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Published Date: 2017-10-31 08:27:40
Subject: PRO/EDR> Gonococcal dis, chlamydia, syphilis - Canada: (ON) increase, MSM, RFI
Archive Number: 20171031.5414788
GONOCOCCAL DISEASE, CHLAMYDIA, SYPHILIS - CANADA: (ONTARIO) INCREASED CASES, MEN WHO HAVE SEX WITH MEN, REQUEST FOR INFORMATION
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International Society for Infectious Diseases
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Date: Sun 29 Oct 2017 6:12 EDT
Source: Ottawa Citizen [edited]
http://ottawacitizen.com/health/sexual-health/spike-in-gonorrhea-cases-worries-ottawa-public-health


Cases of sexually transmitted infections [STIs] continue to rise in Ottawa despite the best efforts of public information campaigns.

Gonorrhea infections in Ottawa have soared 65 per cent this year [2017], another spike in the frustratingly upward climb in the city's rate of sexually transmitted infections, according to Ottawa Public Health [OPH].

Gonorrhea infections last jumped in Ottawa in 2013 and health officials assumed they were dealing with a new normal for STIs, said Leslie Tilley, supervisor of OPH's sexually transmitted and blood born infections management unit. This year [2017], the numbers jumped again.

There have been 446 cases of gonorrhea so far in 2017, compared with 270 cases at the same time in 2016. If the pace continues, there will be 612 cases in 2017, compared with 371 the year before. The number of cases of gonorrhea in Ottawa has increased every year since 2012 when 236 cases were reported.

Most of this year's increase has been among men who identify as gay or bisexual, Tilley said.

Chlamydia cases are also on the rise, up 8 per cent compared with the same time last year. Since 2012, chlamydia infections have climbed 28 per cent, from 2,532 cases in 2012 to 3,262 cases last year.

The number of syphilis infections, which rose dramatically in 2016, has stabilized in 2017, Tilley said.

The increase in STIs is baffling, given the amount of public education about the risks of unprotected sex. "Anyone working in STIs and infectious diseases is asking themselves the same question. There is a lot of information out there and it's hard not to know what's happening with these numbers. But knowledge doesn't equal behaviour change."

One problem, in the case of chlamydia, is that 70 per cent of women and 50 per cent of men with the infection show no symptoms. "That's what we're fighting against. People don't think it's going to happen to them. People have notions of what infections look like and they'd be able to tell if they had them or their partner had them. That's just not the case."

The painful symptoms of gonorrhea are harder to miss, but with both chlamydia and gonorrhea, a simple urine test can detect most cases of genital infections. What many people don't realize, however, is that both infections can also occur in the throat or rectum from oral or anal sex. Many people, and even doctors, don't think to have those areas swabbed for infection. "Our sense is that there's a big cohort in the community who have oral chlamydia or gonorrhea who are never tested and never treated," Tilley said.

Both infections are easily treated with a single dose antibiotic and an antibiotic injection. Fortunately, Tilley said, Ottawa hasn't seen the strains of antibiotic resistant STIs that have been reported elsewhere in North America.

The health unit is continuing its efforts to make condoms available and even provides the antibiotics free for those who can't afford them. But the most important thing is that people can't assume they are free of STIs, Tilley said. "That cannot be the assumption. If you've had oral, anal, or vaginal sex you are at risk and you should get tested. It's scary, of course. But we try to normalize it as much as possible. Lots and lots and lots of people have it. The worse thing that can happen is you find out you have it, you get treated, and it goes away."

More information can be found on the sexual health link at http://ottawapublichealth.ca

[Byline: Blair Crawford]


Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Ottawa is the capital city of Canada, situated in the Eastern subregion of the Canadian province of Ontario on the border with the Canadian province of Quebec (https://en.wikipedia.org/wiki/Ottawa); it is about 124 miles (200 km) west of the city of Montreal in Quebec. The city of Ottawa has an estimated population of 943 260 in 2013. A map of Canada, showing the location of Ottawa, is available at https://www.google.com/maps/place/Ottawa,+ON,+Canada.

The news report above says that most of this year's increase in gonococcal disease cases has been among men who identify as gay or bisexual. Outbreaks of syphilis and gonorrhea among men who have sex with men (MSM) are occurring worldwide. The news report above does not characterize the outbreak in Ottawa further. The rising number of cases of gonorrhea in Ottawa may be due to a variety of reasons that promote unprotected sex, such as engaging in unprotected sex only with partners perceived to have the same HIV status as one's own (serosorting), taking preexposure or postexposure HIV prophylaxis, use of psychoactive "party drugs," use of smartphone apps that facilitate anonymous "hookups," etc. More information on this outbreak from knowledgeable sources would be appreciated. - Mod.ML

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/277.]

See Also

2016
----
Syphilis, gonococcal disease - Canada: (AB) inc. cases, MSM, smartphone apps 20160507.4208142
Syphilis - Canada & USA: Bicillin shortage 20160503.4199492
Syphilis - Canada: (MB) increased incidence, Bicillin shortage 20160501.4195457
Syphilis, gonococcal dis., chlamydia - Canada: (BC,ON) inc. cases, MSM, HIV, RFI 20160212.4016426
Gonococcal disease - USA: (WA) increased incidence, methamphetamine 20160131.3975209
2015
----
Gonococcal disease - USA (06): (MT) increasing incidence 20151210.3853441
Gonococcal disease - USA (05): (NY) increasing incidence, RFI 20150809.3567929
Syphilis - Canada (03): (ON) increased incidence, MSM, RFI 20150725.3535696
Syphilis - Canada (02): (MB) pharyngeal, MSM 20150714.3509230
Gonococcal disease - USA (04): (UT) incidence rising 20150426.3323165
Gonococcal disease - USA (03): (CA) increasing incidence 20150419.3307254
Syphilis - Canada: (NF) increased incidence, MSM, HIV, update, RFI 20150319.3242011
2014
----
Syphilis - Canada (06): (NL) incr. incidence, MSM, RFI 20141201.3000711
Syphilis - Canada (05): increased incidence, MSM, smartphone apps 20141104.2927012
Syphilis - Canada (04): (MO) incr. incidence, MSM, smartphone app, HIV-coinfect 20141027.2906054
Syphilis - Canada (03): (PE) rising incidence, RFI 20140926.2806438
Syphilis - Canada (02): (BC) rising incidence, predominantly MSM, HIV coinfect. 20140822.2715216
Syphilis - Canada: (SK) increased incidence, Internet, social networking 20140419.2415809
2013
----
Syphilis - Canada (04): (NU) increased cases, RFI 20131207.2098056
Syphilis - Canada (03): (BC) increased incidence, MSM, urban 20130608.1761566
Syphilis - Canada (02): (NS) MSM, mobile phone apps 20130320.1594646
Syphilis - Canada: (NU) RFI 20130214.1542486
2012
----
Syphilis - Canada (04): (NS) MSM, Internet 20121019.1353614
Syphilis - Canada (03): (NU) RFI 20120912.1291334
Syphilis - Canada (02): background 20120211.1038978
Syphilis - Canada: (NB) 20120210.1038543
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