EDMONTON -- A syphilis outbreak is worsening in Alberta, and the majority of new cases are in the Edmonton zone.

Edmonton saw 1,186 of the 1,753 infectious syphilis cases reported in Alberta in 2019, a total of 68 per cent. Syphilis is a sexually transmitted disease (STI) that can be treated with antibiotics if caught early on. If left undetected, it can become serious.

Alberta Health Services declared an outbreak in July 2019, saying cases had 'increased dramatically' in the province since 2014. The number increased again in July. 

AHS sent a new public health alert to doctors on Nov. 27, asking for their help to control the outbreak.

"It's very significant," said Dr. Ameeta Singh, a clinical professor in infectious diseases. "That's an alarming rise in new syphilis cases in Alberta."

She said it's the highest number of cases the province has seen since the 1940s.

WHY SO MANY NEW CASES?

According to Dr. Singh, the increase in cases being reported is partially due to a greater number of people getting tested.

“We know more people are coming in to get tested, but if we look a bit closer at the data we have, we do see there’s in fact a [bigger] rise in the number of cases than we would expect to see,” said Singh.

Another factor could be the rise in methamphetamine use in Edmonton. 

"I believe this is a major factor. Meth also stimulates risky sexual behaviour and increases the chance people will engage in multiple, usually casual or anonymous partners as well and not use precautions such as condoms to protect themselves during sex," she said.

RISE IN CONGENITAL SYPHILIS

What's also alarming, Singh said, is the spike in cases of congenital syphilis, where the disease is passed on to newborns.

According to AHS, there have been 38 cases of congenital syphilis in 2019, 31 of which were in the Edmonton area.

That accounts for more than half of the 61 cases of congenital syphilis reported since 2014.

"Those are not numbers we should be talking about in Canada ever...in a country that has universal access to health care, in a major city in Canada where syphilis testing is offered to all pregnant woman who access prenatal care," she said.

"What we’re seeing with the congenital syphilis cases is many of the woman are not accessing prenatal care until they come into the hospital to deliver and then the tests are being done."

SYMPTOMS

The disease can also spread because nearly one-third of people who have it won't experience symptoms. Others may notice sores on their genitals or on the mouth, and six months later if untreated it can develop into a rash, swollen lymph glands, a fever and sore throat.

The second stage of infection can cause serious damage if left untreated, including blindness, six to 12 months later.

"We’ve had a couple people go completely blind from syphilis. We’ve also had people develop stroke like symptoms and paralysis due to syphilis," said Singh. “These kinds of things can also happen years down the road if not treated.”

Treatment is as easy as a single injection of penicillin that is widely available.

PREVENTION

AHS is encouraging people to take precautions when engaging in sexual activity.

“If you’re going to be sexually active outside a mutually monogamous relationship that’s long term to really get tested between partners,” said Grace Salvo, Medical Officer of Health for the Edmonton zone.

“We also encourage people to talk about STIs with their family physician or with their local STI services... If you’re asymptomatic you could still carry the disease,” she said.

AHS sent a new public health alert to doctors on Nov. 27, asking for their help to control the outbreak.

Doctors are asked to provide safe sex counselling, take a sexual history with the patient's permission and to provide testing for STIs. 

With files from CTV Edmonton's Kesley Dyer, Jeff Lawrence and Jay Rosove.