Surge in the number of syphilis cases

The number of people in New Zealand with syphilis is surging and casual hook-ups through dating apps are making it harder to control the sexually-transmitted infection.

Nationally cases have doubled in the past two years, with 470 cases reported in 2017, and a national working group has been formed to address the issue.

In Taranaki, where there were 13 cases between January 2017 and August 2018, the District Health Board has formed a local steering group to develop a plan to increase awareness and support services, service director of clinical management Wendy Langlands said.

Gay or bisexual men made up 70 per cent of cases, and Langlands said dating apps like Grindr were not helping the issue, as the rise in its use had made contact tracing more difficult.

‘‘Taranaki DHB is taking the increase in syphilis cases seriously and is working to ensure regular screening of those people at risk of sexually-transmitted infections,’’ she said.

‘‘The difficulty with the dating apps is that often people use an alias, and the resulting meeting or ‘hook up’ is normally for a short one-off encounter.

‘‘During these encounters phone numbers are not always exchanged or saved for long-term use, which can make contact tracing challenging.’’

Contact tracing usually involves the patient telling their sexual partner of the diagnosis, or telling the contact tracing nurse who then follows up.

If the patient doesn’t want their partners to know, they can remain anonymous and only enough personal information is given to permit the contacts to be traced.

The method can prevent reinfection of the patient and identifies contacts who may benefit from medical treatment before they get symptoms, Langlands said

‘‘It has public health benefits as well as health benefits for the individual with the infection and their partners.’’

Early symptoms of syphilis include painless ulcers on the mouth, genitals or anus and swollen nodes, and can develop into rashes, fever, tiredness, headaches, persistent lymph node swelling, hair loss and ‘‘warty growths’’.

Left undiagnosed and untreated, further hidden symptoms can develop over months or years, and the brain, nerves, eyes, heart, blood vessels, liver, bones and joints can all be affected.

Director of Public Health Dr Caroline McElnay said the work to prevent syphilis, which was worst in Auckland and Wellington, was ongoing.

The cross-agency working group was assisting the Ministry of Health with the development of a syphilis action plan, looking at ways to address the increase in syphilis numbers in New Zealand, she said.

This included awareness and testing, and improving diagnosis and the management of the infection.

McElnay said one of the issues being worked on was the challenge of contact tracing, especially where the only contact was through a dating app, she said.

‘‘A first step is sharing good practice – sexual health clinics often have more experience than GP clinics in using dating apps for contact tracing where individuals still have their profiles online.

‘‘The working group will also look at how good practices can be better shared with health professionals involved in contact tracing,’’ McElnay said

A Taranaki worker in sexual health, who did not want to be named, said more needed to be done.

Those who controlled funding were not taking the syphilis epidemic seriously, with more hours and more staff needed to deal with the issue, especially when it comes to contact tracing, the worker said.

A nurse who used to do contact tracing has now had to pick up other duties as well, the worker said.