Syphilis Outbreak in Alberta: Primary Care Nurse Information and Links

As per AHS since 2014, Alberta has seen a dramatic rise in infectious syphilis and gonorrhea cases. Gonorrhea cases have more than doubled, with over 5,400 cases reported in 2023 compared to 1,900 in 2014. From 2015 to 2023, more than 17,000 cases have been reported in adolescents and adults, along with over 280 cases in babies. Additionally, over 340 cases of congenital syphilis were reported between 2015 and March 2024, resulting in 60 stillbirths. Cases continue to be reported in 2024.

Our Education Chair viewed Current State of Syphilis: The Critical Role of Primary Care

the information presented is summarized here. As primary care nurses, you're on the frontline of patient care, including the critical task of managing sexually transmitted infections (STIs). Effective STI management isn't just about treating the patient; it's also about ensuring that their partners are informed and treated to prevent further spread. If you haven't begun speaking to your patients about the syphilis outbreak start today!

Who should be screened?

• Asymptomatic individuals who are sexually active with new, anonymous, or multiple partners

• Individuals with frequent partner changes

• Symptomatic individuals

• Populations at higher risk of STI prevalence

• Sexual contacts of individuals with STIs

• Pregnant persons. Screening for STIs during pregnancy is essential for the health of both the mother and the baby. Follow these guidelines:

  • First Trimester: All pregnant individuals should be screened for STIs.

  • 24-32 Weeks: Optional screening during this period can be beneficial, depending on the patient's risk factors.

  • At Delivery: Conducting a final check can help identify any infections that may have developed later in the pregnancy.

Check out this resource for comprehensive overview

Syphilis: Symptoms and Stages

Understanding the symptoms of syphilis is crucial for accurate diagnosis and treatment:

• Primary Syphilis: Look for poorly defined rashes, especially on the palms and soles, and painless (or sometimes painful) ulcers on the genitals, mouth, or anus.

• Secondary Syphilis: Symptoms may include alopecia, condyloma lata (warts), and neurological symptoms such as headaches and vision changes.

• Tertiary Syphilis: This stage is marked by neurological symptoms, cardiovascular issues (such as an ascending aorta aneurysm), and, less commonly, gumma (large ulcers).

Neurological Symptoms: These can include severe headaches, vision changes, stroke, psychosis, and behavioral changes.

Positive Cases and Partner Notification

Who Does What?

All HCP are responsible for providing testing and prevention of STI's. A positive case should trigger immediate treatment, Public Health Services consultation and follow up. A positive STI test should trigger follow-up testing for other STIs, including syphilis and HIV. This is particularly important as genital ulcers can increase the risk of HIV transmission. Treatment Guidelines and Management Tools are available to help primary care providers navigate.

• Gonorrhea and Syphilis: Public Health Services are responsible for notifying partners of these infections.

• Chlamydia: This falls under the jurisdiction of the primary care provider (PCP).

To avoid delays in treatment and ensure effective partner notification, it’s ideal to complete the partner notification form at the time of testing and treatment. If you require public health assistance in notifying partners about chlamydia, it’s crucial to explicitly request this on the notification form. Remember, this will not be done automatically.

Visit the AHS Syphilis Outbreak page to review more resources.