Syphilis has nearly doubled in numbers among young people in BC over the past five years, and health experts say it’s important for young people to get tested, as the sexually transmitted infection (STD) can often come with unnoticeable symptoms.
Among young people aged 20-24, the number has almost doubled since 2018, from 96 cases in 2018 to 181 cases in 2022, according to the BCCDC.
Among 15-19 year olds, the number increased from 14 cases to 30 cases, peaking in 2021 with 35 cases.
“Getting the diagnosis, knowing to go get care, is very important,” says Dr. Jason Wong, a public health physician with the BC Center for Disease Control (BCCDC).
Experts attribute the rise to several factors, including a decline in condom use and the rise of infectious syphilis in the general population. BCCDC data shows a 27 percent increase in syphilis cases between 2021 and 22 in the general population.
They also say that people may not know they are infected because syphilis is not always accompanied by noticeable symptoms.
While young people are a minority of the population diagnosed with syphilis without proper knowledge and preventive measures, experts say the STI can continue to spread among partners and cause serious health problems, including infertility and hearing and vision loss.
Why the increase?
Experts say there could be many reasons for the increase, including young people who don’t know how to prevent an infection or how it is spread.
Aileen Ghandi, patient care coordinator at the Surrey Youth Clinic just southeast of Vancouver, says some young patients don’t think it’s possible to catch an STI through oral or anal sex.
“That’s a huge learning curve for some of our youthful clients,” Ghandi said.
Young people have also reported that condoms break, are not the right size or do not work. That’s why it’s important to explain the importance of using protection, Gandhi added.
Wong says not using condoms can increase a person’s risk of syphilis.
According to a 2020 McMaster University study, men diagnosed with an STI were about three times more likely to never use condoms compared to men not diagnosed with an STI.
When the number of infections increases, you’re more likely to be exposed to them, which is partly the case with syphilis, Wong says.
What are the symptoms and risks?
Most STDs, including syphilis, can be treated today, but testing for the infection can help prevent long-term consequences, says Adele Lane, population and public health manager at Fraser Health Authority.
A syphilis infection progresses in stages: In the primary stage, a painless sore may develop on the genitals, anus, or in the mouth. The ulcer will often go unnoticed, but the infection will continue to progress.
In the secondary stage, a non-itchy rash may appear on parts of the body, including the chest or abdomen. Other symptoms include fever and hair loss.
If left untreated, the infection will progress to a latent stage, meaning a person may not have any symptoms. The latent period can last up to 30 years or more, according to the BCCDC website.
Females can also pass on an STI to fetuses and newborn babies, which can be deadly, especially in the case of syphilis, Lane says. The number of babies born with syphilis in Canada grew from seven in 2017 to 96 in 2021, according to figures from the Public Health Agency of Canada (PHAC).
Syphilis can also cause other problems such as vision or hearing loss if left untreated.
A safe space for education, treatment
Gandhi says it can be intimidating for young people to seek medical help for sexual health, as they sometimes face stigma from family and friends for sexual activity.
She says youth clinics are an example of a safe, confidential space to seek information and support, including getting tested and treated for STIs.
She says that if a diagnosed person doesn’t feel comfortable telling their partner about the STI, public health nurses can contact and notify that partner anonymously, to help track the spread of the infection and the resulting prevent subsequent health problems.
