Mass treatment campaigns against the endemic treponematoses.

In pre-antibiotic times, mass campaigns against the endemic treponematoses required multiple injections of arsenicals and bismuth. The essentiality of a population census, an examination of the total population, and the treatment of clinical and latent cases were all appreciated, as was the value of a multipurpose approach. It was also recognized that, in combination with the anticipated slow correction of economic circumstances and attitudes, chemotherapy was the chief weapon against disease but that this weapon, even if successful in a particular area, could not prevent later reintroduction of infection. With the introduction of single-dose penicillin therapy and the impetus of worldwide, internationally assisted mass campaigns came a dramatic reduction in incidence. However, in some areas continued surveillance by the local health services did not materialize. Thus, there has been not just a low-level continuum of disease but a resurgence, particularly in Africa, where a return to mass therapy has once again proved necessary--this time combined with multipurpose immunization.