'Horrifying' rise in Alberta syphilis rates draws calls for renewed public health efforts

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The rising rate of babies being born with syphilis in Alberta is drawing calls for a targeted public health response after being put on the backburner during the COVID-19 pandemic.

The latest Alberta Health statistics tracking sexually transmitted infections (STIs) and HIV in 2022 show the rate of cases of congenital syphilis went to 169.1 per 100,000 live births from 152.2 per 100,000 in 2021.

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That’s compared to 30.8 cases per 100,000 in 2018 — a more than fivefold increase.

Of the 273 congenital syphilis cases diagnosed between 2018 and 2022, 50 were stillborn. The report said that routine surveillance data doesn’t track miscarriages, so the total impact of congenital syphilis is likely under-estimated.

Dr. Ameeta Singh, an infectious disease specialist at the University of Alberta, called the numbers “horrifying.”

“That’s not something we should be seeing in Canada today, nor ever,” said Singh, who practices at the Royal Alexandra Hospital and Edmonton STI Clinic.

“I think that is a public health emergency, it needs to be acknowledged as such, and resources need to be put into responding to it,” said Singh, noting that would include the province putting more money into outreach, expanded access to services, and scaling up the availability of rapid testing.

Alberta’s former chief medical officer of Health Dr. Deena Hinshaw declared a syphilis outbreak in July 2019. In August, 2021, Hinshaw said the response to COVID-19, which directed most public health resources to the pandemic response, came at the cost of “not fully working on other threats, like syphilis and opioid deaths.”

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Singh said the outbreak never stopped.

“Essentially, all attention to this issue fell off during the pandemic and I think it’s time that that outbreak declaration be refreshed,” said Singh, noting that those who access prenatal care in pregnancy can get syphilis screening and preventative treatment.

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In 2022, all AHS Zones reported an increase in infectious syphilis rates, but the hardest hit areas were the North Zone, with 144.1 cases per 100,000 population, and the Edmonton Zone, with 86.4 cases per 100,000 population.

Province-wide, the number of HIV cases rose by 17.2 per cent from the previous year, while chlamydia cases increased by 19.4 per cent.

David Shepherd, NDP health critic for primary and rural care, told reporters Thursday he hopes to see the government take leadership and activate public education and engagement campaigns.

“Those numbers are deeply concerning and it’s quite clear we need to take some quick, swift action to address this,” said Shepherd, pointing to the importance of culturally competent outreach and access to primary care.

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“We have to be able to offer that testing, that support and treatments in an accessible way,” he said.

A mandate letter to Health Minister Adriana LaGrange outlining priorities from Premier Danielle Smith is expected to be released this month.

In a statement to Postmedia Thursday, spokesman Chris Bourdeau said Alberta Health is monitoring the rise in STIs, including syphilis, which is seeing a resurgence globally.

He said the reasons behind the rise aren’t fully known, but there are some contributing factors, including “a decrease in public perception of risk, individuals not being diagnosed in a timely manner, dating apps becoming more popular, and individuals feeling less comfortable accessing health services during the pandemic.”

Bourdeau added the government would continue to make “targeted investments to prevent infections and to provide wrap-around supports for people living with these infections.”

Singh said that while financial and human public health resources were diverted during the pandemic, homelessness, poverty and addiction also worsened.

“We need to enhance our testing and treatment, and we also need to address the root causes of what is driving this,” she said.

Singh emphasized that anyone who is sexually active outside of a mutually monogamous relationship is at risk for one or more STIs and should get tested.

“Many people will never know that they’ve been infected until they get tested.”

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