New Zealand is close to a syphilis epidemic, says an Auckland doctor.
Writing in New Zealand Doctor, Sunita Azariah, an Auckland Sexual Health Service physician, said there was evidence that the incidence of infectious syphilis was increasing.
Last year's sexually transmitted infections surveillance report by the Institute of Environmental Sciencesand Research indicated a 53 per cent increase in cases of infectious syphilis diagnosed in public sexual health clinics since 2003.
Most of the 46 cases were in the Auckland and Waikato districts (63 per cent) and most of the diagnosed cases were in men (74 per cent).
An audit of case notes between January 2002 and September 2004 revealed 40 cases of infectious syphilis were diagnosed by the Auckland Sexual Health Service - twice as many cases as had been diagnosed in the previous four years.
Most cases, 82.5 per cent, were in men. The main risk factors appeared to be either having a history of recent sex overseas (47.5 per cent) and men having sex with men (45 per cent).
However since that audit the service had dealt with at least 10 more cases. "In contrast to the recent audit, 90 per cent of the cases were heterosexual and 90 per cent also gave no history of overseas sex.
"Many of these later cases ... were young heterosexual adolescents and indicate the risk factors for acquisition of syphilis are diversifying - further evidence of an emerging epidemic," she wrote.
Dr Azariah said an important first step in evaluating the epidemic would be to start compulsory laboratory notification so risk factors could be identified and interventions targeted at the right people.
"It will be unforgiveable if this scourge is permitted to re-emerge in a developed nation."
