Rise in syphilis cases prompts calls to practise safe sex

Media release

13 April 2018

A rise in the number of syphilis cases being reported in New Zealand is prompting renewed calls for people to practise safe sex, including the use of condoms.

The unfortunate rise has seen New Zealand fall into line with current international trends.

The incidence of syphilis has been on the rise in New Zealand since 2012.  Provisional data from the Institute of Environmental Science and Research (ESR) Ltd, indicates that the number of syphilis cases reported in 2017 has more than doubled since 2015, with 470 cases reported.

The highest number of cases were reported in males aged 20-39 years, particularly those in the 25-29 age group, in the Auckland and Wellington regions.  Nearly 70% of the cases were reported in men who have sex with men (MSM) and nearly 21% of these cases were also HIV positive. 

MSM remains the group most affected by syphilis.  However over recent years there has also been a steady increase in cases diagnosed in heterosexual males and females in New Zealand. For women the highest number of cases reported in 2017 was in the 20–39 years age group. 

Similar trends have been seen in Australia, the UK and the US in recent years, with cases first increasing in MSM, followed by the heterosexual population, with an increased risk of congenital syphilis if pregnant women are affected.

The Ministry of Health’s Director of Public Health Dr Caroline McElnay says the ministry is committed to seeing a reverse in this trend.

Dr McElnay says there are a number of key messages to remind people how best to prevent the transmission of syphilis and other sexually transmitted infections (STI).

“Transmission of these STIs can be reduced by using condoms every time with casual sexual partners; and regular partners.”

“If you have unprotected sex, or more than one sexual partner, the Ministry of Health encourages you to get tested even if you don’t have any symptoms.”

If you think that you have syphilis or are at risk of syphilis, see your doctor or local sexual health clinic.

Additional information on syphilis can be found on the Your Health Syphilis page.

In January 2017, syphilis was made anonymously notifiable under the Health Act. This is expected to help to further identify at risk groups and enable appropriately targeted sexual and public health interventions.

Further information about syphilis 

Syphilis is a serious bacterial infection that can cause significant complications. Syphilis is usually sexually transmitted but can also be transmitted from mother to baby during pregnancy or birth, resulting in serious complications and sometimes death.

Syphilis can be treated and cured with antibiotics.  If not treated, over time, syphilis can affect the brain, spinal cord and other organs. Having untreated syphilis also increases your risk of catching HIV infection.

The symptoms of syphilis depend on the stage of infection; primary, secondary, and late (tertiary).

The first symptoms of syphilis usually include genital (or possibly oral or anal) ulcers that are often painless, with swollen local nodes. The ulcers usually last a few weeks, often followed by rashes, and sometimes with fever, tiredness, headache, persistent swollen lymph nodes, hair loss or warty growths especially in the genital or anal areas. 

Symptoms disappear after a few weeks without treatment, however the disease continues to slowly develop if left undiagnosed and untreated. Complications appear after months or years and can affect multiple parts of the body, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.

As the symptoms and the severity of syphilis may vary  and as the symptoms will disappear even though the disease continues to develop, it is recommended that people at risk of sexually transmitted infections (STIs) (i.e. those with multiple sexual partners and/or practising unprotected sex) are tested regularly for syphilis and other STIs, even if they use condoms. 

Preventing syphilis transmission to others also requires timely diagnosis and treatment to reduce spread, contact tracing and follow-up of treated individuals.