Another search with unusual if not unique aspects was reported in The Wall Street Journal for March 30, 1970, from the VD center in Atlanta. This incident involved a single prostitute near Los Angeles who, for one thing, had a clientele made up entirely of truck drivers and, in addition, kept a diary in which she recorded the names and "home bases" of 310 customers who had seen her from early September, 1969, to mid February, 1970. The men's movements following their contact spread over thirty eight states, Canada, Mexico, and Germany (to which one driver's Army reserve unit was sent). As it turned out, of 168 of these men who were found with the aid of the diary, only seven needed treatment for syphilis. Evidently the chance of contracting syphilis by a single sexual contact is sometimes small. The woman had secondary syphilis a highly infectious stage; yet only some 4 per cent of the men examined were found to have been infected. Nor is there a suggestion that they had spread the disease further; it is noted that the wives of the married truck drivers were examined, but it is not recorded that any of them were infected. Willcox, in 1958, cited a study in which L. M. Ram interviewed 194 men infected by prostitutes in Singapore in 1950. Three quarters of these prostitutes were known to have YD. Of these 194 men, “19.5 per cent exposed themselves on the average of once a month, 29 per cent twice a month, and 20.5 per cent more than twice a month. Of 154 [additional] men, only 3 per cent were infected following the first exposure, 15 per cent in less than ten exposures, 40 per cent so late as the fortieth exposure and up to one hundred exposures were achieved with impunity by 33 per cent.”

Willcox points out that these figures do not take into account men who may not have been aware that they had syphilis when they were questioned. Nevertheless exposure to VD does not necessarily lead to infection, and the fact ought to be entered on the credit side of the control ledger.

Something like the control method used in the southern prison, as mentioned before, but without the use of force, has been the basis of the WHO campaign of mass eradication of the treponematoses in many parts of the world. Attempts had in fact been started along these lines even in the days of arsenical drugs; but the introduction of single dose penicillin preparations after World War II led, with the support of UNICEF, to a massive campaign. Up to 1965 it had involved 363 million people, of whom 46,117,000 active and latent cases and contacts had been treated, at a cost of $50 million. Some forty five developing countries and areas were included, in Africa, the Americas, the Eastern Mediterranean, Europe, Southeast Asia, and the West ern Pacific. As a result, original incidences such as 18 per cent of the population in parts of Indonesia (yaws) and 5 per cent in parts of Yugoslavia (bejel) were reduced to levels of the order of 0.1 per cent; while in Bosnia (Yugoslavia) complete eradication was reported.

If we could apply the "blitz" approach universally, would it work? The question is not so simple as it may seem, since all the factors in the control problem are wrapped up in it, many of them hidden, some of them no doubt still unclear to anybody. But without assuming for the moment anything different from what we now have, say, in the United States, except for virtually unlimited resources: if every case of infectious VD that came to notice could be given the full epidemiological shock treatment, could we expect to reverse the present trend? If we could simplify the question down to a matter of finding every case of infectious VD and administering treatment sufficient to make the case noninfectious as I have said before in other words the answer would be "yes." And if we could have done something of this kind with gonorrhea before the gonococcus began acting up, we would certainly be in a better position than we are today. If the Chinese and the Cubans have really done what our meager information suggests, the key to their success must be some such operation. We will look into this as far as we can a little later on. (see AFTER PENICILLIN: FAILURE PART V)