I don't know if you've noticed, but a while ago a billboard addressing the rise of syphilis in Canada appeared on Kensington Avenue. Shortly thereafter, similar ads in public washrooms in Estevan also caught my attention.
And from there, I started noticing more and more information about this sexually transmitted infection entering public space. Like before, the new talks about what was once known as "social disease" seem quiet and discreet. Even though the information about the situation and tendencies is not that loud, the news about the rise of syphilis in Canada at first appeared pretty unbelievable in today's day and age.
I don't know about you, but to me, syphilis and some other sexually transmitted infections used to feel like something we largely left in the 20th century. I'm not that young and come from a country where mass sex education was never really introduced. (The first experiments with sex education in Russia occurred in 1994, and there was some progress in the early 2000s, but it never became a part of the school curriculum and was pretty much eradicated over the last decade).
But even my schoolbooks included scary pictures and long talks about why condoms are a must. And I felt that it worked, turning syphilis into an old disease from the books.
But things changed.
Canada has witnessed a notable surge in syphilis diagnoses since 2016, prompting several provinces to declare outbreaks, with Saskatchewan, Manitoba and the Northwest Territories reporting the highest incidence rates lately. And the problem seems to be global. In industrialized countries, syphilis infections were on a decline until the 1980s and 1990s due to the widespread use of antibiotics. However, since the year 2000, there has been an upward trend in syphilis rates noted in the U.S., Europe and Australia, among others.
The chief public health officer of Canada reported in mid-February that in 2022, Canada documented close to 14,000 instances of infectious syphilis, along with 117 occurrences of early congenital syphilis, wherein the infection is transmitted from a pregnant woman to their baby. (The latest was almost eradicated by the new millennium.) The new statistic shows a twofold surge in infectious syphilis cases and a sixfold escalation in congenital syphilis compared to the data reported in 2018.
So what has happened?
It's hard to name the precise reasons. Maybe we let our guards down, feeling that once deathly, and now mostly just dangerous, sexually transmitted infections became a notion of the past. Maybe the popularity of alternative birth-control options also lessened the focus on the need for barrier protection. The advent of highly effective HIV treatment and prevention methods might have contributed to a decline in old-style protection as well.
The other advances of today's world, such as online dating platforms which offer increased accessibility to sexual encounters, also reshaped the landscape, where casual sex has become more common. Drugs might have a role to play as well.
I feel that mistrust in the health-care system, more widespread among particular groups of the population, as well as disparities in health care are other big parts of the trend we are seeing (and not just in this particular case).
In sum, changing sex practices and the lack of access to proper health care and information, especially for particular groups of people, create a positive environment for sexually transmitted infections. And when the numbers start growing within some groups, it's just a matter of time before the disease starts spilling over to others.
While in its core the problem is very intimate and personal, to be resolved it needs a systematic approach. Addressing these multifaceted factors is crucial to developing effective strategies for syphilis prevention, surveillance and overall public health.
But it's also important to remember that what seemed to be out of the picture is now back again, and even if it still feels surreal, it is real. So, two things: first, the good old methods of preventing the bacterial sexually transmitted infection combined with the advanced medical options are more important than ever. And second, regular screening can change a lot. Syphilis, if diagnosed, is largely preventable, treatable and curable. Unfortunately, access to testing and treatment is impeded by many barriers like stigma and discrimination, socioeconomic factors such as income disparities and educational gaps, and a deficiency in culturally safe care. So, there is work to be done on many levels, but it all starts with simple awareness.
