'Horrifying' number of syphilis infections in Alberta reaching pre-antibiotic levels

Despite advances in health care, the number of syphilis infections is skyrocketing across Alberta, reaching their highest levels in about 70 years. 

Cases of the disease in Alberta have exploded since 2000, when only 17 were reported. By 2020, there were 2,509 cases in the province.

"The highest rates we've seen since the 1940s, which is, of course, the pre-antibiotic era," said Dr. Ameeta Singh, an infectious disease specialist who works at Edmonton's Royal Alexandra Hospital. 

"Despite all of our advances, we are seeing a horrifying rate of syphilis cases."

Syphilis was cited by Dr. Deena Hinshaw, Alberta's chief medical officer of health, as one of the worrisome health threats going unchecked while resources are tied up with COVID-19. Devoting more resources to those threats was the key reason for Alberta's controversial rolling back of COVID-19 measures, announced in late July. 

The disease is a bacterial infection, usually spread by sexual contact, that infects millions around the world each year. Without treatment, syphilis may attack major organs resulting in death. 

Most cases in Edmonton

Almost half the cases were in Edmonton, which had about three times as many as were reported in Calgary. In fact, Edmonton has one of the highest syphilis rates in Canada. 

In the first three months of 2021, there were 765 cases reported in Alberta.

LISTEN | Infectious disease expert talks about what's driving Alberta's high syphilis rates: 

The popularity of social media apps being used for dating, such as Facebook, might be part of the reason for the surge, said Singh.

As well, people may also be taking fewer precautions and using condoms less frequently, she told CBC Edmonton's Radio Active.  

There is also a significant link between methamphetamine and sexually transmitted infections. 

"Not only does the drug stimulate the sex drive, but it also encourages risky behaviour," said Singh. 

Edmonton also has the highest rate per capita for methamphetamine use, according to a wastewater survey by Statistics Canada. The agency has been testing wastewater in five major cities since 2019. 

The last time syphilis was this prevalent in Alberta was in 1948, just a few years after penicillin became widely available and cases began to decline.

"Remarkably, the bacteria has not developed resistance to penicillin," said Singh, noting that it is still used as a treatment today.

In 1998, Canada announced a goal to eliminate syphilis. However, the following year an outbreak was reported in downtown Vancouver and soon after another in northern Alberta. 

Disease can be passed to babies

Syphilis can be particularly alarming for pregnant women as it can be passed to the baby and result in stillbirths. 

Singh said about 15 per cent of cases in Alberta occur in pregnant women. 

"And many of those women are disproportionately affected by other social determinants of health, such as homelessness, poverty, addictions and mental health issues."

A syphilis outbreak was declared in 2019 by Alberta Health Services after 12 stillborn births. 

This problem is not solely Alberta's as the disease is also surging across Canada, the United States and Australia. 

To fight the increasing numbers, Singh said heightened public awareness is essential to push individuals to get tested. 

Rapid testing is also in the works for syphilis and HIV to give patients a preliminary result within minutes. 

"If we find someone is syphilis-positive, we can offer treatment right there, which will hopefully prevent transmission as well as complications," Singh said.