Rapid tests deployed to curb growing syphilis outbreak in N.W.T.

Public health officials in the N.W.T. are rolling out a limited supply of rapid syphilis tests to try and bring a growing outbreak of the disease under control and to prevent it from being passed on to babies. 

Dr. Kami Kandola, the territory's public health officer, said syphilis rates have "far exceeded" what they were when she declared an outbreak in 2019. There were 98 cases in 2021 she said, and 47 cases within the first three months of this year. 

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.

The sexually transmitted disease can first appear as painless open sores usually in the genital area and can be cured with antibiotics. Left untreated, the infection can lead to permanent neurological issues and death. 

It can also cause severe health problems in newborns when passed on from pregnant women to their babies — which is why Kandola said catching the infection during prenatal care is her highest priority. 

"If a baby is born with congenital syphilis, that's a lifetime of heartache and pain," she said during a media briefing Tuesday, noting the majority of cases in the N.W.T. are in residents who can have children. 

So far, only two babies have been diagnosed with congenital syphilis in the N.W.T. said Kandola.

Dr. Ameeta Singh is an infectious disease specialist in Alberta, the only other jurisdiction where the rapid tests have been used in Canada. She came to help train N.W.T. nurses how to do the tests, and said congenital syphilis in an infant can cause the liver or spleen to be too big, severe anemia, a "very nasty, shedding" rash, and death. 

Singh oversaw a 19-month clinical trial which used a rapid test that detects syphilis and HIV on 1,500 participants in Alberta with more than 90 per cent accuracy. Singh calls the tests a game changer, but they still need Health Canada approval — she expects that'll come by the end of the year — which means the N.W.T. needed special approval for 1,100 of them. 

It's better than none, said Kandola, but she expects they'll be "swallowed up very quickly" and is hoping for more. 

Kandola said syphilis rates in the N.W.T. grew by more than 1,100 per cent in women and 484 per cent in men between 2018 and 2021, and she wants to test as many people as possible in a short period of time. The rates are highest in the Dehcho, the Yellowknife region and Hay River, followed by Fort Smith and the Sahtu region, she said. 

The Northwest Territories Health and Social Services Authority (NTHSSA) is still in the process of procuring the 1,100 tests from Biolytical Laboratories, said Kandola, and she hopes they'll arrive in the coming weeks. 

The test involves pricking a person's finger, drawing blood, mixing it in a series of solutions and putting a few drops in a plastic sample collector that'll deliver results within 15 minutes.

The quick results will allow health-care staff to immediately start tracing the contacts of a person who tests positive. Without the rapid test, Kandola said it can take days to get results from a lab. She estimates they've lost contact with five per cent of patients during the followup process. 

Stephanie Gilbert, a territorial public health specialist for the health authority who will lead the rollout, said the tests will be used in places with the highest risk of syphilis infection. 

The rollout plan is still in the development stages and will be tailored to individual communities, she said. 

"There is no cookie cutter approach to surveillance and contact tracing. If there was, we wouldn't have outbreaks across the country," said Gilbert.