Syphilis epidemic evolving at an alarming rate

A/Prof Eric Chow checks longitudinal data. Image: Alfred Health

A 220 per cent spike in syphilis infections in women has experts warning an 'epidemic' is in place and swift action is required to bring it under control.

Epidemiologist Associate Professor Eric Chow said the epidemic, which was once focussed on gay men in inner Melbourne, has now become much more generalised and has spread to the outer suburbs, according to recent mapping conducted at the Melbourne Sexual Health Centre.

“Overall, there was a 45 per cent increase in notified syphilis cases from 950 cases in 2015 to 1375 cases in 2018,” Associate Professor Chow said.

“While the number of syphilis infections among gay men continued to rise (a 21% increase), there was a sharp increase in cases among women (a 220% increase) and heterosexual men (a 129% increase).

Associate Professor Chow said the increase in cases among heterosexual men and women was largely among people residing in outer Melbourne suburbs, areas that are considered to be socio-economically disadvantaged, which previously wasn’t the case.

The city of Melbourne recorded the largest number of cases among heterosexual men, while the outer northwest suburbs of Brimbank and Melton also recorded a high number of cases.

While most cases were recorded in the northwest and southeast, the largest number of cases in women was reported in Port Philip.

Associate Professor Chow said the increasing number of cases in women was of the most concern.

“The major concern with the rise in syphilis among women of reproductive age is infection during pregnancy and congenital syphilis.

“We know syphilis can cause major complications during pregnancy and even result in the death of the child so we’re urging all women at high risk to get screened during their third trimester in addition to the universal screening during the first.”

Associate Professor Chow said the re-emergence of syphilis among heterosexuals in Victoria means that prevention messaging should also be targeted at heterosexuals, particularly those residing in outer metropolitan areas.

Earlier this year Alfred Health launched the Victorian Sexual Health Network - a network of bulk-billed GP sexual health clinics aimed at reducing the tyranny of distance and improving access to screening for people in the outer areas of Melbourne.

Reference

Aung ET, Chen MY, Fairley CK, Higgins N, Williamson DA, Tomnay JE, Cook K, Peel J, Dharmakulasinghe V, Alpren C, Chow EPF. Spatial and temporal epidemiology of infectious syphilis in Victoria, Australia, 2015-2018. Sex Transm Dis. 2021 Apr 14. doi: 10.1097/OLQ.0000000000001438. Epub ahead of print. PMID: 33859143.