READ

Everything old is new again: a not-so-welcome infection returns

Throughout 2020, many scientists were focused on COVID-19. But all this time, another infection has been spreading quietly throughout WA ...
Alex Dook
Alex Dook
Freelance writer
Everything old is new again: a not-so-welcome infection returns
Image credit: Getty Images

Be honest. Before January 2020, did you know what an epidemiologist was?

I know I didn’t.

For those who’ve been socially distancing under a rock, epidemiology is “the method used to find the causes of health outcomes and diseases in populations”. Basically, they’re the clever people who work out what to do when a dangerous disease, virus or infection is making its way through a population.

Throughout 2020, most epidemiologists have been rightly focused on COVID-19. But all this time, another infection has been spreading quietly throughout WA …

Guess who’s back

It’s syphilis, the sexually transmitted infection (STI) most people associate with romantic poets in the olden days.

Portraits of (left to right) Oscar Wilde, Lord Byron, Charles Baudelaire and William Shakespeare, all of whom reportedly suffered from syphilis
View Larger

It’s thought that (l-r) Oscar Wilde, Lord Byron and Charles Baudelaire all suffered from syphilis. Shakespeare was apparently obsessed with the disease and “suspiciously familiar with its symptoms“.

Image credit: Getty Images
It’s thought that (l-r) Oscar Wilde, Lord Byron and Charles Baudelaire all suffered from syphilis. Shakespeare was apparently obsessed with the disease and “suspiciously familiar with its symptoms“.

In March 2020, there was a 23% increase of syphilis notifications compared to March 2019.

According to the WA AIDS Council, there has been a 40% increase for men who have sex with men, and it has more than doubled for people who identify as heterosexual (both over the previous five-year mean).

And while epidemiologists have been working hard to understand how it’s spreading, there are challenges that make tracking an STI different than COVID-19.

According to Joe Staniszewski, Practice Manager and Clinical Nurse Consultant at M Clinic, men who have sex with men have shown higher numbers of syphilis for the past 5–10 years.

“But in the past year or two, we have started to see rising numbers in other population groups,” says Joe.

“We have seen the disease spread from Northern Queensland through the North of Australia and down to Perth and Mandurah.”

Video credit: WA Aids Council

OK, syphilis is back. That’s bad. But you’re probably thinking if they’ve tracked it that far, then surely they’re all over it?

Unfortunately, it’s complicated. While they have successfully tracked the infection across the country, it’s hard to know where it’s going next.

Take a look at the graph below (from these Department of Health reports), which shows the number of cases over the past few years. The peak is early 2020 – right in the middle of the COVID-19 lockdown.

Department of Health graph which shows the number of syphilis cases from 2018-2020. The peak is early 2020.
View Larger

Department of Heath Quarterly Surveillance Report

Image credit: Infectious syphilis notifications in WA
Department of Heath Quarterly Surveillance Report

Transmission in lockdown

You’d think in a lockdown people would have fewer sexual partners, which would lead to fewer infections. But that’s not the case at all.

“Over 50% of people with infectious syphilis had a low number of partners over the previous 6 months,” says Joe.

“The rises have primarily occurred within groups of people who don’t test regularly or don’t have ready access to healthcare.”

Now we’re starting to see how difficult it is to track sexually transmitted infections.

And it gets more difficult.

The troubles of tracing a syphilis outbreak

When looking at how an infection spreads through a population, it’s tempting to break the population into little groups. But when you’re dealing with people’s sex lives, things aren’t so neat.

Professor Donna Mak is a public health physician and medical epidemiologist at the Department of Health. “You can look at demographic groups like age, gender at birth or where people live. But there is not always a 100% correlation between how people identify and how they behave,” she says.

“For example, someone might identify as heterosexual, but how they behave is quite different.”

Public health also doesn’t exist in a vacuum. Social attitudes can impact people’s willingness to be honest about their sexual history and sexual health.

“We have treated men with STIs who are comfortable telling their male partners because of the social context but aren’t as comfortable telling their female partners. They might not know how to do that.”

Doctor, Doctor

According to Joe, another issue is a lack of education among health practitioners about the prevalence of syphilis, which can lead to less testing for people who need it.

Microscopic black-and-white image showing Electron micrograph of Treponema pallidum, the causative agent of syphilis
View Larger

Electron micrograph of Treponema pallidum, the causative agent of syphilis

Image credit: CDC/Dr David Cox
Electron micrograph of Treponema pallidum, the causative agent of syphilis

“Some groups with rising numbers are not even on clinicians’ radar as being at risk,” says Joe.

