Syphilis risk up, newborn rate a concern: province’s top doctor By: Jessica Botelho-Urbanski Posted: 7:00 PM CST Monday, Feb. 25, 2019

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As Manitoba’s latest syphilis outbreak enters its fifth year, the acting chief provincial public health officer warned Monday the bacterial infection is increasingly affecting newborn babies.

Dr. Michael Isaac said the province recorded its first recent case of congenital syphilis — where the infection was passed from a pregnant mom to her unborn child — in 2015 and another case the following year.

Yet in the last six months, more than 10 infants have been treated for congenital syphilis in Manitoba, which Isaac said is cause for concern. The Winnipeg and northern health regions have experienced the highest numbers of cases, though the risk is high provincewide.

"Congenital (syphilis) cases are rare and have been very rare in Manitoba in the past… So the risk level has changed and we wanted to make sure that providers and the public know about that," the province’s head doctor told reporters Monday.

Isaac said while Manitoba’s syphilis outbreak has been ongoing since 2014, the sexually-transmitted infection has recently begun affecting more heterosexual people and women.

“In the past, syphilis outbreaks have occurred mainly in urban areas of Canada between men who have sex with men. But over time, and especially over the past three years, we’ve noticed that that has changed," he said.

Female syphilis cases reported in Manitoba jumped from 16 in 2014, to 168 last year.

Syphilis is curable with a single dose of penicillin for adults, but could have more serious consequences for babies.

Isaac noted babies born with congenital syphilis can have deformed bones, severe anemia, enlarged livers and spleens, jaundice, brain and nerve problems (such as blindness or deafness), meningitis and skin rashes. Affected pregnant women can be at risk for miscarriage and stillbirths.

Isaac said the cause of the syphilis outbreak comes from "a combination of intersecting epidemics" and singled out a spike in intravenous drug use as problematic. He noted the spike in IV drug use has been linked to a surge in crystal methamphetamine consumption.

"So we have sexually transmitted and blood-borne illnesses, which we’ve always had in Manitoba, intersecting with substance use and injection drug use. And those two factors together have made this very difficult to control," the doctor said, noting the province has seen about 70 per cent of mothers with congenital syphilis reporting substance use.

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Another 30 per cent of affected mothers didn’t have adequate prenatal care, he said, which would have included being tested for syphilis, as is customary across Canada.

Isaac said the province is increasing its education resources about syphilis at all health-care facilities and working with community partners, such as the Manitoba Harm Reduction Network, to get the word out among vulnerable communities.

At Nine Circles Community Health Centre, community engagement co-ordinator Teri Stevens said staff is seeing "unprecedented rates of syphilis and other STIs right now."

"Our nurses are dealing with syphilis daily, either testing for it or treating for it," she said in an interview Monday.

Nine Circles recommends those who are sexually active get tested for STIs annually, or more frequently if they have multiple partners or are sharing drug-use supplies.

At their 705 Broadway location, they have a drop-in clinic available Wednesdays from 12:30 p.m. to 7 p.m. and can book other appointments by phone or online, Stevens said.

Manitoba NDP Leader Wab Kinew also weighed in, saying the provincial government waited too long to sound the alarm about syphilis.

He noted the NDP released documents obtained from a freedom of information request in December that showed a spike in sexually transmitted and blood-borne illnesses in Manitoba.

"The government is way behind the times and it is having a real public health cost," Kinew said. "Manitobans are less well, Manitobans are sicker because of the inaction of this government."

Health Minister Cameron Friesen fired back about Kinew’s partisan argument.

"This is not a political issue, this is a medical issue," Friesen said. "I will take advice from the chief medical officer. Mr. Kinew is not a doctor."

jessica.botelho@freepress.mb.ca

Twitter: @_jessbu

wfppdf:https://www.gov.mb.ca/health/publichealth/factsheets/syphilis.pdf | Public Health Branch Syphilis Factsheet:wfppdf