Syphilis • Saskatoon Sexual Health

SYPHILIS

Syphilis is a bacterial sexually transmitted and blood-borne infection (STBBI). Symptoms can range from relatively no symptoms at all to serious illness. It can also impact pregnancy and lead to health issues for newborns (e.g. stillbirth, cranial neuropathies). Syphilis can affect anyone! Syphilis is called the great imitator because it can mimic other illnesses due to the various symptoms it can cause. If you’re sexually active, STBBI testing is the only way to know your status.

ADDRESSING THE RISE IN SYPHILIS

Over the last few years, there has been a rise in STBBI. Particularly, there has been a resurgence in syphilis over the past few years, leading to high and rising rates of syphilis across Canada. While syphilis is a curable STBBI, it can lead to adverse health issues and pregnancy complications if it is untreated. This increase in syphilis has impacted Saskatchewan greatly. Saskatchewan has high rates of syphilis and other STBBIs. For example, the 2023 statistical analysis from the Public Health Agency of Canada found …

Saskatchewan had a syphilis rate of 5 times the national average
Syphilis increased 1,213% between 2018-2023 in Saskatchewan
Saskatchewan’s rate of congenital syphilis is about 6 times the national average (rate of confirmed early congenital syphilis per 100,000)
Saskatchewan, Manitoba and Ontario accounted for 67% of all congenital syphilis cases

But, there is good news! Both Canada and Saskatchewan had a decrease of 16% in syphilis rates between 2022 and 2023. Syphilis is curable, but we need more people to be aware of the syphilis rates and get the testing and treatment needed to prevent transmission and health issues.

CONGENITAL SYPHILIS

Congenital syphilis, or CS, occurs when syphilis is transmitted from a pregnant person to their baby. CS can be dangerous for a pregnancy and even deadly for newborns; it can cause stillbirth, prematurity, or other serious lifelong complications. 3 in 4 maternal syphilis cases will result in adverse pregnancy outcomes if they are untreated.

Although congenital syphilis is curable and preventable, it is currently a major public health issue. The rates of CS are increasing globally, and 2022 had the highest rates of CS since 1997. Hence, STBBI testing is an important part of a healthy pregnancy. Various STBBIs can cause adverse health issues during pregnancy, but treatment to cure or manage STBBIs are available. Talk to your healthcare provider to ensure STBBI testing is a part of your prenatal screening.

Note: Inadequate or no access to prenatal care is a major risk factor for CS. Healthcare providers and frontline services should discuss prenatal care and community support services with high-risk patients/clients. However, syphilis education and testing should be offered to all patients, regardless of whether they fit a particular ‘risk profile’. Additionally, all newborns should have a physical examination for signs of syphilis.

PREVENTION

Prevention, early detection and testing can reduce the severity of the impact of syphilis on your overall health. It can also enhance your individual and community’s sexual health. Some examples of ways to prevent syphilis include …

Condoms: Reduce STBBI transmission with barrier methods like condoms and dental dams. Syphilis is spread through sexual contact or contact with infected sores. When used correctly, condoms can reduce the fluid exchange and skin contact that leads to STBBI transmission.
Doxy PEP (Doxycycline Post Exposure Prophylaxis): Doxy PEP is a medication taken within 72 hours of an exposure (unprotected sex). It helps your body avoid syphilis and gonorrhea infections.
- So far, the research and efficacy of DoxyPEP is among gbMSM and trans women. Doxy PEP is not an adequate form of prevention for people engaging in vaginal sex.
Regular STBBI Testing
Early Detection & Treatment: There is a treatment that can cure syphilis. Earlier treatment can reduce the severity of syphilis’s effects on your health. The antibiotic benzathine penicillin G is the gold standard for syphilis treatment.

TESTING

A blood test is used to screen for syphilis. Direct detection from a syphilis chancre or sore may be used to diagnose syphilis as well. Your family doctor, walk-in clinic or local sexual health centre can arrange STBBI testing. To find out more about STBBI testing, visit …

Saskatchewan Health Authority Wellness Bus (available in Saskatoon, Regina and Prince Albert)
Idylwyld Sexual Health Clinic (Saskatoon)
Find your local clinic at Sex Life Sask
Walk-in clinic (ask for STBBI testing, including bloodwork)

Note: There are also syphilis point-of-care tests (or combined syphilis and HIV POC tests). However, these are not widely available in Saskatoon at the moment, and SSH does not provide them.

It is recommended that syphilis testing be done multiple times during pregnancy to ensure a healthy pregnancy and delivery. Pregnant individuals should be tested at:

First trimester
28–32 weeks
At delivery

STBBI testing windows are the amount of time that needs to pass before tou can expect an STI test to be accurate. The length of the window depends on the type of STBBI. For syphilis, the testing window is 3 to 4 weeks after the exposure or sexual contact.

At Saskatoon Sexual Health, we offer STBBI testing and treatment. You can book an appointment or come to our drop-in clinic. You can click here to see what STBBI testing may be like for you.

RESOURCES

Healthcare providers, community-based organizations and more can learn more about syphilis from Saskatoon Sexual Health’s educational materials. Below are presentations and other resources on syphilis from our project funded by the Public Health Agency of Canada.

Syphilis Pamphlet

Syphilis Poster

Pregnancy & Syphilis Pamphlet

Congenital Syphilis Slides

Community-Based Syphilis Care & Prevention Slides

Congenital Syphilis Guide for Healthcare Providers

Local Resources & Organizations (Saskatchewan)

Sanctum Care Group (Sanctum 1.5 support for high-risk pregnant women and their children)
Saskatoon Community Clinic & SWITCH
Sex Life Sask
Prairie Harm Reduction
Saskatchewan Prevention Institute

Saskatchewan has high rates of syphilis, among other poor sexual health outcomes. Addressing these issues requires building capacity among healthcare providers and raising awareness among the public. You can learn more about syphilis from the following online resources:

Syphilis should not get between you and a healthy life or pregnancy.

Get Tested. Get Treatment. Get Cured.

CITATIONS

Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada. (2020, November 18). Syphilis in Canada: Technical report on epidemiological trends, determinants and interventions. Canada.ca. https://www.canada.ca/en/services/health/publications/diseases-conditions/syphilis-epidemiological-report.html#5

Doxy-pep: Medication to prevent syphilis, chlamydia, and gonorrhea. (n.d.-b). https://www.cbrc.net/doxy_pep_medication_to_prevent_syphilis_chlamydia_and_gonorrhea

Leslie, S. W. (2024, August 17). Congenital and maternal syphilis. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK537087/

Reno H;Fox B;Highfill C;McKee A;Trolard A;Liang SY;Stoner BP;Meyerson BE; (n.d.). The emerging intersection between injection drug use and early syphilis in nonurban areas of Missouri, 2012-2018. The Journal of infectious diseases. https://pubmed.ncbi.nlm.nih.gov/32877535/

Society, C. P. (n.d.). Diagnosis and management of congenital syphilis – avoiding missed opportunities. Canadian Paediatric Society. https://cps.ca/en/documents/position/congenital-syphilis

STI testing. STI Testing | Action Canada for Sexual Health and Rights. (n.d.). https://www.actioncanadashr.org/sexual-health-hub/sti-testing#:~:text=Syphilis%20has%20a%20window%20period,are%20present%20during%20an%20outbreak.

Syphilis. CATIE. (2023, August 16). https://www.catie.ca/syphilis-0