Rapid-response syphilis test could be lifesaver in ongoing outbreak, says Edmonton doctor

An infectious disease specialist in Edmonton is pushing to get access to a new syphilis test kit that could tackle a massive spike in congenital syphilis cases which led to 12 stillborn deaths in Alberta in 2019.

Doctor wants access to finger-prick blood tests that provide an answer in 5 minutes

In this May 23, 1944 file photo, the organism treponema pallidum, which causes syphilis, is seen through an electron microscope. (The Associated Press)

An infectious disease specialist in Edmonton is pushing to get access to a new quick-response blood test that could tackle a massive spike in congenital syphilis cases, which last year in Alberta led to 12 stillbirths.

Last summer Alberta Health Services declared a syphilis outbreak, noting that rates of the disease were at their highest level since 1948. By late November, there had been more than 1,750 cases in Alberta in 2019, including nearly 1,200 in the Edmonton area.

Among the cases last year were 40 cases of congenital syphilis, where a pregnant woman passes the infection on to her unborn child, leading to complications such as liver damage, neurological problems or stillbirth. The 40 cases of congenital syphilis included 12 stillbirths.

The numbers are particularly devastating given that syphilis screening is part of early prenatal care and the disease itself is easily treated, said Dr. Ameeta Singh, a physician at the Royal Alexandra Hospital and clinical professor at the University of Alberta.

"That's almost a third of the babies who died as a consequence of syphilis. So that's pretty horrifying," Singh said Monday on CBC Radio's Edmonton AM. "Our expected number in the province, in Canada today, should be zero."

The problem is concentrated among pregnant women who — for reasons including homelessness, addiction, mental health issues or simply fear that their child might be apprehended — aren't seeking prenatal care through the public health system, said Singh. 

"Our traditional ways of reaching people — which is people coming into the hospital or doctor's office —  doesn't work well for everybody, in particular our most vulnerable populations. So we have to find ways to go out and find them."

One solution could be syphilis diagnostic kits that could be done outside of a health-care setting and could provide an answer in five minutes with a simple finger-prick blood test, she said. That would mean a pregnant woman could be tested and treated in the same visit. 

"After they're tested from the usual blood draw, the results aren't available for a week to 10 days. Sometimes there have been long delays in finding people to treat them or they don't return for follow-up," she said.

Singh has been working with Alberta Health Services and the Canadian Institutes of Health Research to get permission from Health Canada to test two Canadian-made rapid-response test kits.

She said the trial would be set up as a research project, to ensure that the kits could work well in the field.

"Our frigid temperatures may affect the viability of the test kits so it is important that we evaluate them properly before we start using them widely."

But the approval process, which began in October, has been slow, said Singh,who hoped trials could get underway in April. She said everything is currently in limbo as they await responses from Health Canada and the  research ethics board.

"As a society, we should not be seeing this happen and just sitting back and accepting this. I hope that in response to this we will have an opportunity to ramp up our services."