Prof Mary Horgan, CUH
The Health Protection Surveillance Centre’s Scientific Advisory Committee has published a new national document, ‘Guidance on Management of Outbreaks of Sexually Transmitted Infections’, designed for health professionals involved in the prevention, investigation, and control of outbreaks of STIs.
The publication of the guidance, which is also relevant for non-governmental organisations who may be asked to contribute to and/or support the work of outbreak control teams, comes as the HSE warned of a significant rise in syphilis cases among men who have sex with men (MSM) in the Cork area in the past year, with almost eight-in-10 reported cases among MSM.
Dr Áine McNamara, Chair of STI guidelines subgroup of the HPSC SAC Sub-Committee on Managing Outbreaks of Infectious Disease, said infections that were sexually acquired could be complex and challenging to investigate. “Social stigma and confidentiality can complicate the collection of information and instigation of control measures. Therefore, the investigation and control of an STI outbreak will usually take longer than outbreaks of other infectious diseases.”
However, the components of an STI outbreak investigation were broadly similar to any other infectious disease outbreak investigation, i.e. preliminary investigation, formation of outbreak control team, epidemiological and microbiological investigation, control measures, communications, review and evaluation and formal declaration that the outbreak was over, she said.
The HSE Department of Public Health in Cork has expressed concern that compared to January to June 2015, when seven cases were reported in Cork and Kerry, cases had trebled, with 23 cases of early infectious syphilis reported from July to December 2015 and 21 cases from January to June 2016.
The Department is encouraging all sexually active homosexual men, and women whose partners have sex with men, to get tested for STIs and always use a condom when having sex, stressing that safer sex practices and regular testing and treatment of infectious syphilis were the key to prevention.
Dr Aileen Kitching, Consultant in Public Health Medicine at the Department, said: “The cases we are seeing are mostly in men who have sex with men, with over half of male cases in older adult age groups, over 35 years of age. Around one-in-five of these cases have had one or more other STIs.
Increased public awareness about STIs including signs and symptoms and where you can get tested is essential. Having syphilis once does not protect a person from becoming infected again.”
Prof Mary Horgan, Consultant in Infectious Diseases at CUH and clinical lead for STI services in Cork and Kerry, added: “I would encourage MSM who have had unprotected sex, including unprotected oral sex, to book an STI test as soon as possible.
“While 90 per cent of the cases we are seeing are primary syphilis, up to half of people with syphilis may not have any symptoms, and therefore could pass it on unintentionally.”
Highlighting that syphilis was curable with treatment, Prof Horgan warned unrecognised, untreated syphilis could lead to serious long-term complications.
“The earlier we diagnose and treat; the better. As syphilis can take up to 90 days to show up on a blood test, we encourage routine twice yearly testing for all sexually active MSM, as part of regular STI screening.”
lloyd.mudiwa@imt.ie
