EARLY SYPHILIS IN AN ACTIVE-DUTY MILITARY POPULATION AND THE SURROUNDING CIVILIAN COMMUNITY, 1985-1993

Syphilis among active duty soldiers at Fort Bragg, North Carolina, and the nonmilitary population of Cumberland County was examined during a 9-year period encompassing the most recent nationwide syphilis epidem ic. A total of 762 cases of primary and secondary syphilis were record ed between 1985 and 1993, 27% of which occurred in soldiers. The epide mic struck both military and civilian populations simultaneously; epid emic curves in the two populations were parallel, peaking in 1990-1991 , with highest annual incidences of 122.6/ 100,000 (military) and 48.0 /100,000 (civilian), Individual risk factor data were not available fo r analysis, but a relationship was observed between primary and second ary syphilis diagnoses in both populations and cocaine arrests in Cumb erland County. Our findings provide epidemiological support for a high degree of interplay between the military and the surrounding civilian communities that has significant implications for control of sexually transmitted diseases. Enhanced collaboration between military and civ ilian public health authorities is essential to the control of syphili s and other sexually transmitted diseases.