By Dr. Colin Lee, Associate Medical Officer of Health
Since 2018, the number of syphilis cases in Simcoe Muskoka has increased fivefold. Syphilis is a bacterial infection that spreads through sexual contact, such as genital, anal, or oral sex. It can affect anyone who is having unprotected sex. The largest increase in cases has been among women, although most cases are still in men. We are also seeing a concerning trend of increased infections in pregnant people and newborns throughout Canada. Pregnant individuals can pass the infection to their babies during pregnancy or at birth. Meanwhile, the number of cases among men continues to grow.
If a person has syphilis, they may not have any symptoms. For those who have symptoms, they may have painless sores at the site of exposure, followed by a rash, fever, and other symptoms. These symptoms may disappear without treatment; however, the infection stays in the body. Syphilis that remains untreated for a long time can permanently damage organs such as the heart, brain, and liver.
Because it can present with symptoms that are very similar to other health conditions, syphilis is called the “great pretender” which can sometimes complicate its diagnosis. Syphilis is easily detected with a blood test and is best treated with an injectable antibiotic. This particular antibiotic is only available through the public health unit for free and a treating health care provider can access this medication on behalf of patients at no cost.
We recommend that people who are sexually active get tested regularly through a blood test. When detected sooner, the infection can be treated sooner, requiring fewer doses of antibiotic, and lowering the risk of developing long-term health problems. Testing for syphilis and other STIs is available through your healthcare provider’s office, walk-in clinics, community health centres, certain community agencies and sexual health clinics, including the Simcoe Muskoka District Health Unit (SMDHU). STI testing is free through a healthcare provider for those with an Ontario Health Card. A valid health card is not required to access free STI testing at the health unit.
It is important for people to get tested for syphilis if they have been sexually active with new or multiple partners without the use of barrier protection (i.e., condoms, dental dams), especially if their partners were anonymous and if they have symptoms or have previously experienced symptoms consistent with syphilis (even if the symptoms are now gone).
Anyone who is pregnant or planning to be pregnant should be tested. If left untreated, a syphilis infection can lead to congenital syphilis. This is when syphilis is spread from those who are pregnant to their babies during pregnancy or at birth. Syphilis can result in serious health complications for babies. All pregnant individuals are recommended to get tested in the first three months and at seven months of pregnancy. Ongoing screening during pregnancy is also recommended for individuals who engage in sexual activity with new or multiple partners or are having unprotected sex.
People can reduce their risk of getting syphilis by making informed decisions before participating in sexual activities, such as using barrier protection, limiting their number of sexual partners, talking to their partner(s) about STI testing, and being aware of how alcohol and other drugs can affect sexual decision making.
Use of barrier protection, such as condoms and dental dams, is the best way to protect against syphilis and other STIs during sex. Condoms and other forms of barrier protection are available for free at all health unit office locations through self-serve dispensers.
To find out more about syphilis, including symptoms, stages, and treatment, visit smdhu.org/GetTested. You can self-book a SMDHU sexual health clinic appointment at www.smdhu.inputhealth.com or by calling Health Connection at 705-721-7520 or toll free 1-877-721-7520, weekdays between 8:30 a.m. to 4:30 p.m. All of our sexual health services do not require OHIP and are free, confidential, nonjudgemental and 2S-LGBTQIA+ friendly with nurses who are easy to talk to.
Dr. Colin Lee is an Associate Medical Officer of Health for the Simcoe Muskoka District Health Unit. To learn more about sexual health and other public health topics, visit smdhu.org.