{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T22:14:34Z","timestamp":1772748874407,"version":"3.50.1"},"reference-count":26,"publisher":"American Public Health Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2001,8]]},"abstract":"<jats:p> Objectives. After syphilis outbreaks were reported at 3 Alabama State men's prisons in early 1999, we conducted an investigation to evaluate risk factors for syphilis infection and describe patterns of syphilis transmission. <\/jats:p><jats:p> Methods. We reviewed medical, patient interview, and prison transfer records and documented sexual networks. Presumptive source cases were identified. Odds of exposure to unscreened jail populations and transfer from other prisons were calculated for case patients at 1 prison. <\/jats:p><jats:p> Results. Thirty-nine case patients with early syphilis were identified from 3 prisons. Recent jail exposure (odds ratio [OR] = 8.0, 95% confidence interval [CI] = 0.3, 158.7, P = .14) and prison transfer (OR = 32.0, 95% CI = 1.6, 1668.1, P &lt; .01) were associated with being a source case patient. <\/jats:p><jats:p> Conclusions. Probable sources of syphilis introduction into and transmission within prisons included mixing of prisoners with unscreened jail populations, transfer of infected inmates between prisons, and multiple concurrent sexual partnerships. Reducing sexual transmission of disease in correctional settings is a public health priority and will require innovative prevention strategies. <\/jats:p>","DOI":"10.2105\/ajph.91.8.1220","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:33:29Z","timestamp":1227965609000},"page":"1220-1225","source":"Crossref","is-referenced-by-count":52,"title":["An Outbreak of Syphilis in Alabama Prisons: Correctional Health Policy and Communicable Disease Control"],"prefix":"10.2105","volume":"91","author":[{"given":"Mitchell I.","family":"Wolfe","sequence":"first","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fujie","family":"Xu","sequence":"additional","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priti","family":"Patel","sequence":"additional","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"O'Cain","sequence":"additional","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia A.","family":"Schillinger","sequence":"additional","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"St. Louis","sequence":"additional","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyn","family":"Finelli","sequence":"additional","affiliation":[{"name":"At the time of the study, Mitchell I. Wolfe was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), and the Medical Examiner Program, National Center for Environmental Health, CDC, Atlanta, Ga; Fujie Xu was with the Epidemic Intelligence Service, Epidemiology Program Office, CDC, and the Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, CDC. Priti Patel is with the Epidemiology Program Office, CDC...."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"St. Louis ME, Wasserheit JN. Elimination of syphilis in the United States. Science.1998;281(5375):353\u2013354.","DOI":"10.1126\/science.281.5375.353"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199601000-00006"},{"key":"R3","unstructured":"Centers for Disease Control and Prevention. Outbreak of primary and secondary syphilis\u2014Guilford County, North Carolina, 1996\u20131997. MMWR Morb Mortal Wkly Rep.1998;47:1070\u20131073."},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199601000-00003"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.4.552"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-2-199301150-00010"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1993.00410150083008"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/152.1.214"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.12.1937"},{"key":"R12","unstructured":"Polonsky S, Kerr S, Harris B, Gaiter J, Fichtner RR, Kennedy MG. HIV prevention in prisons and jails: obstacles and opportunities. Public Health Rep.1994;109:615\u2013625."},{"key":"R13","unstructured":"Smith WH. Syphilis epidemic in a southern prison. J Med Assoc State Ala.1965;35:392\u2013394."},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.86.9.1211"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.310.6975.289"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268898001022"},{"key":"R20","unstructured":"Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Morb Mortal Wkly Rep.1997;46(RR-10):34\u201338."},{"key":"R21","unstructured":"Centers for Disease Control and Prevention. 1998 guidelines for treatment of sexually transmitted diseases. MMWR Morb Mortal Wkly Rep.1998;47(RR-1):28\u201340."},{"key":"R24","unstructured":"Centers for Disease Control and Prevention. Assessment of sexually transmitted diseases services in city and county jails\u2014United States, 1997. MMWR Morb Mortal Wkly Rep.1998;47:430\u2013433."},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.79.4.467"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199909000-00003"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.9.1423"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199704000-00006"},{"key":"R30","unstructured":"Centers for Disease Control and Prevention. Syphilis screening among women arrestees at the Cook County Jail\u2014Chicago, 1996. MMWR Morb Mortal Wkly Rep.1998;47:432\u2013433."},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199904000-00003"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-112-7-539"},{"key":"R33","unstructured":"Centers for Disease Control and Prevention. HIV\/AIDS education and prevention programs for adults in prisons and jails and juveniles in confinement facilities\u2014United States, 1994. MMWR Morb Mortal Wkly Rep.1996;45:268\u2013271."},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.2.97"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.91.8.1220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T23:10:42Z","timestamp":1652137842000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.91.8.1220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,8]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2001,8]]}},"alternative-id":["10.2105\/AJPH.91.8.1220"],"URL":"https:\/\/doi.org\/10.2105\/ajph.91.8.1220","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,8]]}}}