Tuesday, 10 September 2024

Syphilis

Sarah MANSFIELD (Western Victoria) (18:26): (1124) My adjournment is for the Minister for Health, and the action I am seeking is dedicated funding for syphilis prevention and increased screening. This month is world Sexual Health Month and an opportune time to look at the growing problem of syphilis in our community. While syphilis is often considered a disease of the past, suspected of afflicting historical figures from Lenin and Nietzsche to Oscar Wilde and Al Capone, Victoria is currently in the midst of a syphilis epidemic. In 2022 there were 1716 cases of infectious syphilis notified in Victoria. In 2012 that number was only 466. In 2002 it was 29. After years of no cases of congenital syphilis there were two in 2017 and there were three congenital syphilis cases in the first half of 2023. Two of these resulted in fetal death.

Syphilis is an infection caused by bacteria spread by different forms of sexual contact, also to babies via pregnancy, and via infected blood such as through transfusion or sharing needles when injecting drugs. While it has been known to affect men who have sex with men at disproportionately higher rates, rates in other populations have climbed significantly, with an 11-fold increase in rates in women. Many people do not know the symptoms of syphilis infection, but there are various stages. Untreated in adults it can cause irreversible brain, heart and nerve damage, often many years down the track. Pregnant people with syphilis are at risk of congenital syphilis, which can result in pregnancy loss, stillbirth, preterm birth seizures and severe physical and cognitive impairments in babies.

But syphilis is readily diagnosed and is completely curable in a functioning healthcare system. Evidence shows that increased prevalence of sexually transmitted infections like syphilis is driven primarily by lack of access to services rather than sexual risk behaviours. Syphilis is cured by injecting a special penicillin and sometimes other antibiotics. Testing is primarily via a blood test and is routine in pregnancy because the infection of the fetus has such a high mortality rate. Congenital syphilis can be an indicator of breakdown in a healthcare system, highlighting many missteps for detection and intervention. Currently, testing outside of pregnancy is typically conducted using a risk-based approach, either based on symptoms or risks of acquiring the infection, but given the changing epidemiology of syphilis, screening needs to be widespread and testing should be done across a broad range of clinical presentations and should be universal in pregnancy. This would catch much of the disease early, reducing its spread in the community and the harmful impacts on individuals. The resurgence of syphilis in Victoria represents a significant public health challenge and one that I urge the health minister to do more to address.