A patient with visible symptoms of syphilis. Photo / CDC Public Health Image Library
A patient with visible symptoms of syphilis. Photo / CDC Public Health Image Library
Parliament's health select committee has raised concerns about the growth of syphilis in south Auckland and the need for extra funding for primary and sexual health services to stop its spread.
But at least one leading academic says there's also a need for more up to date data and contact tracing to get on top of the disease.
Syphilis is a sexually transmitted infection which can be treated and cured with antibiotics. But if it isn't treated, over time it can affect the brain, spinal cord and other organs.
The select committee released a report last month as part of its 2019/2020 annual review of the Counties Manukau DHB. It said 40 per cent of syphilis cases in New Zealand were in the Counties Manukau area and states:
"Counties Manukau DHB told us that extra resourcing for primary care would be key to reducing the incidence of syphilis, and other reproductive and sexual health issues.
"Greater resourcing for the Auckland Regional Public Health Service, which has had to divert substantial focus to Covid-19 response in the last year, would also contribute to helping tackle infectious diseases in the area."
A patient with visible symptoms of syphilis. Photo / CDC Public Health Image Library
The most up to date data released by the Institute of Environmental Science and Research (ESR) this month is from 2019 and shows a noticeable jump from 629 recorded cases of syphilis nationally in the 12 months to December 2018 to 727 in December 2019.
And the recent New Zealand Paediatric Surveillance Unit's Annual Report 2019-2020 highlighted the impact of congenital syphilis in south Auckland, where a woman infected with the condition passes it on to her unborn child.
It cited a study between April 2018 and June 2020 which found of the 30 recorded cases of children with the condition nationally, all of them involved newborn infants and 10 of the cases were recorded by the Counties Manukau DHB.
Peter Saxton is a senior lecturer in population health at the University of Auckland's medical and health sciences faculty. His research includes work on the control of sexually transmitted diseases.
He said it is hard to find solutions and to stop the spread of conditions like syphilis if the people and organisations that are dealing with it don't have up to date statistics to work from.
"We've been working with old stats for several years now. We don't know where to make interventions if we don't have up to date data," Saxton said.
But he said it will be difficult to interpret the data from 2020 when it is released because the pandemic has impacted the ability of people to get tested and access sexual health services.
Saxton said there was a noticeable jump in the number of cases of syphilis nationally from 2018 to 2019.
"It's not a new problem, but it's getting worse," he said.
An historic photo from the US of a patient's ankle with coin shaped lesions caused by secondary syphilis. Photo / CDC Public Health Image Library
Saxton said, in areas like south Auckland, poverty and poor access to primary healthcare services are a key factor in the spread of communicable diseases like syphilis.
He said the DHBs and the Ministry of Health needed to look at how they are fighting the disease and what they were doing to stop its ongoing spread.
"If it's congenital syphilis how are we implementing our pregnancy screening guidelines? How accessible are sexual health services and what about contact tracing?
"Covid-19 has shown us with the political will and investment we can have a gold system of controlling the spread of infectious diseases," he said. "But we need some more transparency."
A spokesperson for the ESR said it is still compiling its syphilis data from 2020 and it isn't ready to be published.
They said the release of the statistics had been delayed due to resources being redirected to the Covid-19 response.
In a statement, a Ministry of Health spokesperson said the institute remains the lead agency in New Zealand undertaking syphilis surveillance.
"ESR is continuing to collate the latest data and we expect this will be available within the first half of this year."
The ministry spokesperson said clinicians are required by law to report all cases of syphilis to the Crown research institute under the Health Act 1956.
According to the Ministry of Health, in New Zealand syphilis has been increasing since 2012, particularly in men who have sex with men. But infection rates in heterosexual men and women have also been increasing, which has led to an increase of congenital syphilis.
The first sign of the condition is often a sore or ulcer (called a chancre), which usually appears about three weeks after infection and can last between three and six weeks before it heals, with or without treatment.
However, someone who doesn't get treatment remains infectious.
And if the disease is left untreated it will then progress to the next stage, where symptoms include rashes, often with red or brownish spots on the palms of the hands and soles of the feet.
Other symptoms include swollen lymph glands, fever, hair loss, muscle and joint aches, headaches, tiredness, and warty growths in skin folds.
If it isn't treated a small number of people will get late stage tertiary syphilis years after the initial infection which can cause damage to the heart, brain, nerves, eye, blood vessels, liver, bones and joints.
