Syphilis infections in Alberta are continuing to increase despite a two-year effort by the province to halt the outbreak.
The province had 267 cases of new infection in 2009 for a rate of 7.4 per 100,000 residents. The number of cases represents a nine per cent increase over 2008. The per capita infection rate is a 5.7 per cent increase.
The situation is most dire among infants, as seven Alberta babies were born with congenital syphilis in 2009, with another six under investigation. There was only one other case of congenital syphilis reported elsewhere in Canada in 2009.
A report entitled The Syphilis Outbreak in Alberta, released before Christmas, says the number of cases has dramatically increased in the province since 2000 and in the past few years has spread outside known high risk groups to the general population.
“I think it’s very serious and the scary part is it’s not getting better over these last couple of years,” said Health and Wellness Minister Gene Zwozdesky.
The province is pouring $4 million into syphilis prevention and has already hired 11 of 13 new prevention co-ordinators, he said.
“We have to become much more aggressive and that’s why we’re designing a much harder-hitting and targeted awareness campaign,” Zwozdesky said.
In 2007 the province announced an awareness campaign aimed at reducing the syphilis infection rate. Since that time the head of the province’s STI prevention efforts left her position and the infection numbers have climbed slightly.
The Alberta Liberals suggested government dysfunction was the root cause.
“Continued confusion over the role of Alberta Health Services and the Ministry of Health and Wellness has delayed action to curb syphilis,” the party asserted in a press release.
The party also criticized the latest report because it “offers no budget, nor a timeframe for action.”
Dr. James Talbot, Alberta’s deputy chief medical officer of health, admitted the last effort to increase testing and raise awareness didn’t work.
“We had moved to increase the amount of pre-testing that was done in the prenatal period but what we’re finding is that the women who are having the babies are not getting prenatal care of any kind,” he said.
An awareness campaign also failed to reach those engaging in risky behaviour like drug use, the sex trade and unprotected sex with multiple partners.
“In terms of bringing the numbers down to the levels we want to see, it hasn’t worked as effectively as we would have hoped,” Talbot said. “It’s a hard thing to get people to change their behaviour around sexual transmission.”
He said infection rates are climbing in other provinces too, but not as quickly as in Alberta. This could be because Alberta’s robust economy has attracted a younger population, which is at higher risk for sexually transmitted infections, Talbot said.
The outbreak has spread throughout the entire province with Edmonton and Calgary continuing to report the highest number of cases, the report states. But Fort McMurray and Lethbridge have emerged as new “hot spots,” it says.
In general, increased infection can be attributed to people having more unprotected sex because improved treatments for HIV/AIDS have made it less deadly, Talbot said.
The province hopes to have a strategy and action plan in place in a couple of months.
“If everything went right we might expect to see some kind of effect on the rates within a year,” Talbot said.
What is it?
Syphilis is a bacterial infection that’s transmitted during intimate sexual contact. An infected person can unknowingly transmit syphilis because it often doesn’t cause symptoms in the early stages or its symptoms might be indistinguishable from those of other diseases.
Left untreated, the infection can cause severe damage to the brain, heart, blood vessels and bones and can eventually lead to death.
An infected pregnant woman can transmit syphilis to her unborn child. About 40 per cent of babies will die through miscarriage, stillbirth or within a few days of birth. Infants born with congenital syphilis are at risk for extensive damage to the bones, teeth, vision and hearing and can also experience delayed mental development and slowed physical growth.