Syphilis outbreak |03 February 2023
Dr Gedeon and Dr Morel during the press conference (Photo: Louis Toussaint)
New testing method introduced at the CDCU
Following the statement issued last week on an outbreak of syphilis in Seychelles, the Ministry of Health has introduced a new method of testing at the Communicable Disease Control Unit (CDCU) where the result is available in 15 minutes.
If the person is found positive, the same day he/she will be starting treatment.
This was announced by Dr Louine Morel, senior registrar at the CDCU and Public Health Commissioner Dr Jude Gedéon during a press conference yesterday at the Ministry of Health.
Dr Gedéon confirmed that in 2022, 71 confirmed syphilis cases were reported in Seychelles. “The people voluntarily came forward to test at the CDCU and 63% were males (n=45) and 37% were females (n=26). A peak for 30-34 year age group (n=13), age groups from 15-39 represented 63% of all the cases. Nine of the cases were reported among men who have sex with men (MSM). Among 44 cases tested for HIV, 13 tested positive representing a coinfection of 30%.”
Dr Gedéon noted that in 2021, there were only six cases reported and in 2022, there was a nearly twelvefold increase in cases recorded with Seychellois (n=61) representing 86% of the total cases in 2022.
“But we have to acknowledge this is a global trend right now where most countries are registering a hype in cases,” shared Dr Gedéon.
Regarding the age groups of people being infected, the biggest number recorded is between the ages of 15 to 39. But there are also 5 males above 75 years who have been tested positive and almost all districts on Mahé have recorded cases. Unfortunately there are also four babies who were born with syphilis.
Case classification of Syphilis
Dr Morel explained that the incubation period for acquired primary syphilis is typically 3 weeks but ranges from 10-90 days after exposure.
“The primary stage of infection is characterised by one or more ulcerative lesions (at the point of entry of the bacteria). The secondary stage of infection is characterised by localised or diffuse mucocutaneous lesions, often with generalised lymphadenopathy. The primary ulcerative lesion may still be present. The early non-primary non secondary stage of infection is where initial infection has occurred within the previous 12 months, but there are no signs or symptoms of primary or secondary syphilis. There are also unknown duration or late which is a stage of infection in which initial infection has occurred less than 12 months previously or in which there is insufficient evidence to conclude that infection was acquired during the previous 12 months.”
Dr Morel, who has been at the CDCU for the past 15 years, shared that this is not a common situation. If the situation is not treated, it can affect your brain, your liver, your ocular, your cardio among others.
Syphilis is a sexually transmitted infection. The signs and symptoms for men and women are burning sensation during urination, milky discharge, sore throat, itching of anus/private part and sores on private part. Other symptoms for men are irritation around opening of penis, pain in groin and pain/swelling in testis. Other symptoms for women include spotting or bleeding between periods, pain in back/lower abdomen, pain during intercourse and nausea and fever.
Complications of syphilis
According to Dr Gedéon, “about 15% to 30% of people infected with syphilis who don't get treatment will develop complications known as tertiary syphilis. In the late stage, the disease may damage the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection. This is why we are asking people to practice safe sex, have one partner and use condom. Nowadays there are some sexual practices where people are having group sex and no one knows the condition of the other. Abstinence also is a way to prevent getting infected. If you get infected once, you can get infected several times. Increased unsafe sexual activities; multiple partners at any one time; group sexual encounters and unprotected sex are possible reasons for surge in cases”.
Syphilis also increases the risk of HIV infection and can cause problems during pregnancy.
How can sexually transmitted infection be treated?
Most sexually transmitted infections can be treated. It is important to take your treatment properly and as early as possible: Take them at regular intervals, as instructed; finish the course of treatment even if the symptoms disappear or else the treatment may not be effective; discuss the treatment with your doctor or nurse in case you have any doubts and you may need to cut or drink less alcohol for the time that you are on treatment.
What can the public do help contain and reverse the surge?
“Our aim is to treat people and stop the spread of the disease. We will have more tests done and we will do active contact tracing among the groups at risk and we are also engaging different stakeholders to disseminate the information. Posters and leaflets will be distributed to the population. Be informed and take preventive steps to avoid getting infected. Abstain from unsafe sex, stay in monogamous relationship, avoid casual sex and use a condom consistently and properly. If having any syptomns of syphilis or any STIs, visit your health centre for testing and treatment and inform the health care worker of all sexual contacts you have been in and assist with informing them to go and get tested and treated,” urged Dr Gedéon.
Dr Morel reassured the public that all information about the patients are kept confidentially.
To conclude Dr Gedéon has this piece of advice: “LaValentine’s pe vini, reste avek ou vye Valentine...taler en nouvo Valentine i anmenn Syphilis konman ou kado.”
Vidya Gappy