Hamilton sees spike in syphilis cases: report

Nearly absent from the city just over a decade ago, syphilis is once again on the rise in Hamilton.

A report to be presented to the city's board of health on Monday raises concerns about a jump in new infections over the last two years. The report notes that more than three quarters of the infections in Hamilton since 2011 were among men who have sex with men.

"In Hamilton, there have been more cases reported since 2012 than in 2010-2011," Michelle Baird, the city's manager of infectious disease prevention, wrote in the report. More cases have been reported in each quarter over that period.

About 28 cases of syphilis were recorded in 2012, up about 60 per cent over the year before. And the city is on track to exceed last year's total, recording 18 new cases in the first half of 2013.

Though the disease is highly treatable — a single dose of antibiotics is enough to cure a newly infected person — the spectre of a resurgence poses serious concerns.

Babies born to infected mothers sometimes have birth defects and can go on to develop severe complications, including digestive and neurological problems.

And adults who contract syphilis, but don't seek treatment over many years, risk developing cardiovascular problems, large lesions all over the body, as well as neurological problems.

A person can contract syphilis through oral, anal or vaginal sex with an infected person. Signs of the disease include a rash, hair loss, achy joints and muscles, and sores at the site of infection.

Links to HIV

The trend in Hamilton is consistent with what officials are observing in cities such as Toronto and Ottawa, said Ashleigh Tuite, a University of Toronto public health researcher who specializes in sexually transmitted infections.

In the last decade, she said, "rates were increasing, then they plateaued and then they started rising again."

In Toronto, she said, the increase occurred largely among homosexual men who were already infected with the human immunodeficiency virus (HIV).

Tuited attributed the correlation in part to a phenomenon dubbed "sero-sorting" — when people with HIV seek out sexual partners who are also infected with the virus.

"Because they are less worried with engaging with HIV, "sometimes there is less of an emphasis on using protection."

That, in turn, makes participants more vulnerable to acquiring other sexually transmitted infections.

Tuite also linked the rise in syphilis in Toronto infections to attitudes surrounding unprotected oral sex. Some view the practice "less risky" than intercourse without a condom because it's less likely to lead to the transmission of HIV, she said.

Syphilis, on the other hand, is relatively easy to contract via oral sex, she said.

Prevention

To quell the spread of syphilis, Tuite said, cities must tout condom use and the need for people to get tested.

Sexually active gay men with HIV should get screened every year, Tuite said. And she recommended regular testing for people with multiple sexual partners.

In its report to the city, public health says "staff are working with community partners to promote awareness of syphilis, condom use and testing, particularly in men who have sex with men."

"PHS has increased the distribution of free antibiotic treatment for syphilis to community physicians and hospitals to ensure prompt medical treatment."

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