Rodney Stevens
A sharp rise in the number of Syphilis cases reported across the region has prompted a warning from health authorities to be alert and get tested after with the North Coast experiencing an increase in cases far higher than the five-year average.
Syphilis can be transmitted by unprotected vaginal, anal or oral sex, through kissing and/or close physical contact, plus pregnant mothers can pass the condition on to their unborn babies leading to stillbirth or permanent disability of the baby.
Traditionally syphilis has been largely limited to Aboriginal communities and gay men, but a spike in the number of young people and people having unprotected casual sex has seen the numbers significantly increase.
Director North Coast Population and Public Health, Dr Valerie Delpech, said since 2020, infectious syphilis cases in the North Coast have increased each year, with 29 cases in 2020, 41 cases in 2021 and 85 notifications in 2022.
“This increase reflects an unprecedented number of cases, especially amongst young heterosexuals and those who engage in casual unprotected sex,” Dr Delpech said.
“Syphilis does not always present symptoms.
“We suspect there are many other cases of infectious syphilis in the community that are undiagnosed, so early testing and treatment is key to helping us control this outbreak.
“We are encouraging all sexually active people, particularly those who have multiple sexual partners or unprotected casual sex, to talk to their GP or visit their Sexual Health Service to be tested, even if they are not experiencing symptoms.”
For those who experience symptoms, the first sign of syphilis is the appearance of sores or ulcers at the site of the infection.
Though syphilis can cause serious health problems, it is easily tested and cured.
Regular check-ups are needed to prevent passing the infection on to other people and to avoid long-term health consequences.
The spike in Syphilis cases has medical experts concerned about the infections impact on pregnancies.
The Covid pandemic, where lockdowns influenced the way we socialised and interacted with sexual partners, shaped the latest figures.
A report by the UNSW’s Kirby Institute shows that most Sexually Transmissible Infections STI’s remain untreated in Australia, highlighting the need for increased testing.
The report revealed a dramatic increase in syphilis among women of reproductive age.
There was an eight-fold rise in non-Indigenous women, while Aboriginal and Torres Strait Islander women recorded a four-fold escalation over the ten-year reporting period.
“While the numbers among women in cities are still relatively small, the upward trend in this group over the last 10 years has been substantial,” one of the report’s authors Dr Skye McGregor said.
She was “particularly concerned” about syphilis in women aged 15-44 years because of pregnancy outcome risks.
Pregnant mothers should be tested for syphilis during routine antenatal screening; in the first trimester of pregnancy and between 26–28 weeks, or if presenting for the first time in late pregnancy without previous antenatal care.
Repeat testing throughout gestation is required for mothers at high risk of STIs and in all mothers presenting at any stage of pregnancy with the clinical signs of any other STI.
Signs and symptoms
Primary Syphilis – Syphilis can initially cause very contagious sores or ulcers around the genital area, mouth, or throat 10–90 days (average 21 days) after infection. These sores, called chancres, can be any size or shape. They are often painless, don’t bleed, and can feel like a hard button on the skin. If not treated, the sores usually heal and disappear after a few weeks, however, the syphilis infection remains in the body and the person can still pass the infection on.
Secondary Syphilis – Occurs two to six months after getting infected. Symptoms may include a flu-like illness, a rash on the trunk, palms, and soles of the feet, swollen glands, wart like lumps around the moist areas of the body, and hair loss. Some people also get headaches, tiredness and pains in the bones, muscles and joints. Even when these symptoms resolve on their own the person can still pass the infection on.
Early latent Syphilis – A person doesn’t have any signs or symptoms but is still infectious. The only way to confirm syphilis is to have a blood test.
Late latent Syphilis – A person isn’t infectious. A blood test can confirm this.
Tertiary syphilis – can develop years after the infection was first acquired. If left untreated, the bacteria can damage major organ systems including the heart, brain, spinal cord, eyes and bones, resulting in heart disease, mental illness, blindness, deafness and neurological problems. At this stage, syphilis can still be treated, and the person is not infectious.