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BC expected to hit new highs in syphilis outbreak

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While COVID-19 has been understandably hogging all the headlines, there’s been another outbreak spreading throughout B.C. since 2019.

Syphilis has been spreading throughout the province and the country for over a decade, spiking in 2019 when the province declared an outbreak.

The sexually transmitted infection is spread through penetrative sex and sexual activities where there is an exchange of body fluids or skin contact, and can cause serious medical problems if left untreated.

“There’s no question overall rates of syphilis across the country are increasing and have been for the last decade,” said physician lead of the HIV/Sexually Transmitted Infection program for the BC Centre for Disease Control, Troy Grennan. “In provincial reports you see it’s going up in all age groups, including younger age groups.”

All health authorities in the province are seeing an increase in cases, with the Northern Health Authority having the highest rate according to the latest data collected by the control centre. Grennan said there was a brief reduction in reported cases during the first few months of COVID 19 restrictions for all STIs, but the numbers quickly rebounded.

There may be multiple reasons why the infection is spreading and none Grennan can know with certainty — he said he “can only speculate”— and there are ways to get a handle on the outbreak.

“Maybe people have more sexual partners, we don’t really know,” he said. “We know condom use is decreasing in certain groups including younger people based on our data.”

While the infection can be treated with antibiotics, many people infected with syphilis don’t have symptoms and don’t get tested. Grennan speculates things are changing, and perhaps more people are getting screened as a routine health care, including pregnant women, even when they don’t have symptoms.

“The more people start talking openly about this issue, the more we’ll reduce stigma around it and get people treated,” he said. “We’re seeing an increase in awareness and more people are getting educated and starting to get tested.”

The gay male population was historically the most impacted by the infection, but Grennan said because gay men tend to be proactive in their sexual health care, the trend is changing where over 50% of cases in that population are diagnosed and treated.

More than other sexually transmitted infections, syphilis has the potential to cause very serious health complications. The infection goes through stages, starting with a painless ulcer at the sight of entry. The secondary stage and most common symptom is a rash on the body, but in some cases, more serious symptoms can occur.

“You can get a lot of other stuff including liver issues and neurologic involvement from mild headaches to strokes,” he said. “It can affect the eyes or cause auditory syphilis that requires an IV therapy. It’s rare but it can happen. Some enter a latent stage where there are no symptoms but if left untreated 15 to 20 per cent will develop neurologic symptoms, and cardiac and muscle issues.”

Pregnant people with syphilis can pass syphilis to their babies during pregnancy and birth which is called congenital syphilis and can cause premature birth, low birthweight, death or lifelong physical problems.

Between January and March this year, 527 cases of syphilis were reported in B.C. while there were 474 at the same time last year, an 11.2% increase, according to the first quarter 2023 BCDCC surveillance reports. The highest number of cases were reported in the Vancouver Coastal Health Authority while the Northern Health Authority showed the highest rate.

In the Interior Health Authority, 225 cases of syphilis were reported last year, 96 cases in 2021 and 51 in 2020, with 252 reported cases projected for this year. The region initially had 29 cases reported in 2015 and the cases have been steadily increasing since.

While males represented 67.6% of syphilis cases, this year’s data showed an 86.7% increase in reported cases among females with the highest rate of female cases in the 25 to 29 year age group. The proportion of reported syphilis cases among men who have sex with men continues to decrease.

Syphilis testing can be done with a blood sample or a swab from the initial sore, and the medications used to treat the infection are free in the province.  Follow up tests are done after treatment at regular intervals for up to two years.

Grennan said for people who are experiencing symptoms or for those having a sexual relationship or multiple partners “it wouldn’t be unreasonable” to get screened every three to six months even without having symptoms.

“The more we talk about this and engage in better health around the issue, the more we’ll destigmatize it. We need education around sexual health and to keep talking more about it.”


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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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