[SWAF-Potluck] Syphilis rates soar in Vancouver as testing urged...

[Andy Sorfleet]

I have a few comments. First, the Medical Officer of Health is calling
this an "epidemic" in this article. Syphilis rates in Vancouver and
Lower Mainland are their highest in 32 years.

Secondly, I cannot stress this enough: syphilis testing becomes much
less reliable, and treatment more and more ineffective the longer one
has syphilis. We lost someone very dear to us, who had several
negative test results (including 4 lumbar punctures) and several
courses of treatment, who eventually was found to have lesions on his
brain, before he fell off a bridge and died.

Self examination and a good education about what syphilis symptoms
look like are key to diagnosing syphilis and treating when one is
first infected.

In solidarity,

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http://www.theglobeandmail.com/
GLOBE AND MAIL
Thursday, August 21, 2014

Camille Baines, The Canadian Press



Syphilis rates soar in Vancouver as testing urged for men who have sex with men

Syphilis rates in Vancouver are at their highest in 32 years,
prompting public health officials to issue a warning to the group at
greatest risk -- men who have sex with men.

Medical health officer Dr. Reka Gustafson of Vancouver Coastal Health
said Thursday that 561 new syphilis cases were reported in British
Columbia last year, and 86 per cent of them were among gay and
bisexual men.

She said syphilis rates in 2012 across the Lower Mainland were already
at their highest in 30 years, and the numbers climbed further in 2013.

Men who have more than one partner at the same time are at greater
risk of becoming infected, Gustafson said.

The highest rates in Vancouver are among men between 30 and 49, though
infections are increasing in all age groups.

She urged men who have sex with men to get tested every three to six
months through blood tests available at doctors' offices, walk-in
clinics, the B.C. Centre for Disease Control and other facilities.

Treatment involves antibiotics, especially penicillin.

"If you're a sexually active individual, especially a gay man in
Vancouver, you're at risk for syphilis. The earlier you're diagnosed,
the easier the treatment is and also the less likely you are to
transmit to someone else. And the treatment is curative."

Syphilis is spread primarily by oral, vaginal or anal sex and if left
untreated the disease can lead to blindness, hearing loss, brain
damage and even death.

An infected person may not have any symptoms or initial ulcers or
sores resembling bug bites on genitals and rashes on the palms and
soles of the feet may disappear while the infection circulates through
the body, Gustafson said.

"So awareness becomes really, really important. The initial symptoms,
even if you have them, including the initial ulcers, can be painless."

Many factors are involved in the syphilis epidemic among gay and
bisexual men but behaviour could be a key issue, Gustafson said.

"Our syphilis outbreak right now in Vancouver is affecting adult men,
and a disproportionate rate are HIV-positive -- about 69 per cent. Men
who are HIV-positive typically have sex with other men who are
similarly affected."

But the idea of preventing HIV transmission by having unprotected sex
with someone of a similar HIV status may backfire when it comes to
syphilis.

Gustafson said transmission doesn't necessarily involve intercourse
because the disease can be passed on through oral sex or close
skin-to-skin contact.

While rates of syphilis among men began to increase around 2003 and
2005, there was a dip in 2007 before a spike in 2010, she said.

Sometimes a temporary immunity to a sexually transmitted disease
reduces rates before they rise again, Gustafson said, adding cities
across Canada and elsewhere are struggling to deal with the issue.

"Practise safe sex, have fewer sexual partners and get tested and
treated as soon as possible. Make sure all your partners are also
tested and treated."

The latest Public Health Agency of Canada report in 2010 said that
while reported syphilis rates across the country had declined overall,
they started climbing sharply among men in 2001.

That report also cited the highest rates among men who have sex with
men, as is the case in the United States and Europe.

"The causes for these increases are complex and include demographic
shifts, as well as changing sexual attitudes and social contexts
related to increased risky sexual behaviour," the report said.