The Mid North Coast is experiencing a steep increase in syphilis infection rates. Healthy North Coast has engaged Dr Kym Collins, Staff Specialist, HIV/Sexual Health Services, Mid North Coast Local Health District to hold a lunchtime Q&A session. This is an opportunity to have any questions regarding high infectious syphilis rates answered.
Date: Tuesday 21 February
Time: 1:00pm – 1:45pm
Where: Online – register here
The graph below highlights the spike.
The data to 31 December 2022 shows that rates of infectious syphilis are at 8.6 times the previous five-year average. Many of these cases are women of reproductive age, with 13 recent cases of infectious syphilis diagnosed in pregnancy at antenatal screening. These cases in pregnancy are the canary in the coalmine and indicate that there are many other cases of infectious syphilis in the community. All people presenting with genital lesions, rashes or wanting an STI screen, should be tested for syphilis.
Rates of infectious syphilis in women are at least three times the rates of any other local health district in NSW.
Risks factors associated with the outbreak include being young, heterosexual, homeless, using crystal meth (or partner using), incarceration (or partner with current or recent incarceration) and identifying as Indigenous.
The most recent case, a pregnant 18-year-old from Port Macquarie, does not have any of these risks, indicating infectious syphilis is circulating in all Mid North Coast communities. Clinicians need to have a low threshold to test. Remember, syphilis is the “Great Pretender”.
Some practical hints and resources below:
- All pregnant women (no matter their perceived risk) should have syphilis screening at the time of appointment and at 28 weeks. Use Australian STI Management Guidelines [email protected].
- The first line treatment is long acting Benzathine Benzyl Penicillin (L-A Bicillin). You can get boxes of 10 for free on your doctor’s bag (if you give a script it will cost more than $300). The treatment is two syringes, one in each ventro-gluteal IMI.
- Make sure you screen also for HIV and other STIs according to the patient’s risk as per the NSW Testing Tool www.stipu.nsw.gov.au/gp/hiv-and-sti-clinical-management/stihiv-testing-tool.
- The Australasian Society of HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) has an excellent Syphilis Decision Making Tool if you want a refresher.
Learn more about the outbreak and gain more tips by registering and attending the Q&A.