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From the Halifax Daily News, January 9, 2005. Reproduced without permission.
Health officials worried about syphilis resurgence
By Andrea MacDonald
A potentially fatal disease that can strike with no symptoms is making the rounds in Nova Scotia, hitting the GayCommunity hardest.
Syphilis, a sexually transmitted disease associated more with the Renaissance, is on the upswing. Nova Scotia normally has one to three cases per year.
In 2003, health officials began seeing a cluster of new infections in gay men, some of whom had met their partners on the Internet or at bathhouses.
That year, there were five cases of what's called primary or early stage syphilis. During that phase, there may be a painless lesion or there may be no symptoms at all.
Four cases involved gay patients.
Then came last year and a total of 13 primary cases, all in people identified as being gay. Eight additional cases of more advanced syphilis were reported during those two years, though only one was a gay patient.
Most cases have been within the Capital District Health Region, around metro.
"We do have a significant outbreak of syphilis, and this is not unique to Halifax. In the last few years, there have been outbreaks of syphilis in most major urban centres across Canada," says Robert Strang, the medical officer of health for CapitalHealth.
"Again, they've been focused mainly in the GayCommunity and the sex-trade community. In the GayCommunity, often it's focused where there's casual or anonymous, unprotected sex. In the sex trade, the same thing often goes on."
Strang stressed that anyone engaging in risky sexual behaviour is in danger.
The numbers may sound low, but health workers are worried because the jump may spell an increase in high-risk behaviours, and because having syphilis puts gays at risk of a more serious disease.
"It's definitely a concern for us, because we know that if people are contracting syphilis, they're also at risk for contracting HIV because there is an entry point," says AIDS Coalition of Nova Scotia spokeswoman Maria MacIntosh, explaining that lesions on the skin make HIV infection easier.
Another hazard is that syphilis has been off the radar screen for so long -- after a peak of 24 total cases in 1994 for Nova Scotia, things levelled off -- a doctor may not even recognize the symptoms.
"Many physicians, through their training, haven't seen syphilis or miss it if it's right in front of them," says Strang.
This time last year, Strang's office met with lab workers, infectious-disease doctors, public-health workers, PlannedParenthood, HIV groups and gays to raise awareness about syphilis. Their posters now line the walls of GayBars and bathhouses around Halifax.
The parties will meet again later this month to review their progress and brainstorm for 2005.
Strang said the jump in cases last year may mean that awareness campaigns in 2003 are paying off because more people are getting tested.
Syphilis is treatable with penicillin, but could be fatal if left untreated for too long.
Strang said officials aren't trying to blame or label any one group and the HIV crisis taught them that doing so can drive those people underground.
This page is part of the HealthCategory. Here are some facts about syphillis: http://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm