Over the past year, Ottawa Public Health (OPH) has seen a 76 percent increase in the number of cases of infectious syphilis. Alarmingly, all of these cases have been male, and over 90 percent report that they are men who have sex with men. It’s a staggering increase, and one that has the OPH rallying media to spread a simple message: get tested.
“I don’t think a lot of people even know syphilis is still around,” says Patrick O’Byrne, registered nurse and Sexual Health Centre spokesperson for OPH. “It seems antiquated somehow, like something you’d get in the Victorian era.”
O’Byrne is on the front lines of OPH’s education campaign, setting up STI testing booths at local bathhouses for clients interested in knowing their status in regards to sexually transmitted illnesses. Despite the potential for putting a damper on the steamy fun, he reports that many men have taken the opportunity to get tested.
“It’s been pretty successful,” he says. “I get one of the rooms and put a sign on the door that says nurse on site for testing HIV, gonorrhea, chlamydia and syphilis. We selected a nurse as opposed to a non-healthcare provider so we can do more comprehensive testing, as well as offer counselling and prevention information.”
And with HIV still holding onto its status as the worst case scenario for many who fear getting tested, O’Byrne points out that syphilis is riskier than some may think.
“Syphilis is highly infectious,” he says. “With HIV, the risk of infection is less than one percent per unprotected sexual contact. Syphilis is around 60 percent, over 60 times more infectious than HIV.
“The other risk is that people often don’t even know they have it. There are classical symptoms that can be easily missed or misclassified.”
The symptoms are fairly straightforward. The first sign is the appearance of a chancre at the site of the infection. Now, a chancre is not the same as a canker — the type of painful sore you get in your mouth after eating too many potato chips. A chancre is a painless lesion that can appear in or around your mouth, around the anus or on your genitals. It usually appears within one to four weeks (average is the third week), followed by a non-itchy rash on the trunk, palms or soles of the feet.
“Some might think it’s a heat rash,” O’Byrne points out. “Or an allergic reaction to food or soap or detergent. Syphilis is known as the great imitator.”
Once the rash goes away, the disease begins to attack small blood vessels in the body and can cause irreversible damage to the brain, heart, liver and bones.
“If left untreated, syphilis is fatal,” O’Byrne says. “But it’s completely treatable with antibiotics. So getting tested is the most important thing.”