Heterosexuals who regularly engage in casual sex are hampering efforts by Edmonton health officials to trace partners in the region's largest syphilis outbreak since the 1980s. Dr. Ameeta Singh, medical director of Capital Health's STD Centre and a consultant for Alberta Health, said many of those testing positive for syphilis cannot identify their partners, leading those unknowingly infected to continue spreading the disease. People with syphilis are up to five times more likely to contract and transmit HIV.

Over the last decade, between one and five new cases of syphilis were reported each year in the Capital Health region. In 2003, the region reported 32 confirmed cases. About five more cases have surfaced in the last three months. "We are exceedingly concerned about it," said HIV Edmonton Executive Director Sherry McKibben. "When people are diagnosed with syphilis... they are more at risk for HIV. It does mean we potentially face an increase in the number of people with HIV."

According to Singh, about half of those confirmed syphilis cases were gay men and half were heterosexuals. While outbreaks among heterosexuals are typically related to the sex industry, many Edmonton cases are related to casual sex. "The challenge has been that a number of people have said they don't know who they had sex with, so many of these individuals have been left untraced," Singh observed. Some of the people who tested positive for syphilis have also been found to have HIV.

The region has seen a huge increase in other STD cases. Gonorrhea rates have almost doubled from 260 in 1999 to 507 in 2003. Though 2003 statistics are incomplete, chlamydia cases, which reached 2,326 in 2002, are also expected to show increases. HIV cases in Edmonton dropped slightly from 92 in 2001 to 83 in 2002, but reporting delays -- including fallout from the syphilis outbreak -- could change that trend, McKibben said.

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