Syphilis is Here

***Note: This article originally appeared in the July issue of Wayves.

Syphilis is here! Have You Been Tested?

By Wayves Staff

Syphilis is here. Get tested; tell your friends to get tested. That was the message delivered at a community forum held on May 30th at FRED on Agricola Street. Organized by prideHealth, (Capital Health/IWK's LGBTI health initiative), in partnership with Public Health, the ACNS, Halifax Sexual Health Centre, and NSRAP. The meeting was dubbed HoMobilzing Halifax and was aimed directly at the LGBTQ community.

Sexually transmitted infections have been on the rise throughout in Canada since 2001. Throughout the 1990s the number of syphilis infections was going down and its eradication seemed like a real possibility. But a sharp rise in new cases in 2008/2009 led to an outbreak being declared in Halifax by Public Health (Capital Health). New diagnoses were among men, with an average age around 37. Data shows that unprotected sex, including oral sex, and the use of the Internet for social contacts account for the rise. 40% of men who’ve been diagnosed with syphilis reported meeting sex partners through the Internet. The disease is affecting different populations in different regions; in Nova Scotia the rise is among men who have sex with men (MSM).

Syphilis is a bacterial infection, and transmission is relatively easy. You can get it through unprotected anal, oral, and/or vaginal sex (that is sex without condoms); childbirth; and/or blood transfusions; less frequently, through needle-sharing among injecting drug users. People with multiple sex partners are at an increased risk for infection and transmission. Anyone who is having, or has had, unprotected sex should get tested for syphilis, as should anyone who's had sexual contact with someone who they learn has had syphilis, and/or anyone who's experiencing the symptoms described below. People with HIV are encouraged to get tested, as syphilis and HIV can go hand in hand, and both can be transmitted through unprotected sex.

The dangerous thing about syphilis is that its initial symptoms don't last very long and can easily be mistaken for something else. Syphilis has been called "the great mimicker" because it imitates other diseases. The first sign of syphilis is a small, painless, pimple-like ulcer (chancre) that disappears in three to six weeks. A month or two later, a rash may form (sometimes accompanied with fever and fatigue) which also goes away. One might mistake the rash for a drug, or other, allergic reaction, but a dermatologist can usually spot the difference. Syphilis can be easily treated with penicillin. For those with penicillin allergies, there are other options, but they require more follow-up.

Positive test results are reported to Public Health. Someone testing positive for syphilis is contacted to ensure they have all the information that they need, are getting treatment and understand the treatment, and to assist with contact tracing. Follow-up is done by Public Health in a discreet fashion that alerts contacts about the need to get tested, while protecting the infected person’s anonymity. Public Health has told us that, on average, only 28% of partners can be contacted. So the difficulty of managing the outbreak is that health officials cannot contact all sexual partners who’ve been exposed. A big worry regarding unreported cases or contacts is that, when the symptoms go away and the disease is left untreated, years down the road patients may end up with tertiary syphilis, including Neurosyphilis, where the lining of the brain is affected. Neurosyphilis in HIV seropositive patients is difficult to treat. Cases of neurosyphilis have presented as strokes. Another risk is of mothers unknowingly infecting children during childbirth.

"Turnout for the forum was good!" said NSRAP's Lucas Thorne-Humphrey. "There was some great brainstorming about coming up with more effective advertising campaigns, dissemination of very important info about who is getting sick, and how we combat this on the ground in the clinic, and at a public health level. The issue facing our community is getting the word out: Syphilis is here. Get tested. Tell your friends to get tested. That’s the message."

If you think you should get tested, contact your doctor. The test for syphilis is a simple blood test. For more information, contact prideHealth’s Anita Keeping, clinical nurse specialist at anita.keeping@cdha.nshealth.ca or call (902) 220-0643. The Halifax Sexual Health Centre offers information and testing for all manner of sexually transmitted infections; follow this link to  find them online or call them at (902) 455-9656, Ext. 0.

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