Control of Sexually Transmitted Disease: The Canadian Perspective

The ability to control a disease depends on knowledge ofits epidemiology. Such information on sexually transmitted diseases (STDs) can be ascertainedby surveillance data involving the analysis of notification reports, as well as laboratory reports,hospital discharge data, and data from sentinel clinics and health units. In the case of sexuallytransmitted hepatitis B, notification data will probably have to be corroborated by data fromsentinel clinics, health units or physicians. A vigorous attempt must be made to elucidate themode of transmission in acute cases and newly discovered carriers. Appropriate treatment,contact tracing and primary prevention strategies appear to have had some success incontrolling gonorrhea and syphilis. Rates of genital chlamydial infection may also be reducedby the same methods. These diseases will, however, persist in certain 'core groups'. Control ofsexually transmitted hepatitis B will require a primary prevention strategy of risk reduction,sexual health promotion and immunization. Targeted immunization programs on their ownare not Likely to work. Thus, universal immunization will probably be required along with publicacceptance of immunization against STDs and appropriate human and financial resources.Reliable surveillance data will be required for program evaluation