What’s behind Australia’s syphilis outbreak and the rise of STIs?

In what Minister for Indigenous Health, Ken Wyatt, described as a ‘surge response’, on 8 August the federal government injected an emergency $8.8 million into tackling an outbreak of syphilis in Northern Australia, sending 62,000 point-of-care test kits to Townsville, Cairns, and Darwin.

First recorded in 15th century Naples, syphilis – also known as ‘The Great Pox’ – devastated Europe in the 16th and 17th centuries and was almost eradicated in the early 2000s but has suddenly flared up again in remote Australia at an alarming rate.

Far from being innocuous the Sexually Transmitted Infection (STI) spreads lesions and sores across the body and is particularly problematic for pregnant women. If contracted, the baby of a pregnant mother has a 50 per cent chance of survival, and if they do survive, they risk blindness, deafness and cognitive issues.

Since two cases of syphilis were diagnosed in Queensland a decade ago, it is has now come to affect thousands of patients, notably in Indigenous communities.

Mr Wyatt approved the immediate dispatch of 10,000 test kits – 3,000 to Townsville, 3,000 to Cairns, and 4,000 to Darwin – with a further 52,000 ordered and sent on.

What’s the immediate plan?

Because syphilis can be in the system for six months before symptoms arise, the infection can be spread unwittingly through sexual activity.

This puts a premium on rolling out syphilis tests. A syphilis TP rapid test takes around 15 minutes to deliver a result. Early detection means treatment is not only more manageable for those who have contracted it, but also helps prevent its further spread.

Director of Sexual Health at Cairns Sexual Health Service, Dr. Darren Russell, says if someone is found to have syphilis, treatment can begin straight away.

‘Early syphilis is treated with a single injection of penicillin, which is highly effective at curing the infection. Within days, the symptoms resolve and the person is no longer infectious.’

In the short to medium term, communication and education materials will be rolled out to explain the potential impacts of syphilis and how to avoid contracting it.

So, what’s behind the rise?

‘Changes in sexual behaviour since the advent of better treatments for HIV, combined with a high degree of mobility, mean that syphilis has been able to take off in this population, notably in the gay community. Heterosexuals are also affected in many countries, particularly those in disadvantaged and marginalised groups.’

But syphilis is not the only STI on the increase in Australia.

The Kirby Institute’s 2017 Annual Surveillance Report into HIV, viral hepatitis, and STIs found that while HIV rates remained stable from 2012-2016 after an 8 per cent spike in the year preceding, gonorrhoea rates increased by 63%, while syphilis increased by 107% in the same period.

There have been several ideas advanced to explain the reasons for the influx of STIs; from the uptake of online dating sites which expand sexual encounters, the low usage of condoms among young men, the greater degree of travel and sexual experimentation tied in with that, and the perhaps more lax approaches to safe sex tied up with advances in HIV treatment medications.