This can include groups not typically thought of as vulnerable to health risks, such as white cisgendered men or even pregnant women.

“Pregnant women receive plenty of medical attention through different trimesters but are not given routine syphilis testing.”

Undetected syphilis can be passed to an unborn child, which can lead to potential organ damage or even stillbirth. Women should feel empowered to request a syphilis test if their doctor or midwife is not proactive in offering it.

So what can people do to be safe?

Safety first

First of all, it’s important to note that, while syphilis can be serious, it is treatable if detected early.

Syphilis poster: Easy to catch, Easy to treat.
View Larger

Easy to catch, easy to treat

Image credit: Department of Health WA
Easy to catch, easy to treat

But that doesn’t mean you don’t need to be careful. Cast your mind back to the posters in your high school sex ed class. Remember the ‘if it’s not on, it’s not on’ guy? Using condoms can greatly reduce the risk of getting an STI. But it’s important to remember they’re not foolproof.

If you don’t want to catch it, the advice is pretty simple.

“Get tested early and often, and be your own advocate. When you go in for an STI test, ask to be tested for syphilis,” says Joe.

It’s also important to remember that, when possible, contact tracing is vital to stop any transmissible infection from turning into an outbreak. If you do get a positive test, make sure you tell all your partners in the past 3–6 months to get tested and treated for syphilis. If you are not comfortable telling your partner(s), ask your doctor to help you – or use an online contact tracing services like Let Them Know or The Drama Down Under.

If there is one thing WA has shown, it’s that we’re great at stopping the spread of dangerous infections. Let’s make this one next.

Alex Dook
About the author
Alex Dook
Raised by a physics teacher and a university professor, Alex had no choice but to be a science nerd. He has worked in science communication in both Perth and Melbourne, mainly setting things on fire for delighted children. Alex is now a freelance science writer and content creator.
View articles
Raised by a physics teacher and a university professor, Alex had no choice but to be a science nerd. He has worked in science communication in both Perth and Melbourne, mainly setting things on fire for delighted children. Alex is now a freelance science writer and content creator.
View articles

NEXT ARTICLE

We've got chemistry, let's take it to the next level!

Get the latest WA science news delivered to your inbox, every fortnight.

This field is for validation purposes and should be left unchanged.

Republish

Creative Commons Logo

Republishing our content

We want our stories to be shared and seen by as many people as possible.

Therefore, unless it says otherwise, copyright on the stories on Particle belongs to Scitech and they are published under a Creative Commons Attribution-NoDerivatives 4.0 International License.

This allows you to republish our articles online or in print for free. You just need to credit us and link to us, and you can’t edit our material or sell it separately.

Using the ‘republish’ button on our website is the easiest way to meet our guidelines.

Guidelines

You cannot edit the article.

When republishing, you have to credit our authors, ideally in the byline. You have to credit Particle with a link back to the original publication on Particle.

If you’re republishing online, you must use our pageview counter, link to us and include links from our story. Our page view counter is a small pixel-ping (invisible to the eye) that allows us to know when our content is republished. It’s a condition of our guidelines that you include our counter. If you use the ‘republish’ then you’ll capture our page counter.

If you’re republishing in print, please email us to let us so we know about it (we get very proud to see our work republished) and you must include the Particle logo next to the credits. Download logo here.

If you wish to republish all our stories, please contact us directly to discuss this opportunity.

Images

Most of the images used on Particle are copyright of the photographer who made them.

It is your responsibility to confirm that you’re licensed to republish images in our articles.

Video

All Particle videos can be accessed through YouTube under the Standard YouTube Licence.

The Standard YouTube licence

  1. This licence is ‘All Rights Reserved’, granting provisions for YouTube to display the content, and YouTube’s visitors to stream the content. This means that the content may be streamed from YouTube but specifically forbids downloading, adaptation, and redistribution, except where otherwise licensed. When uploading your content to YouTube it will automatically use the Standard YouTube licence. You can check this by clicking on Advanced Settings and looking at the dropdown box ‘License and rights ownership’.
  2. When a user is uploading a video he has license options that he can choose from. The first option is “standard YouTube License” which means that you grant the broadcasting rights to YouTube. This essentially means that your video can only be accessed from YouTube for watching purpose and cannot be reproduced or distributed in any other form without your consent.

Contact

For more information about using our content, email us: particle@scitech.org.au

Copy this HTML into your CMS
Press Ctrl+C to copy