem encouraging, several years' results will be needed before firm conclusions can be drawn regarding the trends in the incidence of these diseases. Control measures must therefore not be relaxed, or the number of medical, nursing, and ancillary staff decreased.
Contacts In the first half of 1975, 951 contacts of cases of syphilis were approached to attend at a clinic. As a result, 468 males and 189 females attended; of these, 118 males and 61 females were found to have syphilis. The corresponding figures for gonorrhoea were 19 119, 4459 and 7628, and 2272 and 5601 respectively. Table 2 shows the numbers of cases of other sexually transmitted diseases reported in the first six months of 1975, with comparable figures for the first six months of 1974. The incidence of non-specific genital infection continues to rise, though from the figures (Table 2) it can be seen that the increase was mostly in females. Most of the other diseases on the list showed some increase, particularly genital herpes and genital
Imported cases In the first half of 1975, 15-3% of
cases
of early
warts.
Table 1 Cases of syphilis, gonorrhoea, and chancroid reported in the first six months of 1975 (incidence rates are given in Table 3) Numbers of cases Disease
Total
Males
Females
Syphilis Early
Primary and secondary only Late
Congenital Gonorrhoea All forms Post-pubertal All ages
Under 16
16-17 18-19
20-24 25 and over Chancroid
1083 771 586 89
(1101) (813) (541) (71)
926 677 395 34
(18)
157 (177) 94 (125) 191 (157) 55 (53)
27 241 (27 431)
17 195 (17 523)
10 046 (9908)
27 209 (27 396) 258 (267) 1665 (1667) 3695 (3572) 9207 (9343) 12 384 (12 547) 29 (26)
17 188 (17 513) 45 (52) 471 (510) 1681 (1665) 5600 (5759) 9391 (9527)
10 021 213 1194 2014 3607 2992 4
Figures for the second half of 1975 will be published in next year's Report. Figures for first six months of 1974 are shown in parentheses.
68
25
(924) (688) (384)
(23)
(9883) (215)
(1157) (1907) (3584) (3020) (3)
Annual Report of the Chief Medical Officer 1975
69
Table 2 Other sexually transmitted diseases reported in the first six months of 1975 (incidence rates are given in Table 4) Nuimbers of cases Disease
Total
Lymphogranuloma venereum Granuloma inguinale Non-specific genital infection (NSGI) NSGI with arthritis Trichomoniasis Candidiasis Scabies Pediculosis pubis Genital herpes Genital warts Genital molluscum Other treponemal diseases Other conditions requiring treatment in a centre Other conditions not requiring treatment in a centre
18 8 41 543 243 9516 16 694 1358 2456 2897 10 122 380 497 18 525 41 984
Males (17) (8) (40 663) (189) (9219) (15 959)
15 (13) 4 (5) 33 581 (33 486)
221 (179) 725 (694) 2688 (2563) 1116 (1049) 1784 (1731) 1967 (1691) 6615 (6272) 278 (229) 304 (296) 12 354 (11 897) 26 113 (25 935)
(1315) (2379) (2478) (9395) (348) (468) (17 169) (41 323)
Females 3 4
(4) (3) (7117) (10) (8525) (13 396)
7962 22 8791 14006 242 (266) 672 (648) 930 (787) 3507 (3123) 102 (119) 193 (172) 6171 (5272) 15 851 (15 388)
Figures for the second half of 1975 will be published in next year's Report. Figures for the first six months of 1974 are shown in parentheses.
The present position The appeal to raise money for an academic department in genito-urinary medicine at the Middlesex Hospital is making good progress and it is hoped that the first medical staff appointment may be made in 1976. Staff engaged in genito-urinary medicine in England and Wales in September totalled 206 (180 8 whole-time equivalents (WTE)) including 100 (91-1 WTE) consultants, 29 (27 9 WTE) senior registrars, and 37 (33 5 WTE) registrars compared with a total of 188 (161 8 WTE) in September 1974 with 95 (84-1 WTE) consultants, 23 (22 2 WTE) senior registrars, and 32 (30 5 WTE) registrars. In September 1974 70 out of 104 consultants in Great Britain were full-time. The recruitment of married women doctors (Department of Health and Social Security, 1969) continued. Some difficulty is being experienced in recruiting candidates for training courses in sexually transmitted diseases organised through the Joint Board of Clinical Nursing Studies. Physicians in charge of clinics are again reminded of these important facilities. It is also hoped that tutors at nurse training schools (SRN and SEN) will ensure that newly qualified nurses are informed of the courses. Research projects in sexually transmitted diseases continue to be supported by the Medical Research Council and by the Department of Health and Social Security. In addition the Department of Health and Social Security has provided financial support to enable 11 doctors, nurses and technicians to travel abroad for research purposes during the last two years. Their reports demonstrate the value of this activity.
A final report (World Health Organization) has been issued on the meeting, which was mentioned in last year's Report, on health education in the control of sexually transmitted diseases. It considers, in detail, the context and application of health education in this field. The progress made in the Health Education Council's project to develop a training programme for staff engaged in contact tracing was satisfactory. A standardised information system was introduced in a number of sexually transmitted diseases clinics, together with induction and inservice training, which included an experimental course on interviewing techniques. A British delegation attended and participated in the technical discussions on the 'Social and health aspects of the sexually transmitted diseases; need for a better approach' held during the Twenty-eighth World Health Assembly. A report (World Health Organization) at the end of the discussions considered several aspects of sexually transmitted diseases control: 1. Prevention of sexually transmitted diseases (policy, case finding, diagnosis and treatment, health education and research) 2. Organisation of health infrastructure 3. Training of medical and other health staff 4. Required international action. A resolution of the World Health Assembly at its twelfth plenary meeting on 28 May 1975 (World Health Organization) inter alia 'requested Governments to consider the need: (a) to make optimal use of existing services and health structures to strengthen the control of sexually transmitted diseases, (b) to encourage the appropriate training in this field of medical personnel and other health
70
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Annual Report of the Chief Medical Officer 19/) workers at all levels and the further training of existing personnel, (c) to promote information and health education to all concerned in order to develop the sense of responsibility and respect for the integrity of all human beings.' This country should play in important part in sexually transmitted diseases control by implementing these requests in close co-operation with the World Health Organisation.
71 Department of Health and Social Security (1969). Hospital Memorandum HM69/6. World Health Organisation. Report of Meeting on Health Education in Control of Sexually Transmitted Diseases (INTI VDT/75,364), WHO: Geneva. World Health Organisation, Twenty-Eighth World Health Assembly, (A28/Technical Discussions/6). WHO: Geneva. World Health Organisation, Twenty-Eighth World Health Assembly, Resolution (WHA 28.58), WHO: Geneva.
