With Covid-19 the dominant worry across the territory and nation, health officials in the NWT remain concerned about a syphilis outbreak.
An outbreak was first declared in the NWT on August 22, 2019. At the time, 28 cases had been reported – 70 percent of them in Yellowknife. That outbreak continues.
Andy Delli Pizzi, the NWT’s deputy chief public health officer, said rates of infection are roughly the same as they were in 2019, or slightly lower: approximately 100 cases per 100,000 people.
“There still is a syphilis outbreak occurring,” he said.
A sexually transmitted infection, syphilis goes through four stages if left untreated.
It starts with a painless sore where the bacteria first entered the body, then a rash develops. The third or latent, “hidden” stage has no symptoms, and the fourth stage has the potential to affect the brain, nervous system, blood vessels, heart, bones, and eyes.
Common ways to contract the infection includes unprotected sexual intercourse, having multiple partners, intravenous drug use, and having anonymous partners. People may not know they are infected at the time they engage in sexual intercourse.
Over the past few months, Delli Pizzi said, the Covid-19 pandemic may have led to residents making fewer visits to health services – potentially resulting in fewer people being tested.
As a result, the number of cases currently being recorded may not represent the actual scenario in the territory.
Delli Pizzi says it is not clear whether social distancing related to Covid-19 has had any knock-on impact on the syphilis outbreak.
For example, changes in social activities could have provided fewer opportunities for people to meet. But there’s little to suggest there has been strict observation of social distancing throughout the territory.
“We know that it’s important for people to get tested if they have any concerns or if they are in new relationships,” Delli Pizzi said.
‘Try to feel comfortable’ getting tested
According to the GNWT, 60 percent of recorded syphilis cases in 2019 were male and 40 percent were female.
In 2020, cases recorded to date have evened out: 50 percent are male and 50 percent female, territorial data suggests. (No data was given for other gender identities.)
The NWT’s health authority says it is trying to make testing easier and more accessible, including options where people can text a number and get information from a public health nurse.
Delli Pizzi encouraged women who are pregnant to get tested as “syphilis can cause severe outcomes in pregnancy for the newborn, and it sometimes can cause chronic infection or chronic illness in adults.”
Pregnant women should be tested three times throughout their pregnancy, according to territorial guidance: early on, closer to the delivery date, and then around the time of delivery.
Last year, the territory saw a case of congenital syphilis – the first of its kind in the NWT since 2009 – where a mother passed the infection to her baby during pregnancy.
Embarrassment can be a major barrier for people to get tested, as people are afraid of being judged by peers.
Delli Pizzi said healthcare providers are there to provide assistance and help patients as much as they can, not to judge those who come in.
“We hope people feel comfortable talking to their healthcare providers,” he said.
“They are there to try to help, so we really encourage people to just try to feel comfortable having that discussion.”