Syphilis rates soaring

Ashley Gaboury

Since 1997, there has been a steady increase of the incidence of syphilis infections in Canada. The reported rate of syphilis has increased ninefold, to 3.5 per 100,000 in 2004 from 0.4 per 100,000 in 1997, according to the most recent data available from the Pubic Health Agency of Canada.

While the rate of infection is increasing in both males and females, men accounted for 88 per cent of reported cases in 2004.

Over the past 10 years, syphilis outbreaks have been reported in cities across Canada, including Winnipeg, Vancouver, Calgary, Edmonton, Toronto, Ottawa and Montreal, according to the 2004 Canadian STI Surveillance Report.

Syphilis is a sexually transmitted infection (STI) that can be transmitted through sexual intercourse, sharing needles or passed from mother to infant during birth, according to the Public Health Agency of Canada (PHAC).

The first stage of syphilis is characterized by a painless sore known as a chancre, which may disappear on its own even though the person remains infected. Untreated, syphilis can progress across three stages, which include the primary, secondary and late stage. Once the infection reaches the last stage, it can spread to the organs and brain.

In the past, syphilis often progressed to brain damage and then death, according to Janice Janzen, a registered nurse for the University of Manitoba’s Health Services.

“It used to be known as the ‘crazy man disease’ because it would spread to your brain and organs, and you used to not be able to do anything about it.”

The steady rise of reported syphilis infections over the last decade has been due to a combination of factors, the main one being unsafe sex practices, according to Rhonda Kropp, head of strategic analysis and knowledge transfer of the STI section at the PHAC.

“We always stress to use a condom and know your partners as well before you become sexually active with them.”

Kropp said that decreased worry about the risk of HIV is a factor in the increased rates of syphilis.

“Given that there are HIV treatment drugs available that decrease the morbidity associated with HIV, people aren’t seeing HIV as the death sentence they may have before, so they are less concerned with practicing safer sex in relation to HIV.”

General lack of awareness is also a problem, according to Kropp, occurring both in the general population as well as with many health practitioners who are not aware of the increasing prevalence of the infection.

Contrary to the popular belief that young adults are most at risk for contracting syphilis, it is in fact men over 30 years of age who accounted for about 74 per cent of cases in 2006. Kropp said that this is related to data showing an increase in transmittance between men over 30 who are having sex with other men.

“There have also been heterosexual outbreaks reported . . . many of those linked to female sex-trade workers.”

While young adults do not have the highest rate of syphilis infections, they may still be at risk for becoming infected with syphilis. Janzen links this to the potential lifestyle of young adults.

“They might not be in a monogamous relationship yet and have other contacts. Some of them just have a riskier lifestyle sometimes . . . they think they’re invincible.”

While the PHAC does not have any current goals related to the reduction of syphilis rates in Canada, Kropp did stress the need for increasing public awareness in regards to STIs.

“Increasing the awareness of STIs, especially amongst youth who carry the vast majority of the burden of STIs in Canada is very important, and encouraging youth who are practicing unsafe sex to get tested is very important.”

Kropp also said that having any STI increases your chances of contracting HIV. Data has shown the outbreaks of syphilis across Canada have coincided with high rates of HIV infection.

Because syphilis is a bacterial infection and not a virus it can be treated. Kropp encouraged anyone who has practiced unsafe sex to get tested because treatment is usually a single dose of antibiotics.

“[At the clinic] we’ll treat you, but [your partner] will go on spreading it. So it’s really like a sort of tree branch,” she said. “Here is this one person [we’ve treated], but it keeps on spreading because you can’t get to everyone.”