SYPHILIS CASES INCREASE CONCERN ON NORTH COAST

By TIM HOWARD

A sharp rise in the number of cases of syphilis on the Mid North Coast and Northern Rivers among young people has begun to worry health authorities.

Director North Coast Population and Public Health Dr Valerie Delpech said syphilis had been largely limited to Aboriginal communities and gay men, but a spike in young people and those who engage in unprotected casual sex, was concerning on two fronts.

Dr Delpech said the spread of the disease into new parts of the community was worrying but equally concerning was the high probability there were many more undiagnosed cases of the disease in the community.

She 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.

Dr Delpech said syphilis infections sometimes presented no symptoms, or were so mild they were ignored.

“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,” she said.

She said there was also a stigma associated with sexually transmitted infections and which might make people reluctant to seek a test.

“People might think they’re only having sex with their partner, but there’s always the possibility their partner might be having sex with other people,” she said.

“The best thing for people to do is have a routine sexual health check up at their GP or at a sexual health clinic.

“They will guarantee confidentiality and it will give people peace of mind.”

She said early treatment was also very simple, often requiring nothing more than an injection of penicillin.

“For such a dangerous disease, the cure is actually remarkably quick and effective,” she said.

Dr Delpech said the spread of the disease into younger members of the community could be linked to relaxation of the Covid-19 restrictions.

“Now restrictions have been relaxed young people are going out, there’s mixing and more people are having casual sex or meeting new partners.

“Where the majority of cases we had came from Aboriginal communities or the among gay men, we’re now getting a significant number of cases in young heterosexual people or people who have casual, unprotected sex.

“It’s something that has never really gone away, but has not been prevalent in a long time, since probably during the time of world wars before the 1950s.

“The one thing we know is, syphilis is back.”

While the initial symptoms of the disease can be mild, leaving it untreated long term was disastrous, said Dr Delpech. au.

She said initial symptoms were small sores or ulcers that broke out at the site of the contact with the infected person, often around the genitals, anus or mouth.

“While those symptoms are present the person if infectious,” Dr Delpech said.

She said there was a second chance for an infected person to notice the disease, the outbreak of a rash on the body, often accompanied by flu-like symptoms.

“That’s another chance to people to get treated and clear themselves of the disease,” she said.

While the symptoms might disappear, left untreated the disease lay dormant for as long as 30 years, reappearing sometimes as a form of dementia, causing cardio vascular disease or bone problems.

In its final stages syphilis posed serious, life-threatening health issues including blindness, tumours, paralysis, extensive damage to the nervous system, and death.

In pregnant women the disease was able to be transmitted to the foetus, resulting in stillbirth or permanent mental disability in the baby.

Confidential testing for and treatment of sexually transmissible infections is free of charge through your GP, Aboriginal Medical Service or local Sexual Health Clinics at Tweed Heads, Lismore, Grafton, Coffs Harbour, Kempsey or Port Macquarie.

For sexual health support and information, call the NSW Sexual Health Infolink on 1800 451 624 (weekdays 9am to 5.30pm), go to www. shil.nsw.gov.au or visit NSW Health’s Play Safe website at https:// playsafe.health.nsw.gov.

Syphilis symptoms

1. Visible sores (the primary stage)

The first visible sign of syphilis (if you get any) is a sore – known as a ‘chancre’. These sores are very contagious and if you believe you may have syphilis sores you should avoid sex and get tested.

They’re usually firm and round, painless, and appear in the anus, on the penis, front hole, balls, or sometimes on or around the mouth.

Chancres usually appear around three weeks after infection but it could be anywhere from 10 days to three months.

They’ll usually disappear again after around six weeks, but even if the sores go, you’ll still be positive for syphilis until you get treated and a medical professional confirms that the infection is no longer present.

2. Rashes (the secondary stage)

Another sign of syphilis is a rash that appears on the palms of the hands, soles of the feet, or other parts of the body. This rash often appears after the chancres, but sometimes it might appear before (STIs like to be unpredictable, hey?). It doesn’t usually itch and – like the sores – rashes can easily be mistaken for another illness or ailment, so it’s not always obvious it’s syphilis.

3. Flu-like symptoms (the secondary stage)

If you do get a syphilis rash, be prepared for some flu-like symptoms as they often go hand in hand. They’re usually pretty mild though and might include a bit of a fever, sore throat, fatigue, headache and/or some aches and pains in your muscles.

4. The latent stage

If a person isn’t diagnosed during the primary or secondary stages, then they may progress to the latent stage. During this stage, symptoms might disappear on their own, and the infection will remain latent. This stage lasts indefinitely, unless tested, treated and cured, however after two years you will no longer be infectious. If you aren’t treated at this stage you can experience further health issues in the future, such as with your heart, brain and bones.

5. Severe and ongoing health issues (the tertiary stage)

If syphilis is left untreated for a long time it can cause some serious, life-threatening health issues including blindness, tumours, paralysis, extensive damage to the nervous system, and even death. Today this is uncommon, as regular testing means cases are detected early and can be treated effectively with antibiotics, well in advance of such serious symptoms developing. Syphilis can stay latent for up to 30 years, which is why it’s so important to get tested for STIs regularly, regardless of whether you are experiencing symptoms or not.