Public Health reports rise in syphilis cases in Montreal

Syphilis, a sexually transmitted bacterial infection that had practically disappeared thanks to penicillin, has seen a slow resurgence in the past few years.

Montreal is not immune and is also seeing an uptick in cases, according to health experts, along with many other sexually transmitted diseases.

According to a Montreal Public Health report, in 2022, 691 cases of syphilis were reported in the Montreal region. A 49 per cent increase since 2021.

Men accounted for 90 per cent of the cases.

“It was very common prior to the invention of antibiotics in the mid 20th century and ever since we had penicillin, we were able to treat these infections very easily,” said Dr. Christopher Labos, cardiologist and epidemiologist.

While syphilis is curable and one course of antibiotics can usually resolve it in the early stages, without treatment, it can lead to disability, neurological disorders, and even death.

“You get what we call tertiary syphilis and that causes permanent neurological damage to the brain and the spinal cord. So, people are left with these neurological deficits that just will never go away,” said Dr. Labos.

Syphilis is not the only STI on the rise, so is HIV.

In 2022, there were 310 new HIV diagnoses in the Montreal region, a 120 per cent increase compared to 10 years ago. Dr. Labos says when there’s a rise in syphilis cases, there’s also a rise in HIV cases.

He says part of the reason we’re seeing syphilis and other STDs reappear is because a lot of young people may not be taking them seriously enough.

“People don’t take sexually transmitted infections as seriously as they used to. Part of it is probably that it’s harder to access doctors these days because just more barriers to accessing the healthcare system,” said Dr. Labos.

In addition to the increase in syphilis cases among men, there was also a significant increase in cases among women.

Between 2013 and 2022, cases of syphilis went up from nine to 68.

“It’s very worrying because the women can be pregnant and we saw in 2022 in Canada, more than 100 children were born with syphilis. Most of these cases, they will die or they will have a problem of nervous system,” said Dr. Réjean Thomas, co-founder and director of Clinique médicale L’Actuel in Montreal.

Congenital syphilis is when a pregnant woman catches syphilis then passes it on to the baby, resulting in stillbirth or congenital malformations.

The first sign that you may have caught syphilis is a painless sore. Most people don’t notice the sore, as it does not cause pain, so they don’t consult a doctor.

However, if a person does not receive treatment, the bacteria remain in the body. They can remain dormant in the body for decades before reactivating and damaging organs, including the brain. If your doctor doesn’t perform the appropriate swab and test it and get the correct diagnosis, you may not realize you have syphilis, and it can stay in your system for years.

“The initial lesion can actually be painless and in most people, it’ll go away even without treatment, which is why I think a lot of people don’t realize they have syphilis, because it goes away on its own,” said Dr. Labos.

The disease can be contagious during the primary and secondary stages, and sometimes even later.

“That’s when it starts to cause a lot of damage. So, if you do notice a lesion in the general area and you don’t know what it is, it’s worth going to get it checked out,” said Dr. Labos.

In order to curb the rising trend, Dr. Thomas says people should be taking precautions, like using contraceptives.

“We can not stop the epidemic if people are not getting tested, people are note getting treatment.”