An outbreak of chancroid in Orange County, California: descriptive epidemiology and disease-control measures

From May 1981 through February 1983, greater than 1,700 patients were examined for genital ulcers at the Orange County Special Diseases Clinic in Santa Ana, California. Of these patients, 923 had either confirmed chancroid or genital ulcers of unknown etiology. Haemophilus ducreyi was recovered from lesions or inguinal buboes of 271 patients. In the previous year, no cases of chancroid were reported in this community. Men accounted for 266 (98%) of the confirmed cases; 95% of the men were Hispanic, and at least 53% had had sexual contact with a prostitute. All five culture-positive women were prostitutes. Antimicrobial sensitivity testing showed resistance to both sulfamethoxazole and tetracycline but susceptibility to erythromycin and to the combination trimethoprim-sulfamethoxazole. Treatment of patients with chancroid, their sex partners, and temporarily incarcerated prostitutes contributed to the successful control of this outbreak.