Syphilis outbreak is twice as big as reported

EDITOR—We agree with Doherty et al that regional and national surveillance systems are required to identify increases in the incidence of syphilis.1 It is therefore ironic that the authors' data on the syphilis outbreak in Manchester are incorrect, although enhanced surveillance systems have been in operation for over three years.

The medical response to any sexually transmitted infection outbreak depends on the accuracy of epidemiological data. The Manchester Outbreak Control Group (comprising local specialists in genitourinary medicine, health promotion experts, and voluntary groups supported by the Communicable Disease Surveillance Centre North West and the Centre for Public Health at Liverpool John Moores University) has established a surveillance andcommunication system to ensure that statutory and voluntary sector organisations throughout Manchester have access to accurate up to date epidemiological information on request. If Doherty et al's article were the only source …