Syphilis is on the rise in the Sault and Algoma District.
A presentation delivered to Algoma Public Health’s board at its monthly meeting held Wednesday showed testing for syphilis has gradually increased over the last 10 years. But, the syphilis rate has been going up since 2019 and has seen a substantial increase between 2019 and 2023.
There was a 1,685 per cent increase during that time.
That included Algoma’s first congenital case in which syphilis was transmitted to a baby by an infected mother during pregnancy.
Wednesday’s presentation was delivered by Sandra Dereski, APH's acting manager of infectious diseases, and Casey Cassan, a health promotion specialist.
Jody Wildman, a board member, described a graph accompanying the presentation as “quite alarming.”
Dr. John Tuinema, APH acting medical officer of health, said: “Probably around 2017 public health in Ontario starts to notice that this increase is happening, starting to sound the alarm, looking at it from different ways to try to figure out what's happening.”
The graph showed the number of syphilis cases in Algoma - confirmed through testing of individuals - was higher than the number of cases in the rest of northeastern Ontario and province wide.
“There are a number of risk factors associated with acquiring syphilis at both the behavioural and societal level, for example, having multiple sexual partners and being under housed or street involved. Some additional risk factors for acquiring syphilis include anonymous sexual partners, no condom use, more than one sexual partner in six months, and having had previous syphilis,” Dereski told the board.
In recent years, syphilis has become a sexually transmitted infection of considerable public health importance in Canada.
Syphilis is a preventable and treatable STI caused by the bacteria treponema pallidum. It is transmitted through vaginal, anal or oral sex and can also be transmitted from an infected mother to an infant during pregnancy or birth.
Early symptoms can often include chancre (a painless sore), rash and/or headache. While the early symptoms like a chancre may go away with time, the infection doesn’t. Until effective treatment is administered, the disease will progress and cause more severe health issues.
Complications from untreated syphilis can have serious and life-threatening side effects. Syphilis can enter the brain and nervous system at any time, causing meningitis, inflamed nerves, vision issues, and paralytic dementia.
It can also eventually progress to the heart, causing aneurysms and blockages of arteries.
Over time, syphilis can cause dangerous lesions on any organ in the body. If an infected parent passes syphilis to their infant during pregnancy or birth, it can result in congenital syphilis or even fetal death. Infants born with congenital syphilis may experience developmental delays and severe birth effects affecting many parts of the body.
Increased syphilis infection in the community is linked with increased risk of acquiring HIV infection and an increased risk of transmission for other STIs.
However, syphilis treatment is publicly available and early detection is important.
APH began participating in the Syphilis Point-of-Care Rapid Testing & Immediate Treatment Evaluation study - known as the SPRITE study - in the fall of 2024.
The study is led by Southeast Health Unit in partnership with Queen's University and involves data gathering by eight public health units across Ontario.
SPRITE has received funding through grants from Public Health Ontario as well as a grant from the Canadian Institute for Health Research.
SPRITE provides participating public health units with point of care rapid tests known as POCT.
“They screen for syphilis and HIV and allow for immediate treatment and referrals based on rapid test results,” Cassan told the board.
“The original goal was for us to test 50 to 55 clients using the rapid test, using a blood test to verify each result and make sure that the results of the rapid test are accurate. Then in these clinics, if we had any positive point-of-care tests, we were able to treat them immediately.”
Eligible POCT or rapid test positive clients were treated immediately on site or at clinics - also known as ‘events’ - held by APH, reducing the usual test to treat time from 18 days to mere minutes.
“Beyond testing and treatment, these events also offer clients a well-needed opportunity for connection to build trusting relationships with APH and the community,” Cassan said.
In the first four months of the project, APH hosted clinics in Blind River and Wawa, in addition to Sault Ste. Marie.
“Our plans for 2025 are to expand across higher priority areas in the city of Sault Ste. Marie and beyond. We also aim to work with our First Nation partners across Algoma to offer additional clinics,” Cassan said.
APH hopes that funding for SPRITE will continue beyond March and further locations for clinics will be added.
APH SPRITE clinics tested and treated people from 19 to 66 years old and included:
- People who use substances
- Current and past sex workers
- Underhoused people
- Clients with no previous testing
- Newcomers to Canada
- 2SLGBTQ+ community
The tests among those sectors of the population are coming up positive nearly four times as often as the general population, the board was told.
Dereski and Cassan said limitations to SPRITE include clinic attendance requires word-of-mouth advertising, the work was carried out in addition to APH’s existing workload, and that point of care rapid tests can show false positives and negatives.
But the board was told SPRITE is a step in the right direction.
“Tonight the important takeaways are that early detection through screening has been key for syphilis and all STI's,” Dereski told the board.