Syphilis: Overview for BC health care providers and online course

Issue: BCMJ, vol. 66, No. 10, December 2024, BC Centre for Disease Control
By: Monica Durigon, RN(C), MSc Barbra Arnold, MD, CCFP Rochelle Stimpson, MD, CCFP Kirsty Bobrow, MBChB, DPhil, MSc, MMed Troy Grennan, MD, DTM&H, MSc, FRCPC

Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum. Its natural history is well described in medical literature and typically includes primary, secondary, and latent stages. If left untreated, syphilis can lead to serious complications in multiple organ systems. Syphilis can also be transmitted vertically at any time during pregnancy or delivery and may lead to miscarriage, stillbirth, or complications in infants due to congenital syphilis infection.

Cases of infectious syphilis are on the rise in BC. In 2012, BC saw 369 cases (8.1 per 100 000).[1] In the 4-year period from 2018 to 2022, rates of infectious syphilis increased 98%: from 932 cases (18.6 per 100 000) to 1971 cases (36.8 per 100 000).[1]

While gay, bisexual, and other men who have sex with men represented the majority of reported infectious syphilis cases over the past decade, the epidemiology is changing. This change is reflected in the sharp rise in the number and proportion of cases among heterosexual populations, most evidently seen among women.

Infectious syphilis cases among women increased 938% between 2018 (53 cases) and 2022 (550 cases).[1] In 2022, over 90% of women with infectious syphilis were of childbearing age (i.e., 15–49 years old), thus raising concern about congenital syphilis.[1,2] BC reported no congenital cases from 2014 to 2018. However, between 2019 and 2022, 29 congenital syphilis cases were reported: 15 early congenital probable, 11 early congenital confirmed, and 3 late congenital confirmed.[1,3]

Syphilis overview course

In 2019, the Provincial Health Officer declared an outbreak of syphilis in the province.[4] Subsequently, the syphilis team at BCCDC (composed of doctors, nurse practitioners, certified practice registered nurses, and educators) noted a significant uptick in the number of requests for support and education among providers, who were seeing the epidemiological trends reflected in their practices. In response, and to provide equitable access to information and education, the team developed a self-directed online course to support providers involved in the case management and follow-up of syphilis cases and their contacts.

The Overview of Syphilis for Health Care Providers in BC online course is broken into three modules and a tool kit:

  • Module 1: Introduction to Syphilis. Reviews the impact of syphilis on public health in Canada and BC, as well as the etiology, transmission, and clinical presentation.
  • Module 2: Testing – Screening and Diagnostic Tests. Reviews available screening and diagnostic tests (serological and lesion specific) that enable the correct diagnosis and staging.
  • Module 3: Case Management. Reviews the diagnosis and case management process.
  • Tool kit. Offers additional resources and tools for providers who want to increase their knowledge and capacity to provide effective, strengths-based, person-led sexual health communication.

The course is available on the Provincial Health Services Authority LearningHub.[5] It takes approximately 2 hours to complete and is accredited by the Division of Continuing Professional Development, University of British Columbia Faculty of Medicine, for up to 2.0 Mainpro+/MOC Section 3 credits.

The health and well-being of our communities are improved by early detection and timely treatment of syphilis. Expanding knowledge and understanding helps support this goal.

In BC, syphilis is centrally managed at the BCCDC. For information about syphilis screening, case management, or follow-up, contact the BCCDC public health nurse at 604 707-5607 or physician at 604 707-5610. For the most current syphilis surveillance reports, refer to the BCCDC Sexually Transmitted and Blood Borne Infection (STBBI) and Tuberculosis (TB) Report dashboard.[2] For further information about the syphilis overview course, contact sticourse@bccdc.ca.
—Monica Durigon, RN(C), MSc
—Barbra Arnold, MD, CCFP    
—Rochelle Stimpson, MD, CCFP
—Kirsty Bobrow, MBChB, DPhil, MSc, MMed
—Troy Grennan, MD, DTM&H, MSc, FRCPC
BCCDC

hidden

This article is the opinion of the BC Centre for Disease Control and has not been peer reviewed by the BCMJ Editorial Board.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

1.    BC Centre for Disease Control. Syphilis indicators in British Columbia: BCCDC CPS surveillance report. 2024. Accessed 10 September 2024. www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/STI/BCCDC_website_syphilis_indicators_2024Q2.pdf.

2.    BC Centre for Disease Control. Sexually transmitted and blood borne infection (STBBI) and tuberculosis (TB) surveillance report. Accessed 10 September 2024. https://bccdc.shinyapps.io/stbbi_tb_surveillance_report.

3.    BC Centre for Disease Control. Syphilis: Case definition. Accessed 11 September 2024. www.bccdc.ca/health-professionals/clinical-resources/case-definitions/syphilis.

4.    British Columbia Centre for Disease Control (BCCDC). BC syphilis action plan refresh, 2023–2025. 2023. Accessed 11 September 2024. www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/STI/Syphilis_Action_Plan_Refresh_2023.pdf.

5.    Provincial Health Services Authority. PHSA – BCCDC – Overview of syphilis for healthcare providers in BC. Accessed 15 October 2024. https://learninghub.phsa.ca/Courses/31222/phsa-bccdc-overview-of-syphilis-for-healthcare-providers-in-bc.

Monica Durigon, RN(C), MSc, Barbra Arnold, MD, CCFP, Rochelle Stimpson, MD, CCFP, Kirsty Bobrow, MBChB, DPhil, MSc, MMed, Troy Grennan, MD, DTM&H, MSc, FRCPC. Syphilis: Overview for BC health care providers and online course. BCMJ, Vol. 66, No. 10, December, 2024, Page(s) - BC Centre for Disease Control.


Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply