Syphilis Epidemic

A report back on Dr Clare Huppatz's presentation, 'WA Syphilis Epidemiology'.

At the WA syphilis symposium we heard from Dr Clare Huppatz who outlined the syphilis epidemic as it has moved through Queensland, the Northern Territory, Western Australia and South Australia. We heard that women aged 20-34 were amongst those most affected in Western Australia. Similarly, Aboriginal and Torres Strait Islander people were disproportionately affected with a rate ratio for Indigenous to non-Indigenous of 14:1. We were shown lots of graphs of infectious syphilis going “up and up” and were told that this is not just due to increased awareness and testing but increased test positivity as well.

Dr Andrew Savery, a pediatrician from the Pilbara told us of his experience of managing a case of congenital syphilis and highlighted some significant challenges as well as lessons learnt. He told us that he felt out of his comfort zone being a pediatrician speaking to a room of sexual health clinicians about a sexually transmitted disease. I think many in the room felt equally uncomfortable hearing about a sexually transmitted infection in a newborn. While we hope that this remains a rare event in Australia, as Dr Savery put it, we should all “be prepared.”

Paul Armstrong outlined the public health response to the outbreak including the use of SORTs or Syphilis Outbreak Response Teams and the introduction of systems which would allow remote area nurses to administer treatment for syphilis without the need for a doctor.

As someone who has not worked in public health it was fascinating to hear how a real- world response to an epidemic unfolds. But perhaps the most sobering part of the presentation came from a question from an audience member who asked, will we see an end to this epidemic or is this just going to become the ‘new normal’ for remote aboriginal communities?  I’d expected to hear a definite ‘yes, we will see an end to this epidemic’ but the response was somewhat hesitant.

Many of us who’ve worked in remote communities would have experienced how quickly conditions that seem unimaginable in other parts of Australia start to seem like the new normal. Rheumatic heart disease, teenagers with type 2 diabetes, 30-year old's with AMIs, the health effects of poverty, the burden of disease is already so high for people in these communities.

I imagine the solution is complex but let’s not let syphilis become the new normal.

Author bio: Suzanne is a GP who has worked extensively in rural and remote Australia as well as in Sydney with a special interest in Aboriginal and Torres Strait Islander Health. She is currently working towards a Fellowship of Sexual Health Medicine and is working as a Sexual Health Advanced Trainee at Sydney Sexual Health Centre.