Syphilis Rates At 'Crisis Point' In Victoria As Infections Hit Record High

Healthcare workers are facing a "crisis" as cases of the sexually transmitted infection syphilis continue to rise. 

The Victorian state health department issued a warning on Monday as cases of infectious syphilis -- defined as an infection for less than two years -- in 2018 reached a record high.

There were 1372 cases reported in Victoria last year, up 21 from 2017, with the majority of notified cases occurring among men who have sex with men (MSM), according to Chief Health Office Dr Brett Sutton.

But the rise in recent years is also notable among women, with 163 cases reported in 2018, compared to 152 and 101 in the previous two years.

"Syphilis can be transmitted through unprotected vaginal, anal and oral sex. It can also be spread through skin-to-skin contact if the syphilis rash is present," the warning states.

It's a trend that Professor Christopher Fairley,  Director of the Melbourne Sexual Health Centre, has tracked for years, as the infection became "epidemic" in virtually every developed country.

"We are addressing a crisis; the numbers are going up fairly significantly and that's putting pressure on services," he told 10 daily.

Infectious syphilis was all but eradicated in Victoria by the 1990s, according to records from the Melbourne Sexual Health Centre, amid the AIDS epidemic -- as it became known -- that presented in gay and bisexual men.

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But in recent years, the number of infections climbed to rates not seen since before World War II.

"I think the world became a little bit relaxed about the issue of sexually transmitted infections in the  1990s with the HIV epidemic, where rates of gonorrhea and syphilis plummeted," he said.

But that's all changing now.

For the first time since 2004, congenital syphilis -- that is transmitted from mother to baby during pregnancy -- has re-emerged in Victoria, with two cases each in 2017 and 2018. Two of those four resulted in fetal death.

About 30 percent of cases among men who have sex with men (MSM) were HIV-positive.

While HIV is not a marker on its own, CEO of Living Positive Victoria Richard Keane said the "consistent" numbers were concerning.

"It's a concern for any of us living with HIV, because other infections getting into our system can impact over a long period of time on our undetected status," he told 10 daily.

"It can be a complicated disease should it go to secondary or third levels of infection, where it can have significant long term side effects."

Photo: Getty Images

Researchers say the reasons behind the rise in cases -- among both women and men who have sex with men  -- remain unclear, but Fairley said it may relate to the popularity of online dating and how people mix in sexual networks.

He added much of the rise has occurred amid relatively stable condom use, and cautioned a person's number of partners as a proven factor.

"What is really important is that access to health services for symptomatic individuals in the context of these very large rises are adequate, and that people can know the symptoms," he said.

Keane agreed, saying the common symptom -- a painless  genital ulcer or rash -- can often go unnoticed.

While syphilis can be cured with penicillin, concerns remain for those who don't seek treatment early.

Both Fairley and Keane called on frequent screening -- particularly for men who have sex with men.

"I encourage any sexually active adult -- regardless of their sexual orientation --  if they have more than one partner to test seasonally (four times a year) to ensure nothing gets missed," Keane said.

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As cases continue to rise, health care professionals -- who are already struggling to cope with increased demand -- want to lift sexual health literacy across the community.

"They're not easy conversations to have because they're intimate. But they're really important to have in ways that people can understand," Keane said.

"We don't want people to be scared of sex, but we want people to be thinking about taking responsibility as an active sexual adult."

Various resources are available for specific community groups, including the 'iSpy STI' website, that takes a person's history and generates a referral letter with their probability of their diagnosis.

"If you get symptoms down below, go and see your doctor and ask them. If you've been at risk -- you've changed sexual partners, you've had sex with someone from overseas -- go and get screening," Fairley urged.

"Your GP is the best place to start."

Featured image: Getty