Winnipeg’s regional health authority is grappling with an unprecedented spike in syphilis cases among some the city’s most vulnerable populations.
From 2008 to 2011, there were approximately 36 cases of the sexually transmitted infection reported in Winnipeg. From 2015 to 2017, that number rose to approximately 120 cases.
In the first six months of 2018 alone, there were more than 120 recorded cases – more than the combined total for the previous three years.
Dr. Joss Reimer, Medical Officer of Health for the Winnipeg Regional Health Authority (WRHA), says the increase in syphilis cases can be attributed to the infection moving into a different population with less access to health care.
In the past, she said syphilis mostly affected homosexual men, but that’s decreased in recent years thanks to education and awareness campaigns within the community.
Now, Reimer says the WRHA has noticed an unexpected increase in cases among heterosexual men and women in the city.
“We’ve seen it move into a much more vulnerable, inner city, poor, largely Indigenous population who have a lot of structural barriers and things that are going to make it easy for this bug to take advantage of that population and spread very easily,” she told CTV’s Your Morning on Wednesday.
Of the 120 recorded cases in 2018, the health authority reported that 50 to 60 per cent of infected patients identified as Indigenous, 20 to 30 per cent were crystal meth users, and approximately 20 per cent were homeless.
Syphilis is transmitted from person to person through direct contact with painless sores during sexual activity or from sharing needles.
Symptoms may not be apparent right away in some people and they can arrive months or even years later, according to the WRHA. Infected individuals can experience painless sores, a rash on the palms of the hands or bottoms of the feet, fever, muscle aches, and fatigue.
If left untreated, the WRHA says syphilis will progress and can cause damage to internal organs such as the brain, heart and liver and can even lead to death.
According to Statistics Canada, there has also been an 85.6 per cent increase in syphilis cases across Canada from 2010 to 2015. The highest rates of infectious syphilis were reported in Nunavut, British Columbia, and Manitoba, according to the data.
In addition to syphilis, the Public Health Agency of Canada announced in 2016 that rates of other sexually transmitted infections, such as chlamydia and gonorrhea, have also been steadily rising since the 1990s.
Reimer says it’s possible that Canadians may be taking fewer precautions during sexual contact and drug use because they’re aware of the treatments available to them.
“Now that a lot of these infections are very treatable, people are a little less scared of them,” she said.
Finding a solution
As for how the city’s health authority is addressing the current outbreak, Reimer says they’re trying to track down infected individuals to provide treatment and then figure out who they have been in contact with in order to test and treat them as well.
Reimer says they’re also working with Indigenous and poverty organizations within the city in order to determine the root causes behind the spread.
“Because it’s people who are really hard to reach, who are not well connected to health care, we actually have to go a bit deeper and figure out what’s the cause. Why are the groups vulnerable like they are?” she explained. “If we don’t start looking at the causes, we’re going to end up chasing our tails and trying to catch up all the time.”
Although they don’t have all the answers yet, Reimer says Winnipeggers, and Canadians alike, can protect themselves by using condoms, not sharing needles, and getting tested.
“If you’re having sex, especially without a condom, then you’re at risk of infection and you should get tested,” she warned. “If you get regularly tested, most of these infections we can clear with treatment, and the ones that we can’t, if we catch them early, we can prevent the long-term problems and the complications.”
