Health
13 times more babies born with syphilis in Canada over 4 years, data shows
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The Current15:57Tackling rising syphilis cases across Canada
There has been a sharp increase in the number of babies born in Canada with syphilis, an infection that one doctor says “can be particularly devastating in pregnancy.”
“It can lead to outcomes such as fetal demise … or stillbirth,” said Dr. Darrell Tan, an infectious disease physician at St. Michael’s Hospital in Toronto, and the Canada Research Chair in HIV Prevention and STI Research.
“And then in a child [born with syphilis] there can be many, many manifestations … it can affect organ systems like the brain, the bones and joints, virtually any organ system in the body,” he told The Current’s guest host Mark Kelley.
Figures from the Public Health Agency of Canada (PHAC) show that there were seven cases of congenital syphilis in 2017, but 96 cases in 2021 — an increase of 1,271 per cent over four years. A similar trend has been observed south of the border.
Thirty newborns in Manitoba have been infected with congenital syphilis through the first eight months of 2020, according to information obtained by the Opposition NDP.
That increase is tied to rates of infection within the general population, which have been increasing steadily for the past decade. Last month, health authorities in B.C. revealed a 27 per cent increase in cases from 2021-22.
Historically, the disease has disproportionately affected men who have sex with men (MSM), but Dr. Troy Grennan said B.C. figures show a shift in 2022.
“For the first time the majority — so more than 50 per cent — of the new cases we’re seeing [in B.C. are] in non-MSM populations,” said Grennan, lead physician at B.C.’s Centre for Disease Control’s sexual health programs.
“One of the key challenges around that is that we’re seeing increasing cases in folks who are capable of getting pregnant,” he said.
Experts say there’s likely multiple factors behind the increase, including reduced condom use — a 2020 survey found that seven in 10 of Canadian respondents don’t use condoms. Some experts also point to the increasing availability of routine testing, and the idea that numbers are up in part because more infections are being detected.
Tan said the spread into new demographics “may simply be a numbers game.”
“When you have cases, case rates that are going up to this degree, you start to see it spread beyond just the core sexual networks that had traditionally been involved,” he said.
If caught early, an infection can be easily treated with antibiotics. But Tan said that structural inequalities, such as racism and the legacy of colonization, can also “impact people’s willingness or perhaps ability to access care at earlier stages — where we can maybe nip things in the bud.”
Diverse symptoms, or none at all
Syphilis can present a diverse range of symptoms, which can complicate catching the infection early, Tan said.
On initial infection, an ulcer can appear at the part of the body that was exposed, he said. But that ulcer might be painless, and perhaps on a body part where it’s hard to see, such as the vagina or rectum.
In other cases, the infection sparks a fever or rash. These symptoms may prompt someone to seek medical attention, but they can also be mistaken for many other illnesses.
“The most confusing and frustrating thing is that it can cause no symptoms at all, and people can contract it without even realizing it,” Tan said.
If left untreated, the infection can have serious implications, including neurological problems, organ damage, loss of vision and even death.
Vaccine work ‘not very far along’
Research into syphilis is complicated by the fact that the “bacterium is very difficult to work with,” said Caroline Cameron, one of the few researchers studying the infection in Canada.
“We really don’t understand how it works, how it infects a person or ways to appropriately combat it, or prevent that infection,” said Cameron, a professor in the department of biochemistry and microbiology at the University of Victoria.
While Cameron said she was drawn to those challenges, they’ve dissuaded many other researchers — but that is slowly changing.
“We are starting to get more philanthropic organizations who are providing funding for research and we’re starting to see more people join the field, which is what is really needed in order to get those innovative research programs going,” she said.
The aim is to produce better medical interventions, perhaps even a vaccine for syphilis, she said. But the difficulties in studying it mean that, globally, the research is “not very far along,” she said.
“Conservative estimates [for a vaccine] are five to 10 years away. But we really need more people to join the field to expand the research population,” she said.
Doctors and outreach workers are hopeful wider use of a new rapid test for syphilis could help slow the spread of the dangerous sexually transmitted infection.
Get tested, get treated
Syphilis can be detected by a simple blood test “that can be ordered by any clinician relatively easily,” but the challenge is often knowing when to request it, Tan said.
He suggested people who are sexually active with multiple partners should seek routine STI testing, as frequently as every three months.
PHAC guidelines stipulate universal screening for syphilis during the first trimester of pregnancy. For those at greater risk of exposure, the guidelines suggest a repeat screening at 28 to 32 weeks, and again at delivery.
However, problems can arise for “folks who unfortunately don’t access pre-natal care,” he said.
“We do have very effective treatments … simply two or more injections of plain old penicillin,” Tan said.
“But if folks are not accessing care earlier in the course of infection … then we can see cases continue to spiral as we’ve seen, and have a hard time getting control of the epidemic.”
Nearby regions report spike in whopping cough
Lambton Public Health on Exmouth Street in Sarnia. 27 April 2020. (BlackburnNews.com photo by Colin Gowdy)
March 24, 2023 12:01pm
While some communities in southwestern Ontario are seeing an increase in pertussis, commonly referred to as whooping cough, Lambton Public Health (LPH) has not noted any recent cases within its jurisdiction.
The last case of pertussis reported in Sarnia-Lambton was in 2019.
Earlier this week, the health units in Windsor-Essex and Huron-Perth reported increases in whooping cough cases.
