Public health officials in the NWT are rolling out a limited number of rapid syphilis tests to try to contain a growing outbreak of the disease and prevent it being passed on to babies.
Dr. Kami Kandola, the territory’s public health officer, said syphilis levels have “far exceeded” what they were when she declared an outbreak in 2019. In 2021, there were 98 cases, 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 increased significantly across the country over the past decade, and many outbreaks have been reported in the past five years.
The STD may first appear as painless open sores, usually in the genital area, and can be treated with antibiotics. If left untreated, the infection can lead to permanent neurological problems and death.
Kelly Fredericks, a nurse at Frame Lake Clinic in Yellowknife, draws blood from Kristan Boucher, a public health nurse, during training on how to use rapid syphilis test kits Tuesday. (Linnie Lamberink/CBC)
It can also cause serious health problems in newborns when it’s passed from pregnant women to their babies — which is why Kandola said catching the infection during prenatal care is her highest priority.
“If a baby is born with congenital syphilis, it’s a lifetime of anguish and pain,” she said during a media briefing on Tuesday, noting that the majority of cases in the NWT are in residents who may have children.
So far, only two babies have been diagnosed with congenital syphilis in the NWT, Kandola said.
Dr. Ameeta Singh is an infectious disease specialist in Alberta, the only other jurisdiction where the rapid tests have been used in Canada. She came to help NWT nurses how to do the tests and said congenital syphilis in a baby can cause an enlarged liver or spleen, severe anaemia, a “very nasty, oozing” rash and death.
Dr. Ameeta Singh, an infectious disease specialist in Alberta, came to help train the NWT nurses how to do the tests. (Linnie Lamberink/CBC)
Singh led a 19-month clinical trial that used a rapid test that detected syphilis and HIV in 1,500 participants in Alberta with more than 90 percent 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 they will be “gobbled up very quickly” and hopes for more.
Kandola said syphilis rates in the NWT increased by more than 1,100 percent in women and 484 percent in men between 2018 and 2021, and she wanted to test as many people as possible in a short period of time. Levels were highest in Dehcho, the Yellowknife region and the Hay River, followed by Fort Smith and the Sahtu region, she said.
The Northwest Territories Health and Social Services Authority (NTHSSA) is still in the process of securing 1,100 tests from the biolytics labs, Kandola said, and hopes they will arrive in the coming weeks.
The test involves pricking a person’s finger, drawing blood, mixing it in a series of solutions and placing a few drops in a plastic sample collector, which will give results within 15 minutes.
The test involves pricking a person’s finger, drawing blood, mixing it in a series of liquids and placing a few drops in a plastic sample collector, which will produce results in a pattern of circles in 15 minutes. (Linnie Lamberink/CBC)
The rapid results will allow health personnel to immediately begin contact tracing of a person with a positive test. 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, the health authority’s territorial public health specialist who will lead the rollout, said the tests would be used in places with the highest risk of syphilis infection.
The implementation plan is still in the development stage and will be tailored to individual communities, she said.
“There is no one-size-fits-all approach to monitoring and contact tracing. If there was, we wouldn’t have outbreaks all over the country,” Gilbert said.
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