World War II: The most extensive syphilis case finding program in the history of the world

1. World War II: The most extensive syphilis case finding program in the history of the world By Laura J. McGough, Ph.D. ATPM Postdoctoral Fellow in STD Prevention Dept. of Infectious Diseases & Dept. of History of Medicine Johns Hopkins University, Baltimore, MD CDC, Division of STD Prevention

2. Objective To evaluate the successes and failures of one of the largest STD control efforts in history

3. Methodology Read primary sources of the United States Public Health Service at the National Archives, College Park, MD (record Group 90)

4. Reasons for successful syphilis control Not just reliance on medical treatment Military: decriminalization, prophylaxis, education, treatment Civilian: Education, case finding, case holding, Rapid Treatment Centers (counseling, job training and job placement with treatment) Leadership key: of USPHS and of the country

5. Problems Criminalization of civilian population: prostitution and �promiscuous girls� Stigma remained even after penicillin became available

6. Leadership of USPHS Thomas Parran Assist. Surgeon General Vonderlehr Dec. 7, 1940 urged comprehensive efforts War an opportunity for VD control

7. Problem of VD Draft Evaders Required cooperation between military and civilian authorities James Stewart, MD, State Health Commissioner, Missouri, commenting on the first 1,070,000 men examined by the Selective Service, 83,000 cases of syphilis and gonorrhea, declared unfit. Some avoided treatment and military service.

8. Leadership at the national level: FDR � Refused to define VD as a problem of alcohol consumption, despite political pressure to reinstate Prohibition

9. Gender, race and class issues Females regarded as reservoir of infection for military men, not vice versa, even when soldiers has sexual relations with 13 and 14 year old girls Not just prostitutes but all �promiscuous� women targeted. Class and race were considered to be markers of promiscuity. Black soldiers: less access to prophylaxis.

10. Gender and sexuality Wartime propaganda celebrated masculine sexuality Women given mixed messages: to provide company and comfort to military men at USO dances, where this behavior could simultaneously bring them under suspicion of promiscuity Marilyn Hegarty, �Patriots, Prostitutes, Patriotutes: The Mobilization and Control of Female Sexuality in the United States during World War II� (Ph.D. Diss., Ohio State University, 1998)

16. Rapid Treatment Centers Began in 1942 A total of 64 by March 1945, continued after the war Length of treatment: varied from 10 days to 12 weeks Psychiatric evaluation, counseling from social worker, recreation, job training and job placement

17. Anxiety about post-war VD control May Act extended, Rapid Treatment Centers continued to operate Military personnel could not be released from service if they had an infectious VD

18. Conclusion Control of VD during WWII cannot be attributed to the introduction of penicillin therapy alone, but to the combination of case finding, education, prophylaxis, and surveillance with treatment

19. � V-E Day must not become VD day.� Commander Walter H. Schwartz, U.S. Navy