State ‘fails to act’ on syphilis epidemic

SYPHILIS is making a comeback in Ireland, spurred on by high-risk sexual behaviour, a genito-urinary expert has warned.

Dr Derek Freedman, who saw five new cases of the sexually transmitted disease this month, said the state had slipped up in maintaining vigilance about syphilis following a significant outbreak in 2001 and 2002.

“We don’t have outreach programmes; we don’t have public health programmes; we have not been given any extra resources to deal with the syphilis epidemic,” said Dr Freedman.

The Health Protection Surveillance Centre said the incidence of the disease plateaued after the outbreak, but the figure was still higher than it had been before 2001.

A report published in the Lancet journal warns that syphilis has been on the rise since the turn of the century in high-income countries, including Ireland.

Co-author of the study Kevin Fenton, of the Centres for Disease Control and Prevention in the US, said the increase had been partly driven by increases in cases among men who have sex with men.

Between 2000 and 2006, the centre received almost 1,600 case-based reports on syphilis. Men accounted for 72% of the cases reported, while women accounted for 28%.

The study points out that main European urban centres such as London, Dublin, Berlin, Paris and Rotterdam showed huge increases in syphilis reports since 1996.

Syphilis increases have also been reported in other developed countries including Canada, Australia and New Zealand and while the increases and the affected populations vary, many of the driving factors are similar.

“Syphilis, if left untreated can be lethal. It can be a worse killer than HIV/Aids. But the wonderful thing about syphilis is that its treatment is so efficacious, so simple and so straightforward.”

The increase in syphilis was related to high rates of partner change, marginalisation and poor health services. However, Dr Freedman pointed out that the poor health services could not be solely blamed for the increase in Ireland. He believed there was almost a sense of arrogance and lack of awareness among people at risk — that it could not happen to them.

“Frequently, we find that a lot of cases are transmitted by oral exposure only. That is by oral sex, not penetrative sex,” he pointed out.

Oral sex is advocated as a safe sex practice for the avoidance of HIV, but Dr Freedman said there is no awareness that oral sex was an efficient mode of transmission for many other infections such as chlamydia, gonorrhoea, herpes, warts/HPV and hepatitis B and no symptoms was the norm.

Syphilis How is it spread?

* From contact with an infected partner. Can be spread by kissing, oral, vaginal and anal sex.

* May be passed from an infected mother to her baby.

Symptoms

*50% of infected people show no symptoms.

* First Stage — A sore on the penis, genitals, vulva, mouth or anal region that can be painless. Usually heals by itself in about a month.

* Second Stage — A few weeks later a general rash which may involve the palms of the hands and the soles of the feet.

* Third Stage — After this the disease may cause no symptoms for many years but, if left untreated, it can still damage your health.

Diagnosis

* Examining material from the infected sores.

* A blood test. STI Clinic

* Referral to an STI clinic is essential.

* Full screening for other sexually transmitted infection needed.

* Partners must be screened and treated if necessary.

Source: Irish Family Planning Association