Syphilis rapid tests arrive to help NWT combat years-long outbreak

Newly developed syphilis and HIV rapid tests are making their way to the NWT after trials in Alberta displayed promising results.

While HIV rapid testing is not new, a rapid test for syphilis is only just emerging in Canada and could help diagnose the condition with groundbreaking speed in areas like the NWT that are experiencing an outbreak.

The territory will be one of the first places in Canada to implement such a test outside Alberta.

Alberta infectious diseases specialist Dr Ameeta Singh and clinical study coordinator Noel Ives have been in Yellowknife since Monday to help train healthcare professionals. They demonstrated the tests at the Yellowknife Ski Club on Tuesday.

The tests will soon be available in NWT healthcare facilities. Distribution will focus on areas considered most in need and at-risk, which the territorial government said included the Dehcho, Hay River and Yellowknife.

While traditional tests require a physician to order blood work and can take weeks to deliver results, the new tests require a single prick of blood and can produce results in less than 15 minutes.

“It is transformative to my practice,” said Ives during the demonstration, in which he performed a rapid test on Dr Singh.

Rapid tests manufactured by BioLytical Laboratories – one of two that were part of a clinical trial in Alberta over the past 19 months – have not yet been approved for unrestricted use by Health Canada.

However, the NWT received special-access approval for 1,100 tests.

According to Chief Public Health Officer Dr Kami Kandola, those tests have been ordered and should be received in the coming weeks. She said the territory plans to order more as tests are used.

“Our plan right now is to ensure that we roll this out with community voice in mind,” said Stephanie Gilbert, a territorial health specialist, on Tuesday.

“There will be planning sessions with community stakeholders from various regions, and we are going to try to implement a rollout for every region and community that is based on their individual needs.”

The NWT plans to monitor the results to see how rapid testing affects the outbreak.

Alberta’s clinical trial

Over the 19-month clinical trial, which tested 1,500 participants in Edmonton and northern Alberta, the tests were found to be more than 90-percent accurate. The speed of results means patients can start treatment at the same appointment, whereas previously, Singh said, about 20 percent of those tested would not return for results and could be hard to track down.

Thanks to rapid testing, Singh said, around nine in 10 newly identified infectious cases received treatment at the same time as the test was delivered. That will be the target in the NWT.

“We know for sure not everyone will want to accept immediate treatment,” Singh said. “They might want to wait for our standard test results. But we’re really hoping we can either meet or exceed 90 percent being treated at the time of the point-of-care visit.”

Syphilis in the NWT

From the beginning of 2019 to April 2022, the NWT reports a 253-percent rise in syphilis cases – in other words, the territory says cases more than trebled.

Two cases involved congenital syphilis, where a mother passed the disease to a newborn during pregnancy. According to a 2021 statement from the GNWT, the majority of the cases were seen in Yellowknife.  

From 2021: The syphilis outbreak is two years old. Has anything changed?

Dr Kandola declared a syphilis outbreak in the territory in August 2019. However, the Covid-19 pandemic affected the amount of outreach healthcare officials were able to carry out.

In the past four years, Kandola noted, infectious syphilis cases in the NWT among women are reported to have risen more than 1,100 percent. She said such high rates in women of childbearing age are a major concern.

“If a baby is born with congenital syphilis, it’s a lifetime of heartache and pain,” she said. “And it can be avoidable, because syphilis is exclusively sensitive to the long-acting penicillin treatment we have available.

“So that’s my highest priority.”

According to Singh, if a woman contracts syphilis in the last four weeks of pregnancy, the infant is virtually guaranteed to become infected.

By offering rapid tests for syphilis in the NWT, the hope is to create a targeted campaign for the most at-risk groups. Rapid testing should also speed up contact tracing and slow down transmission, ultimately avoiding neurological and other symptoms that can occur if the disease is left untreated.

Syphilis is spread through unprotected sex and not everyone infected will display symptoms.

“We want everyone who is sexually active in the NWT to take preventative measures such as properly wearing a condom and to get tested often,” stated Kandola in a press release.

“When syphilis is caught and treated early, it can prevent further transmission.”