Incidence of STIs requires ongoing vigilance
As the holiday season approaches, HPEPH is asking health care providers to continue to be vigilant in the screening and testing of sexually transmitted infections, in particular, syphilis, as populations that have not historically been considered at risk are now becoming infected. A larger proportion of heterosexual males and females are being diagnosed with the infection, which presents a greater risk for congenital syphilis. This is in addition to the previously predominant population of men who have sex with men (MSM).
Syphilis
At the current time, HPEPH is recommending heightened threshold of suspicion for syphilis testing for any patient who is sexually active, as anyone who is having condomless/unprotected sex could be at risk. Individuals are also encouraged to consider getting tested, even if they only have one partner. If one individual is engaging in sexual activities outside of a relationship, they could pass syphilis on. HPEPH continues to monitor local epidemiology and will enhance testing recommendations if and when appropriate, in consultation with the local Primary Care Council.
Syphilis can present with a variety of different symptoms that can imitate many other conditions and can be easily missed. Health care providers are encouraged to consider the possibility of syphilis infection in any patient engaging in unprotected sex. Symptoms can range from very mild to severe. The infection also progresses in multiple stages. Early symptoms often include:
- chancres or non-painful ulcers in the genitals, mouth, and/or rectal area,
- lymphadenopathy (swollen lymph nodes),
- body rashes (may be very mild),
- fever,
- malaise,
- sore throat,
- headaches,
- alopecia (hair loss),
- uveitis and/or retinitis (eye inflammation)
For more information on diagnosing syphilis stages, interpreting testing results, treatment, and follow-up monitoring schedules, please see HPEPH’s Syphilis Infection and Laboratory Results Interpretation Guide.
Chlamydia and gonorrhea
Rates of chlamydia and gonorrhea also remain higher than usual in our region. In accordance with recommendations of the Canadian Task Force on Preventive Health Care, health care providers are encouraged to undertake opportunistic annual screening of individuals under 30 years of age. Due to the recent increase in STI rates in our region, any sexually active individual who has engaged in unprotected sex is at risk.
Accessing treatment
Health Care Providers can order publicly funded (no cost) STI medications from HPEPH by using the HPEPH Vaccine/STI form available online at hpePublicHealth.ca. Benzathine penicillin G (Pen G) may be ordered directly from the HPEPH Sexual Health Program (x 418) for patients once a completed Syphilis Surveillance Report Form is returned. In special circumstances, treatment with Pen G may be administered through Public Health with a script from the patient’s own Health Care Provider and a completed syphilis surveillance report form.
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