2023-07-31 21:32:49
In Quebec, 29 cases of congenital syphilis, that is, syphilis transmitted in the uterus, were reported between 2016 and 2022, while only 5 cases had been detected between 2000 and 2015. In a recent report, the Institut national de santé publique du Québec (INSPQ) is alerting the public to this “clearly upward trend”.
Syphilis, twenty years ago, we thought we had the upper hand here in Quebec. But unfortunately, it has progressed, noted Dr. Luc Boileau, national director of public health in Quebec, in an interview on the airwaves of ICI RDI.
Monday morning, The Press reported that two infected fetuses died before birth in the province in 2022, unheard of since the data was collected.
Isabelle Boucoiran, obstetrician-gynecologist and director of the CHU Sainte-Justine Infectiology Center, says she is in no way surprised by these new data. Syphilis and congenital syphilis are on the rise all over the world, even if it’s new in Quebec, she noted, while on the show. All one morning.
Alberta was also sounding the alarm in early July: the number of babies born with syphilis rose from 30.8 per 100,000 people in 2018 to 169.1 per 100,000 people last year.
Patients treated too late
Syphilis attacks in several phases. At first, people with the disease usually see an ulcer forming on their genitals.
During the second phase, flu-like symptoms and rashes may appear.
All of these symptoms normally disappear after a few weeks. People therefore do not consult, lamented the doctor Réjean Thomas, founding president of the Clinique médicale l’Actuel, in an interview on the program Midi info. And there, we go to the tertiary phase, where we can have an attack on the central nervous system.
If the infection is not treated in time, it can cause serious neurological, cardiac or bone damage.
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The bacterium Treponema pallidum is the cause of syphilis which is treated with standard penicillin. (File photo)
Photo : iStock / royaltystockphoto
In Quebec, screening tests for syphilis must be performed on pregnant women during the first pregnancy appointment.
It is a disease that we treat very well, explained Dr. Boucoiran. If treated during pregnancy, before the second trimester, the risk of transmission is [pratiquement] none for the baby.
What explains that so many cases slip through the cracks in the province, as reported by the INSPQ? The doctor Réjean Thomas offers some leads.
We have seen women who have difficulty following up on pregnancy. We are in short supply of doctors. We have also seen the increase in all STBBIs.
Infected pregnant women have two typical profiles, Dr. Boucoiran pointed out.
Some have just immigrated from countries that do not have an effective screening system and where the disease is endemic. They sometimes arrive at the end of pregnancy, at a time when the infection has already done serious damage.
In other cases, syphilis is linked to the resurgence of other sexually transmitted diseases in communities where there are issues of drug use, because it can be linked to unprotected sexual activity, added the obstetrician-gynecologist.
Better to prevent
The key word, hammered home by all the experts interviewed by Radio-Canada, to limit new cases of congenital syphilis: prevention.
The challenges in this prevention is to target the communities that are at risk and to which it is sometimes more difficult to have access, argued Dr. Boucoiran.
Medical personnel must also be better informed, according to Luc Boileau, because sometimes it is worth asking the question again and redoing screening during pregnancy in people who are at higher risk.
Dr. Boileau is also considering the possibility of imposing a systematic screening test for all pregnant women after 28 weeks of pregnancy.
Quebec’s national director of public health remains optimistic about the rise in cases. He recalls recent victories in the fight against other infections, such as monkeypox, which raged last summer in several parts of the world.
Losing a life to syphilis today, in 2022-2023, we want to avoid that. We are a company capable of offering [les traitements]we just have to articulate ourselves as necessary and make sure that we act.
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