frequency of sexual activity. Those with very frequent sexual contacts should be examined monthly, those with less frequent contacts, every few months.

If a person leams he has been exposed to another who has venereal disease, what should be do?

It is very important to go to a doctor or a health department clinic right away when known that a sex contact has a venereal disease. There the proper steps will be taken at once, the patient will be treated well and the information kept confidential. Self-treatment with pills or ointments is dangerous as is treatment by a friend who is not a doctor. Unlicensed "men's doctors" cannot be relied upon. In instances where a person has known contact to an infectious case, it is particularly important to have treatment immediately. This is necessary to prevent the disease from developing in the patient and to prevent the disease from spreading during the days, weeks or months before symptoms appear. Venereal diseases frequently have no symptoms until reasonably late in the infection. The examining doctor may need to verify the infection in the sex partner-which venereal disease-in order to manage the patient correctly.

What medical examination is necessary to reach a diagnosis?

I cannot stress too strongly that the early stages of syphilis are hard to detect, especially when the early signs are hidden within internal organs. It is often difficult even for a physician to find the signs unless he looks for them intently. For primary syphilis it is important to take a scraping from the chancre. By looking under a special microscope, called "the darkfield," the germ may actually be seen and treatment started. If the chancre does not appear or has gone away, the only way to tell is the blood test. It is important to remember that the blood test may not become positive until a month or longer after the disease is caught. In the secondary stage, germs may similarly be found by using the darkfield microscope. By this time the blood test is nearly always strongly positive. Later stages of syphilis can be determined by spinal tests, by fluoroscopic or X-ray examination and by a thorough physical examination to detect heart and nervous changes due to the disease.

Gonorrhea of the penis usually is easily determined by a "smear" test because the drop of pus from the penis is thick with germs. But, because the germs may be few and far between and symptoms rare, rectal and vaginal infections may be difficult even for the doctor to diagnose. In these cases, the doctor employs a laboratory "culture" test

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using specimens from the cervix of a woman or the rectum of the man or woman. The germs from this specimen are grown and studied in the laboratory. Routine tests of this kind on patients who are sexually active is the only certain way to detect presence of the gonorrhea we so frequently encounter without symptoms. Early detection by this means avoids complications in the patient later on and also prevents spread to sex contacts. Blood tests are not used to detect gonorrhea.

What are the methods of treatment?

The methods of treatment are simple. For syphilis, penicillin is given so that it remains in the blood stream two weeks for the early stages or for four weeks in the late stages complicated by positive spinal, heart or other findings. For gonorrhea, one injection of a sufficient penicillin dosage frequently cures gonorrhea, though sometimes more injections are required, particularly when the disease has been undetected in the body for some length of time. For those who are allergic to penicillin, certain other antibiotics can be given effectively, though absolute cure is not quite as certain. Important in the cure of any venereal disease are follow-up examinations and tests to determine whether cure has actually been obtained. Such follow-up requires from one to three months for gonorrhea and one year to a life-time for syphilis. Besides determining whether a patient responds to treatment, follow-up tests can also detect re-infection.

How much bope can be offered from treatment?

In gonorrhea, the disease is quickly cured within a month or two. In syphilis, finding the disease early and treating it early results in close to 100% cure. After the disease has remained in the body for a year or more, the chances of cure are reduced. About 2% of treated syphilis will develop the serious late symptoms if they are not adequately followed by medical examination for the rest of their lives.

Is it true there is an increase in the spread of venereal disease? There is no question that the actual incidence of venereal disease has dramatically risen throughout the country in almost every state and and in almost every city since 1957. In general, the rates for infectious syphilis have increased by about 400% in the past four years, and continue to rise. In many areas it has been stated that gonorrhea is more common than measles. The reason that the public is not aware of the latter fact is that people with measles readily tell their friends about it, and people with gonorrhea do not.

llow does the Public Health Venereal Disease Program function?

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