Syphilis epidemic to be tracked with new system

Acting Associate Health Minister James Shaw. New Zealand Herald photograph by Nick Reed

A beefed-up notification system is being rolled out to track a syphilis epidemic that has claimed the lives of babies.

The updated system goes live from today and will help track outbreaks and target testing and prevention efforts accordingly.

Currently only syphilis cases recorded by sexual health clinics are notified to the Institute of Environmental Science and Research (ESR) and medical officers of health.

From today, an automated system will enable notification by GPs and laboratories.

"This will give us ready access to high quality surveillance data and allow for a better understanding of at-risk populations, planning and evaluation of prevention and control activities and ongoing monitoring," a Ministry of Health spokesman said.

Earlier this year the Herald revealed New Zealand babies have died from syphilis passed on from their mothers during pregnancy.

The stillbirths are the worst-case scenario doctors have long warned of, as sexually transmitted infections boom amidst claims of underfunded health services.

There were about 495 confirmed cases of syphilis last year - over double the number in 2015.

Most cases were among men who have sex with men, but syphilis is increasingly found in the heterosexual community - increasing the risk of potentially fatal mother-to-baby transmission.

There have been four cases of congenital syphilis since 2017, and one probable case. Of the cases last year, two were stillbirths.

Infected babies who aren't treated can have seizures, brain damage, blindness, development delay or die.

Women should have antenatal blood tests at the first contact with a health professional during pregnancy. If detected, syphilis is usually cleared with antibiotics such as penicillin shots.

Acting Associate Health Minister James Shaw said the syphilis outbreak was being taken seriously.

"I am highly concerned and feel for the families affected...by updating the notification system, we are taking steps to ensure a much-needed, stronger public health response to address STIs."

The new notification system was called for by the Royal Australasian College of Physicians in a letter to Associate Health Minister Julie Anne Genter in June.

In slamming the response to the worsening syphilis epidemic as "totally inadequate", the college noted the sexually-transmitted disease had been a notifiable condition for 18 months, but the promised notification system hadn't been delivered.

The college also noted there are only eight full-time sexual health specialist positions across New Zealand, with some DHBs not employing any specialists. That includes in areas where unborn babies have died from syphilis.

Neurosyphilis alert

Untreated syphilis is infecting New Zealanders' nervous systems, documents reveal.

A special working group has met at Ministry of Health offices and by teleconference, tasked with organising efforts to turn around rising syphilis numbers.

Minutes from the inaugural meeting in July, released under the Official Information Act, show the possibility of genetic research has been raised.

"Given neurological symptoms being attributed to current syphilis epidemic knowing more about the strain of trepomena would be useful," the minutes state.

If syphilis is untreated neurosyphilis can develop - an infection of the nervous system including the brain and spinal cord, which can be life-threatening.

The bacteria Treponema Pallidum causes syphilis and later neurosyphilis, which can develop years after an initial infection and be asymptomatic. Having HIV increases the risk.

The working group is developing an action plan, which will include improved data and training for health workers.