Montreal Public Health has reported a spike in cases of syphilis despite the disease being relatively easy to prevent.
Dr. Christopher Labos spoke with CTV News Montreal anchor Mutsumi Takahashi about the disease and why it is seeing a comeback.
Watch the interview above. Some of the questions and answers have been edited.
Mutsumi Takahashi
When we hear syphilis, I think of 18th-19th century Europe. That’s what comes to mind. But it’s still very much with us.
Dr. Christopher Labos
Yeah, it really is. Now, what’s interesting is that syphilis cases were decreasing in the latter part of the 20th century, so from the 1950s onwards, and there was a very genuine belief that right around the late 1990s, early 2000s, because cases were decreasing, we might be able to eliminate it entirely, at least from North America.
But the past few years have seen a slow resurgence of it, along with a lot of other sexually transmitted infections. I think partly because young people may not be taking sexually transmitted infections as seriously as some of us did, you know, 10-20 years ago.
Mutsumi Takahashi
But it is fairly easy to treat when it’s caught early enough.
Dr. Christopher Labos
Yeah, it really is. It’s a course of antibiotics. It’s penicillin, and that was really sort of the dividing line. The reason why syphilis cases were going down throughout much of the 20th century was because of the invention of penicillin and the fact that you could treat it with a very simple course of antibiotics.
Mutsumi Takahashi
So what happens when syphilis is left untreated?
Dr. Christopher Labos
There’s actually multiple phases to syphilis. When you get into the tertiary or the late stage, it affects the nervous system, and can cause permanent neurological damage; it can actually be very, very severe.
So the early phases may not seem that bad to people, and that’s probably why people aren’t taking it as seriously anymore, but once you get into the permanent neurological damage, you can be chronically disabled for for the rest of your life.
Mutsumi Takahashi
There is also something called congenital syphilis.
Dr. Christopher Labos
That’s when a pregnant woman catches syphilis then passes it on to the baby, and that obviously causes a lot of problems to the baby. It can result in stillbirth or congenital malformations. That is one of the things that should be tested for routinely as part of prenatal care. When you start seeing cases of congenital syphilis, it’s because people have started falling through the cracks and are not getting the prenatal care that they should be getting.
Mutsumi Takahashi
So what are the symptoms of syphilis? Is it easy to see early?
Dr. Christopher Labos
Well, that’s that’s the funny part. In the early stages, there may not be many symptoms, and that’s possibly why a lot of people may not even go to the doctor. The original canker sore of syphilis is actually painless, and so if you don’t know what it is, if you can’t recognize it, you may not even go to go to the doctor.
It’s when the infection stays in your system for years and then reawakens much later that you can often get the long-term neurological damage that I mentioned. So that’s the real danger is that if you don’t have access to a good doctor who can do the appropriate swab and test it and get the correct diagnosis, you may not realize you have syphilis, and it can stay in your system for years.
Mutsumi Takahashi
So then, what can be done in terms of prevention?
Dr. Christopher Labos
We need STI clinics, sexually transmitted infection clinics. If you can screen and treat these cases early, these people then don’t go on and spread it to others. That’s why when we’re talking about the elimination of certain diseases like syphilis, we could possibly do that. We just need to have enough doctors, nurses, and testing facilities to test people when they get symptoms and to make it easy for them to get appointments at these clinics so that they can be given their course of antibiotics to eliminate the infection. That’s how you get rid of syphilis, you treat it eventually goes away.
Mutsumi Takahashi
But on the other hand, Christopher, when you say that, it’s very, very difficult to detect, people might not even know they have it. So then why would they think to go to try to detect it?
Dr. Christopher Labos
So that’s the thing. A lot of times, people don’t know, they don’t know if it’s something or not. When you make it hard for people to get an appointment, they might say, ‘well, let me wait a couple of weeks. Let me see if it goes away on its own,’ and the original canker lesion will, even without treatment, it will go away on its own.
So that’s the problem.
You need to have a health-care system that is responsive enough so that people can make appointments. If it’s nothing, you send them home, but if it’s serious, that’s when you can do the treatment, and that’s one of the problems of making it harder and harder for people to access medical care if they don’t have a family doctor or don’t have a good walk in clinic in their area. You don’t treat the easy stuff, and the easy stuff starts to fall by the wayside, and that’s when you get syphilis cases going up.
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.
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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