Viva Vitality: We needs to talk about Alberta’s syphilis outbreak

By Dr. Lena Derie-Gillespie on August 2, 2019.

Let’s talk about syphilis. Ahhhh, syphilis. This disease is somehow both a source of complete fascination and abject frustration to me. In all seriousness, syphilis is something we actually need to talk about now.

Syphilis is currently at outbreak levels in Alberta and the impact it can have on children born with congenital syphilis (when the unborn child gets the disease from its mother) can be severe. Although there are risk factors that may be more heavily represented in patients with confirmed syphilis, do not kid yourself – if you have sex you can have syphilis. Period.

In Alberta, we screen every pregnant woman for syphilis and believe me, every year cases are identified. However, if screening is delayed or if people are re-infected, syphilis can be passed on to children in utero and in Alberta since 2015, more than 25 babies have been born with congenital syphilis.

It isn’t just babies who can suffer; syphilis can lead to neurosyphilis, a condition that can mimic dementia and also cause paralysis and blindness. What makes this so frustrating is that syphilis is both preventable and curable. With early diagnosis and treatment we can keep people healthy. And, as it is with any STI (sexually-transmitted infection), treatment is prevention; when we cure one person we stop the spread to others down the line.

So why is syphilis making a resurgence? Unlike many other infections, antibiotic resistance is not at fault here – although it does remain a significant concern for other STIs such as gonorrhea. Syphilis has remained sensitive to penicillin throughout history (an injectable long-lasting form is used for treatment) and we should thank our lucky stars for this fact as it gives us the chance to attack this issue.

Then why so much syphilis? A few hypotheses likely all contribute. One is that people are lax about using condoms, which is possibly due to the fact that although HIV remains a serious and important health condition, it need not be a death sentence as it was in the past. People with HIV can live very healthy lives with appropriate treatment – which is awesome – but it’s giving some a misguided sense of safety, so they’re not using condoms.

Remember this: Condoms are one of the most amazing, effective and inexpensive harm-reduction aids ever developed. Seriously, a condom can save your life and you can find them for free in many places! Amazing.

Moving past my mad respect for condoms, next up in impact may be social media and platforms that allow for anonymous sex connections. Although I am trying to remain sex-positive, such connections may not be based on the soundest decision-making and from my perspective as a public health physician, the anonymous aspect of these connections can seriously impair our ability to track and treat infected partners.

As such, the disease is allowed to spread like wildfire, just like those school sex-education games told you it would! Finally, there’s the notion that no one ever wants to think it will happen to them, but it can. So talk to your health-care provider and get tested. If you want to find a sexual health clinic that offers testing, check here: http://sexgerms.com/getting-tested but your family doctor is a great resource as well. And be open with your health-care provider. I was taught to think that “everyone does everything.'” You can’t shock us – sex is a part of life, but just don’t let your sexual activities hurt you or those depending on you.

Dr. Lena Derie-Gillespie is Medical Officer of Health in the South Zone. She can be reached by e-mail, Lena.Derie-Gillespie@ahs.ca

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