Canada: "Syphilis Plague" Makes Comeback; Tenfold Increase From 1993-2009

Syphilis in Canada has fought its way back from near elimination 13 years ago, according to the Public Health Agency of Canada (PHAC), with cases increasing nearly tenfold from 1993 to 2009. Of the 1,683 documented cases in 2009, 1,501 affected men.

PHAC spokesperson Jana Lerner attributes the spike to factors including incorrect condom use and inconsistent safe sex practices. "Sexually transmitted infections, including syphilis, continue to be a public health concern in Canada," she said.

To combat the increases, provinces are ramping up innovative marketing campaigns. Alberta's faux dating website, plentyofsyph.com, bills itself as a "one-stop syphilis shop," goading visitors to "Start laughing, flirting and getting infected in seconds with sexy single simmering with syphilis."

PHAC is distributing syphilis prevention information, including audio-visual materials from an online symposium entitled "Return of the Syphilis Plague."

Upwards of 90 percent of Toronto's 508 syphilis cases in 2010 were in men -- 50 to 70 percent of them HIV-positive, said Bruce Clarke of Toronto Public Health (TPH). Clarke credits the rates to the sero-sorting practice of some HIV-positive men, whereby infected men have sex with one another, assuming condoms are not necessary since both parties are HIV-positive. They may unsuspectingly be spreading syphilis, he explained.

TPH, AIDS Committee of Toronto and the local health ministry are using mock 1950s B-movie posters to warn HIV-infected men of the "Attack of the Cursed Syphilis." In the fall, TPH, Toronto's Hassle Free Clinic, Ottawa Public Health and local government will debut ads encouraging men to get tested for HIV and syphilis.

Halifax infectious-disease specialist Dr. Todd Hatchette noted the impact of syphilis countrywide, pointing out increasing instances in eastern Canada. "It's hard to know [why]. Probably it is linked to increased unsafe practices, multiple partners [and] anonymous sex," said Hatchette.

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