Unprotected sex — largely between men — is to blame for more than doubling syphilis rates in Windsor and Essex County over the past two years.

From 2017 to 2019, rates of the sexually transmitted infection (STI) in the region rose 138 per cent, according to a report presented during the Windsor-Essex County Health Unit’s board meeting Thursday. During the same period, the provincial syphilis rate rose by 25.6 per cent.

“We want fewer cases, not more,” Dr. Wajid Ahmed, the health unit’s medical officer of health, said at the meeting.

“Some physicians in the community think syphilis doesn’t exist here,” he said. “We need to show them otherwise. It exists and it is increasing. We need to be actively thinking about it and testing individuals for it.”

From 2010 to 2019, the rate of new syphilis cases in Windsor-Essex rose from 8 to 19 per 100,000 people. In Ontario, the rate rose from 12 to 21 over the same time period.

The bacterial infection is spread by sexual contact, and can result in four possible stages of increasing severity. First, painless ulcers or swollen lymph nodes can appear, followed by rashes and further lymph node swelling if left untreated. The third stage, latent syphilis, involves the infection existing without the presence of physical symptoms.

The final and most serious stage is neurosyphilis, which occurs if the infection is left untreated for many years and can affect the cardiovascular, skeletal and neurological systems.

Individuals can spread the disease through sexual contact at any stage. An infected mother can even pass syphilis to her baby before or during birth.

“It used to be called a ‘disease of the old people’ — but it is important because of the long-term consequences of the disease,” Ahmed said.

In 2019, about 53 per cent of syphilis cases were in people 20 to 44 years of age, a significant increase from 2010 to 2017, when, on average, only 40 per cent of those diagnosed were in that age range.

The vast majority of local syphilis cases are among males, Ahmed said, with 81 per cent of cases in Windsor-Essex affecting men.

With HIV treatments now successfully preventing the virus’s sexual transmission, some individuals are throwing caution to the wind when it comes to protecting themselves from syphilis, chlamydia and other infections, he said.

“Now because of better treatment, people are not scared of (HIV),” Ahmed said. “So now they’re not using condoms, and as a result they’re getting all of the other types of STIs.”

Locally, 79 per cent of people diagnosed with syphilis reported they hadn’t used a condom during sex. Lack of condom use topped the report’s list of risk factors reported in syphilis cases in 2018 and 2019, followed by sex with a same-sex partner, and sex with more than one partner of any gender in the last six months.

“At this point, our role from a public health perspective is to follow up all lab-confirmed cases of syphilis through the provision of direct clinical services, providing services in our building, and also by connecting with local health-care providers to make sure all individuals are appropriately diagnosed, tested, and treated as per the standards,” Ahmed said.

The health unit also contacts the sexual partners of those with a confirmed syphilis diagnosis and encourages those individuals to get tested for the disease.

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