Chief public health officer flags 'alarming' growth of syphilis rates in N.W.T.

The N.W.T. has already seen more cases of syphilis this year than it did in all of 2021, and the territory's chief public health officer is urging people to get tested.

On Monday morning, Dr. Kami Kandola told The Trailbreaker that — three and a half years after she declared a territory-wide outbreak — rates have continued to rise at an "alarming" rate.

"At that time [of the outbreak declaration], rates of syphilis were the highest that they had ever been ... Today, in 2022, rates have far exceeded those in 2019," she said.

In 2021, the N.W.T.'s syphilis rate was seven times higher than the national average. The Public Health Agency of Canada says infectious syphilis rates have gone up substantially across the country over the past decade, and many outbreaks have been reported in the past five years.

A bacterial infection usually transmitted through sexual activity, syphilis is generally infectious for the first year that someone has it, before it tends to go dormant. It can cause serious health issues if left untreated — including blindness, brain damage and death.

There were 115 cases of the infection recorded in 2021, most of them infectious. This year, the territory had already reached 129 total cases by Sept. 7.

Rate increasing in women

In the past four years, the N.W.T. has recorded two cases of congenital syphilis — that is, syphilis passed from mother to baby during pregnancy.

Kandola said between 2018 and 2021, rates of infectious syphilis increased by 1,109 among women, and by 484 per cent among men.

"What concerns me about this rate of increase in women is it also increases the risk of congenital syphilis," she said.

"If women are pregnant, we are asking that they get tested three times: in the first trimester, at 28 to 32 weeks, and around the time of delivery. And if you are thinking about getting pregnant, it is strongly recommended that you have a syphilis test first."

Health officials are also suggesting anyone who isn't in a monogamous relationship should get tested more often, and testing should be done every time you have a new sexual partner.

"This is the only way we are going to pick it up," she said.

Kandola said syphilis may persist in the N.W.T. because some people miss the early signs: a painless sore on the genitals, anus or mouth that can go away by itself; and a rash on palms and soles accompanied by fever or swollen lymph nodes.

It also requires a blood test to detect, unlike other sexually transmitted infections that can be found through pap tests or cervical cancer tests.

Rapid test available

Kandola said the territory runs a workshop for healthcare workers each July. This year, they introduced a new syphilis test.

The test takes up to 15 minutes and can give a diagnosis on the spot — as opposed to tests that have to be sent away and thus create a time gap during which syphilis can be spread.

"We're hoping that this new type of testing will allow us to decrease the transmission," she said.

The territory currently has 2,500 of the tests.

In July, Stephanie Gilbert, a territorial public health specialist, said the tests would go to places with the highest risk of infection.

Kandola said the highest rate of syphilis is in the Dehcho region, followed by Tłı̨chǫ communities. Yellowknife ranks third.

The only region that has not had any cases detected this year is the Beaufort Delta.