Public Health warns of syphilis outbreak in Nova Scotia

Public Health officials have declared a provincial outbreak of syphilis after an increase of syphilis cases in 2019. 
Preliminary data recorded 82 cases in Nova Scotia in 2019. That compares to approximately 50 cases in 2018 and 38 cases in 2017. The cases to date have been diagnosed in people ages 20-to-65+ years across the province. There also appears to be an increasing proportion of cases among females (20 per cent) in 2019, compared to 10 per cent in 2018 and 5 per cent in 2017. This trend is consistent with the pattern seen in other jurisdictions in Canada. 
Syphilis is a bacterial sexually transmitted infection (STI) contracted through unprotected anal, oral or vaginal sex. It can cause serious and permanent damage to the body if untreated. 
“Safer sex practices and getting tested for syphilis can help decrease the number of syphilis cases we are seeing in Nova Scotia currently,” said Dr. Gaynor Watson-Creed, Deputy Medical Officer of Health, Nova Scotia. “Knowing your status for sexually transmitted infections, including syphilis, is really important for our health and also the health of others.” 
Symptoms of syphilis may first appear 10 to 90 days after a person becomes infected, with the average period of time being 21 days. While some people may not experience any symptoms, syphilis can produce different symptoms at each stage of infection, including: 
  • an open sore at the point of infection (genital area, anus, mouth or lips)
  • flu-like illness
  • muscle aches and pains 
  • fatigue
  • a rash on the chest, back, palms of hands and bottoms of feet 
Syphilis is treatable with antibiotics. Later stages of syphilis can cause serious impacts to the brain, heart and other organs, or even death.
Safer sex practices, including the use of condoms and oral dams for each sexual interaction, can help prevent syphilis. Unprotected sexual contact increases risk for syphilis or other sexually transmitted infections. 
While the majority of cases are in males, the 2019 data indicates an increase in syphilis cases in females compared to recent trends. As a precaution to prevent congenital syphilis (an infection in unborn babies or newborns which can cause miscarriage, stillbirth or birth defects), Public Health and Reproductive Care Program recommends that doctors now test for syphilis twice in pregnancy. This second test, completed at 24 to 28 weeks, will complement the routine syphilis screening that takes place early in pregnancy. 
To date there have been no reported cases of congenital syphilis in Nova Scotia.
A syphilis outbreak was declared in Halifax area in 2009, hitting a peak in 2013 with 84 cases that year. The Public Health Agency of Canada has put a Syphilis Outbreak Investigation Coordination Committee in place to inform surveillance and outbreak control measures across the country, which may inform additional protection measures and recommendations.
For now, Dr. Watson-Creed said, it’s most important that people know the signs and symptoms of syphilis, use protection for sexual activity and get tested for syphilis and other STIs if they are at risk. 
“Being informed, taking action and protecting yourself are the best steps right now. Please get tested if you think you are at risk.”
If you have questions about syphilis, please contact your health care provider or call your local Public Health office. Nova Scotians can also call 811 for non-emergency health advice from a registered nurse. More information about syphilis is available at
Media Opportunity:
Dr. Gaynor Watson-Creed, Deputy Medical Officer of Health, will be available to speak to media on Monday, Jan. 20 from 10:30 a.m. to 11:30 a.m., 7 Mellor Avenue, Dartmouth, at the NSHA Public Health office. 
Media located outside HRM will be able to call in to this session. The call-in number will be provided. All attending – in person and by phone - are asked to RSVP to or 1-844-483-3344.