Six infants stillborn in Sask. syphilis outbreak

By Susan McNeil

An increase in syphilis in parts of Saskatchewan has led to the stillbirths of six babies, according to the medical officer of health for Indigenous Services in Saskatchewan.

Dr. Ibrahim Khan said on-reserve sexually-transmitted infection (STI) rates have increased alarmingly for people ages 13 to 70 in the last six months, with very serious consequences.

“We also, unfortunately, had six syphilis-linked deaths among kids, babies and also 19 early congenital syphilis cases from 82 communities in Saskatchewan,” said Khan.

Khan, who can only speak to on-reserve numbers, could not confirm any statistics for what is happening in the remainder of the population. Numbers from Saskatchewan Health were not available prior to publication, but previous reports have shown the entire province has disproportionately high STI rates.

Early congenital syphilis appears in babies in their first three months and is seen as a rash or eruptions on the infant’s mouth, nose, palms, soles or in their diaper area.

When Khan saw the numbers for the first six months of this year — a 928 per cent increase over 2019 — he said he became alarmed.

“We saw an unusual, alarming number of syphilis cases, which is 411 infectious cases reported across Saskatchewan on-reserve communities,” Khan said.

STIs in general have been disproportionately high in Saskatchewan for years. In 2019, Khan and another medical officer of health, based in Prince Albert, declared an outbreak of syphilis that has since grown.

That is also linked with higher-than-average rates of HIV in the province, which has similar risk factors.

“We’re seeing not only an incredible surge in syphilis, but we’re also seeing an incredible surge in co-infections,” Khan said.

Infections are not limited by age. Addiction also increases the level of risk.

“From the data gathered, it seems very obviously that people are not using condoms and are having a previous history of STIs,” Khan said.

Health officials know why the rates are increasing, and now are working on ways to manage the outbreak.

Since many of the people Khan works with as a representative of Indigenous Services Canada are on-reserve, access to testing is a challenge, and that issue is made worse by the pandemic when services were seriously curtailed.

One solution is to bring health care to the people, so outreach programs have started with a focus on Indigenous women, especially those who are pregnant. Outreach programs help patients feel comfortable talking to doctors and nurses about their health, Khan said.

“They feel that comfort, that openness, and that culturally-grounded care,” he said, adding that the care needs to be available on and off reserve so that no barriers exist for testing or treatment.

When diagnosed in its early stages, syphilis is very treatable with penicillin.

According to Health Canada, the T. pallidum bacteria are rendered non-infectious within 24 hours of treatment when given a certain type fast-acting penicillin. For pregnant women, a single dose of benzathine is effective at the beginning of the infection.