Any government document that begins with the words “We have a problem” is enough to make any reader look twice. But when that document chronicles the spread of an easily treatable infection that is moving beyond its traditional core of sufferers and affecting men and women, young and old, and killing infants that could so easily have lived, it begs more of a response than the province has mustered to fight the ongoing syphilis spread in Alberta over the last 10 years.
Compare the numbers — in 1999 there were two cases of the bacterial sexually transmitted infection (STI) in the entire province. In 2009 there were a total of 267, the highest to date after incremental increases in infection rates over the last decade. In the entire country in 2009 there was a single case of a baby being born with syphilis (congenital syphilis), which is passed from an infected mother to her fetus, while in Alberta alone there were 13 suspected or confirmed cases. Four infants died of congenital syphilis in 2009 alone, bringing the total since 2005 to nine.
What the report from the Office of the Chief Medical Officer of Health, entitled The Syphilis Outbreak in Alberta, makes clear is that while the usual high-risk groups such as sex-trade workers and people who use drugs represent much of the outbreak, it is spreading to other sub-groups in Alberta. Oil workers in Fort McMurray are becoming increasingly likely to spread the disease with little access to testing or treatment while aboriginal women are now 18.6 times more likely to contract syphilis, compared to 2.8 per cent for men. It cites cases of 14-year-old teens, an 84-year-old man, professionals and others with the disease.
It also hints at an ongoing void of leadership in fighting STIs, as well as a lack of personnel, resources and innovative ideas as reasons why the outbreak continues to grow. When Dr. Ameeta Singh, a government consultant for sexually transmitted infections, was informed her contract was not being renewed, no one stepped in to fill the gap. As a result, Alberta Health Services (AHS) was left to handle the outbreak. And we’ve all seen this last year just how well AHS handles health care.
The growth of the outbreak and sinister nature of the disease means there is no one single effective method to screen and treat everyone. This is an STI, after all, that often produces few recognizable symptoms after initial infection. Yet it is easily treated. The cross-section of individuals now infected means the approach will need to be immediate, sustained and multi-pronged. Health Minister Gene Zwozdesky can ask for all the “action plans” he wants, but until the government starts putting dollars in place to hire more nurses and social workers to liase with high-risk groups and to build new treatment centres in new areas, per the recommendation of the report, such talk means very little.
The government has been running ads in newspapers and washrooms since 2003, to little effect. Partnerships between frontline agencies that work with sex trade workers, increased condom distribution, accessible prenatal care for high-risk women and better partner notification services are all required to begin taming an infection that should have been relegated to the history books. Syphilis is easily treated. Getting the rest of the province to understand that and take care of themselves appears to be more difficult.
