Canada: MDs Warn of Syphilis Outbreak

Canada has seen a five-fold rise in syphilis and steady increases in other STDs over the past five years, fueling speculation that many Canadians are no longer practicing safe sex. Health Canada reports that syphilis cases nearly doubled between 2002 and 2003, jumping from 1.5 cases per 100,000 people to nearly 3 cases per 100,000. During the mid-1990s, the rate was 0.5 cases per 100,000 people. Concurrently, chlamydia rates increased almost 70 percent, while gonorrhea climbed 40 percent.

Paul MacPherson, infectious disease specialist at Ottawa Hospital's General campus, said the syphilis outbreak is mainly concentrated in the gay community, often among those who are HIV-positive. The increase has physicians looking for ways to re-educate people suffering from safe-sex fatigue. Two decades after AIDS first hit, many Canadians are simply tired of using condoms and taking other precautions when having sex, MacPherson said. "Across the board, we're seeing major lapses in safe sex," he noted.

And while many Canadians know how to protect themselves against HIV, some of those precautions may not be effective against syphilis. "The safer sex messaging that most people are familiar with around HIV doesn't associate oral sex with high-risk behavior," said Jeff Dodds, a senior public health advisor at Health Canada's Sexual Health and Sexually Transmitted Infections Section. "So people aren't understanding that oral sex is high risk for other [STIs] such as syphilis," continued Dodds.

Health officials trace the latest rise in syphilis rates to 1997, when a series of outbreaks occurred across Canada. Last year, the highest numbers were posted in the Yukon, with 16.1 cases per 100,000 -- down from 20.1 per 100,000 recorded the year before. British Columbia had the second-highest number of cases, Ontario the third. But those numbers reflect just those who have been tested. "We really encourage people, as part of their ongoing health maintenance, to consider being tested for sexually transmitted infections -- because of these increases in numbers," said Dodds.

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