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Syphilis

Syphilis rates in the Northwestern Health Unit (NWHU) catchment area is typically low with about 2.9 cases per 100,000 people per year. In 2018 and into 2019 there was an increase in the number of syphilis cases in the region (reaching 61.3 per 100,000 people per year). This increase was deemed an outbreak and is thought to be linked with an outbreak in Manitoba and could have ongoing implications.

Northwestern Health Unit (NWHU) continues to do case and contact follow up and have increased communication and services to high risk groups and the general public. 

Risk Factors observed locally: 

  • Unprotected sex with a casual or anonymous partner
  • multiple sexual partners
  • sex worker
  • substance misuse
  • being underhoused or homeless 
  • other sexually transmitted infections,
  • incarceration 
  • sexual partner of a high-risk individual.

MSM (men who have sex with men) is not being observed as a risk factor in this outbreak locally but is a risk factor for syphilis in Ontario and Manitoba.

Health Care ​Professionals

Prevention

Providing counselling to patients on:

  • Transmission does not require sexual intercourse and can occur with oral sex or contact with a syphilis ulcer that the person may not be aware of.
  • There is a potential risk of transmission with the sharing of needle
  • The importance of condoms and dental dams; these are available from NWHU at no charge for distribution through your clinic
  • The importance of not sharing needles to inject drugs; NWHU provides sterile and clean equipment to people who use drugs. 

Testing 

  • Screen for syphilis in those with risk factors: symptoms of syphilis (including a maculopapular rash typically on the palms and soles),​ unprotected sex with a casual or anonymous partners, multiple sexual partners, substance misuse, incarceration, homeless or unstable housing, those requesting STI testing, those with a confirmed or suspected STI, men who have sex with men, sexual partner with any of the above risk factors.  
  • If there are risk factors, test also for HIV, hepatitis B, hepatitis C, chlamydia and gonorrhea

Test during pregnancy:

ALL pregnant women in the catchment area of Northwestern Health Unit should be screened for syphilis at three time points: their first prenatal visit, 28 to 32 weeks gestation, and delivery; prenatal screening for syphilis, in addition to these three time points, is at the discretion of the health care provider and should be considered based on ongoing risk factors and signs and symptomsScreen any woman delivering a stillborn at 20 weeks gestation or later, for syphilis at the time of delivery. 

Ot​her:

Treatment for sexually transmitted infections can be made available at no charge; please contact NWHU to arrange for free medication through your clinic.

Notify the Northwestern Health Unit if you suspect a diagnosis of syphilis.

Tools and information for healthcare providers on diagnosing and testing:

Clinical guidelines: