There’s A Worrying Increase In Syphilis Cases Across Australia

Despite a fall in testing for STIs during the pandemic, doctors now warn of a dramatic increase in syphilis cases across Australia.

For so long, the only rise in cases we’ve grown accustomed to hearing of late are those pertaining to Covid-19. But two years into the pandemic, as it seems that Covid-19 is simply a reality we are all going to have to learn to live with, a new rise in cases is occurring across Australia – that of syphilis.  

Despite cases of syphilis decreasing between 2019 and 2020, rates of diagnosis increased dramatically in 2021. Studies found that there were 86,916 diagnoses of chlamydia, 26,577 of gonorrhoea and 5,570 of infectious syphilis in Australia, according to findings from the HIV, Viral Hepatitis and Sexually Transmissible Infection in Australia. 

While reductions were seen in the total number of chlamydia and gonorrhoea diagnoses nationally, experts are warning that this might not reflect the reality. Modelling from the Kirby Institute revealed that most chlamydia and gonorrhoea cases went undiagnosed and untreated, with the decrease in cases likely a reflection in the drop in numbers of being tested for sexually transmissible infections (STIs) during the pandemic, after testing for these STIs are down 14 per cent from pre-pandemic levels. 

But while chlamydia and gonorrhoea may have seen a fall – even if not reflective of reality – the same can’t be said for syphilis. According to reports from The Guardian, rates of syphilis have continued to rise among gay and bisexual men, and among Aboriginal and Torres Strait Island people, as well as women of reproductive age in 2021. In the same period, there was a significant increase in the number of congenital syphilis diagnoses, which occurs when syphilis is transmitted during pregnancy to an unborn child. The publication states, “A disproportionate number of these infections – 60 per cent – occurred among Aboriginal and Torres Strait Islander babies, who make up only approximately 5 per cent of all newborns.”

As Dr Skye McGregor, co-author of the report from the University of NSW explains, the trend is particularly worrying when it comes to pregnant women as they should be tested regularly for STIs as part of pre- and antenatal health screening. “Covid-19 has put additional strains on health service delivery and access,” said McGregor. “With timely screening, syphilis can be cured, so even one case of congenital syphilis is completely avoidable and unacceptable.”

According to Dr Kathleen McNamee, medical director of Sexual Health Victoria, the findings from the report reflect current trends that are being seen in clinics and testing services. “Looking at previous years, although the majority of infections are in men, syphilis infections have increased at a greater rate in women. Unlike many other STIs, condoms may not be protective.”

As McNamee explained, there are still a number of barriers that deter people from accessing health care and testing services, ones that are crucial when it comes to treating and diagnosing STIs. These conclude time, embarrassment or feelings of shame, and cost. McNamee suggests that while practice procedure is to collect samples for testing from people during their clinic visit, many people who had tests ordered after a Telehealth consult did not take the next steps of listing a lab to have their specimens taken. 

Everything you need to know about syphilis

What is Syphilis?

Syphilis is a sexually transmitted infection that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary), with each stage presenting different signs and symptoms. 

What are the signs of syphilis?

Primary Stage

You may notice a single sore or multiple sores in the location where syphilis has entered your body, typically around the penis, vagina, anus, rectum, lips or in the mouth. Sores are normally round and painless. As a result, some people don’t notice it and it can last 3 to 6 week before healing, regardless of whether you receive treatment. Even if the sore goes away, you must still receive treatment to prevent the infection from entering the secondary stage. 

Secondary stage

You may have skin rashes and/or sores in your mouth, vagina, or anus. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look rough, red or reddish brown. Other symptoms include fever, swollen lymph glands, sore throat, headaches, weight loss, muscles aches and fatigue. 

Latent stage

This stage is when there are no visible signs or symptoms, but without treatment, you can continue to have syphilis in your body for years. 

How is it spread?

Syphilis can be spread by direct contact with a syphilis sore during vaginal, anal, or oral sex. It can also spread from a mother with syphilis to her unborn baby. However, you can’t get syphilis through casual contact with objects like toilet seats, door knobs, swimming pools, or sharing clothing or utensils. 

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