Enhanced surveillance of infectious syphilis in New Zealand sexual health clinics

Abstract

Following a rise in cases of infectious syphilis in New Zealand, national enhanced surveillance at sexual health clinics was initiated. All public sexual health clinics reported monthly on the number of cases seen, and completed a coded questionnaire on each case. Monthly reports to routine surveillance were compared and discrepancies reconciled. During 2011, 72 cases of infectious syphilis were reported. The majority (83%) were among men who have sex with men who were mainly infected in New Zealand and had an ethnic profile similar to all New Zealanders. Most heterosexual infections occurred overseas, among people of non-European non-Maori ethnicity. About half the cases had symptoms on presentation. Overall, 18% of men who have sex with men were HIV positive. Resurgent syphilis in New Zealand disproportionally affects men who have sex with men, amongst whom HIV is prevalent. Men who have sex with men should be aware of the risks and symptoms of syphilis and encouraged to have regular sexual health checks including serology testing. Control of syphilis should be included in the strategy to check HIV spread. Syphilis serology should continue to be part of routine immigration and antenatal screening, and where clinically indicated. Enhanced surveillance was easily initiated for an uncommon condition seen at sexual health clinics, and provided valuable information.

High Incidence of Congenital Syphilis in New Zealand

“…In NZ the infectious syphilis "epidemic" has been previously been reported to be predominantly affecting MSM. 2,5,14,18 Yet as evidenced by our surveillance and the rising infections among heterosexual women reported in national surveillance 5,14 this has become a complex outbreak across groups. Factors such as socioeconomic adversity, difficulties with delivery of and access to health care, substance abuse and lack of support are known to play a role in the spread of sexually transmitted diseases.…”

Letter response to R Psutka et al. – Enhanced surveillance of infectious syphilis in New Zealand sexual health clinics (Int J STD AIDS 2013; 24: 791–798)

“…We read with interest the work of the Psutka et al. 1 in their report on the surveillance of syphilis in New Zealand sexual health clinics, which describes a resurgence of acute syphilis, particularly among MSM and HIV-positive individuals. These remain the high prevalence groups in the UK, although we have seen a cluster of syphilis infections in young heterosexuals locally.…”