Rolling out rapid tests to curb the growing syphilis epidemic in the Northwest Territories

Public health officials in the Northwest Territories are rolling out a limited amount of rapid syphilis tests to try to control a growing epidemic of the disease and prevent it from spreading to babies.

Dr. Kami Kandola, the territory’s public health officer, said syphilis rates had « significantly exceeded » what they were when she declared an outbreak in 2019. There were 98 cases in 2021, a she said, and 47 cases in the first three months of this year. .

The Public Health Agency of Canada says rates of infectious syphilis have risen dramatically across the country over the past decade and numerous outbreaks have been reported over the past five years.

The sexually transmitted disease may first appear as painless open sores, usually in the genital area, and can be cured with antibiotics. Untreated, the infection can lead to permanent neurological problems and death.

It can also cause serious health problems in newborns when passed from pregnant women to their babies – which is why Kandola said catching the infection during antenatal care is her highest priority.

« If a baby is born with congenital syphilis, it’s a lifetime of heartache and pain, » she said at a news conference Tuesday, noting that the majority of cases in the NWT are among residents who can have children.

So far, only two babies have been diagnosed with congenital syphilis in the Northwest Territories, Kandola said.

Dr. Ameeta Singh is an infectious disease specialist in Alberta, the only other jurisdiction where rapid tests have been used in Canada. She came to help train nurses in the Northwest Territories on how to do the tests, and said that congenital syphilis in an infant can make the liver or spleen too large, severe anemia, skin rash » very disagreeable and excretory » and death.

Singh oversaw a 19-month clinical trial that used a rapid test that detects syphilis and HIV in 1,500 participants in Alberta with over 90% accuracy. Singh calls the tests a game changer, but they still need approval from Health Canada – she expects that to come by the end of the year – meaning the NWT needed special approval for 1,100 of them.

It’s better than nothing, Kandola said, but she expects them to be « gobbled up very quickly » and hopes for more.

Kandola said syphilis rates in the Northwest Territories increased by more than 1,100% among women and 484% among men between 2018 and 2021, and she wants to test as many people as possible in a short time. time. Rates are highest in the Dehcho, Yellowknife and Hay River region, followed by Fort Smith and the Sahtu region, she said.

The Northwest Territories Health and Human Services Authority (NTHSSA) is still in the process of procuring the 1,100 tests from biolytic labs, Kandola said, and hopes they will arrive in the next few months. weeks.

The test involves pricking a person’s finger, drawing blood, mixing it in a series of solutions and putting a few drops in a plastic sample collector which will provide results within 15 minutes.

The rapid results will allow healthcare staff to immediately begin tracing the contacts of someone who tests positive. Without the rapid test, Kandola said it could take days to get results from a lab. She estimates that they lost contact with five percent of patients during the follow-up process.

Stephanie Gilbert, territorial public health specialist for the health authority who will lead the rollout, said the tests will be used in places where the risk of syphilis infection is highest.

The rollout plan is still in development and will be tailored to individual communities, she said.

« There’s no cookie-cutter approach to surveillance and contact tracing. If there were, we wouldn’t have outbreaks across the country, » Gilbert said.