There have been 18 cases since November 2022 in Windsor-Essex, and in Huron-Perth there have been 21 confirmed cases so far this year.
“As always, Lambton Public Health encourages parents and caregivers of children to stay up-to-date on their routine immunizations, which include pertussis, as this greatly reduces the risk of outbreaks and serious illness,” read an emailed statement to Sarnia News Today.
“Other eligible populations for pertussis vaccine include adolescents around 14 to 16 years of age, pregnant individuals preferably between 27 and 32 weeks of gestation, and one adult booster dose for those 18 years of age and older.”
Pertussis is a contagious infection in the lungs and is most dangerous for infants.
In February, LPH said 6,589 letters would be sent to students about routine immunizations.
Health
Waterloo regional COVID-19, cold and flu care clinic closing its doors | CTV News – CTV News Kitchener
It might be a sign of change in the pandemic that has gripped the world for three years.
The regional COVID-19 Cold & Flu Care Clinic run by Grand River Hospital is closing its doors.
The clinic has been open for the last six months, first at 66 Pinebush Road in Cambridge and later at 50 Sportsworld Drive in Kitchener, after the hospital announced it would be expanding the services offered by the clinic.
Healthcare workers said it’s a bittersweet day, noting there is still a need for its services in the community.
“At our peak, we were seeing up to 400 patients per week, and it was incredible to see the way this team would perform. Everyone did their part, everybody held their own,” Lisa Anstey, manager of the regional COVID care clinic, said.
She added that it never felt chaotic or busy at the clinic because it was well organized.
“The patients were all very pleased with the care they received,” she said.
The clinic has cared for over 8,000 patients over the last six months.
The hospital said the clinic`s closure comes with the return of warmer weather and anticipated seasonal decline of cold and flu.
“If their symptoms are severe and worsening they should go to a local emergency department… pharmacies are a wonderful resource as well. They can provide Plaxlovid prescriptions or they can support through PCR testing,” said Anstey.
Care will now transition to family physicians, urgent care clinics and community pharmacies.
The hospital says the regional clinic grew out of the COVID-19 assessment clinics which were run by local hospitals starting in 2020. Their goal was to divert patients away from hospitals and get the COVID-19, cold and flu care they need.
The clinic’s doors closed at 4 p.m. Friday.
Nurses Marilyn Boehm and Lannie Butler have been working side-by-side since March 2020, the pair taking on the pandemic together.
They have worked at the drive-thru testing clinic, vaccine clinic and at the regional COVID-19, Cold & Flu Care Clinic.
“This is our final journey, we’re sad it’s closing,” the duo said. “We worry about what’s going to happen to our patients out there in our community.”
“That’s the only recourse that some of the sicker folks have is to go to the emergency department and we know about the long waits and the high volumes there.”
The clinic has helped divert patients from the emergency rooms, and they say the closure could place the burden back on hospitals.
The Ontario Pharmacist Association also has concerns.
“There can be a challenge with needing to ramp those efforts up again very rapidly given the challenges everyone is facing with workforce, health human resources,” Jen Belcher, vice-president of member relations with the Ontario Pharmacist Association, said
The association is stressing that the pandemic isn’t over yet, despite mandates being dropped.
“It’s absolutely not from what we’ve seen from the impact of the disease on our population both through new infection and some of those longer-term complications associated with people with long COVID for example,” Belcher said.
As for Boehm and Butler, they say they will return if they get called back to the frontlines to continue fighting COVID-19.
OTHER CLINICS SET TO CLOSE
The Grand River Hospital’s COVID-19 clinic is not the only one closing in southern Ontario.
On Friday, the Huron Perth Healthcare Alliance (HPHA) said it will be closing its COVID-19, cold and flu care clinic.
According to the HPHA, the last day of operation for COVID-19 testing will be March 30.
“The contribution this team has made to the quality of our local health system during the pandemic has been outstanding,” said Andrew Williams, President and CEO of HPHA in a news release. “As we close our CCFCC a huge thank you is extended to our community partners including the Stratford Rotary Complex, the wonderful staff at the Stratford Family Health Team, Emad Salama of PrinceRx Pharmacy for generously paying the parking fees for all the CCFCC patients and, of course, all the staff and physicians that worked tirelessly provide this service.”
THE HPHA said over 54,000 PCR tests and over 2,000 clinical assessments have been completed.
Over in Guelph, the Guelph-Wellington-Dufferin Public Health unit said it will be closing its clinic on March 31.
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The Huron Perth Healthcare Alliance’s (HPHA) COVID, Cold and Flu Care Clinic (CCFCC) will be closing due to a steady decline in patients.
The last day of operation for COVID-19 testing will be Thursday, March 30. The last day for physician assessment will be Friday, March 31.
“The contribution this team has made to the quality of our local health system during the pandemic has been outstanding,” said President and CEO Andrew Williams. “As we close our CCFCC, a huge thank you is extended to our community partners including the Stratford Rotary Complex, the wonderful staff at the Stratford Family Health Team, Emad Salama of PrinceRx Pharmacy for generously paying the parking fees for all the CCFCC patients and, of course, all the staff and physicians that worked tirelessly to provide this service.”
For patients seeking COVID-19 assessment, testing, or antiviral treatment after March 31, contact your family doctor or visit Ontario’s COVID-19 web page.
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