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Chief Medical Health Officer Andre Corriveau, left, and Wanda White, communicable disease specialist, held a press conference Thursday to update the media on the syphilis outbreak in the NWT. As of Oct. 31, there were 31 confirmed cases in 2008, with two more unconfirmed cases discovered since. - Herb Mathisen/NNSL photo

SOMBA K'E/YELLOWKNIFE - Syphilis continues to spread in the territory, with the number of confirmed cases jumped to 31 by the end of October, from nine in August 2008.

Since Oct. 31, two more unconfirmed cases have been discovered, bringing the potential number to 33.

According to the Department of Health and Social Services, only four cases had been reported in the previous 10 years.

Dr. Andre Corriveau, chief medical health officer, held a press conference Thursday to provide an update on the syphilis outbreak in the NWT.

Corriveau said as long as new cases were still being discovered and people in sexual contact with those individuals had not yet gone in for testing, more cases could be expected.

"October was even higher than September, so we haven't even reached the peak... of the outbreak," he said.

He urged residents identified as being in contact with infected people to go in for testing immediately if contacted by health care professionals - especially since syphilis is infectious in its early stage.

"When you have a new case and they report eight sexual contacts in the last three months, then there is a lot of work that needs to be done. Those eight people are traced and notified and they come back for testing," he said.

"So this is not something we are expecting to disappear overnight."

Wanda White, communicable disease specialist, said without co-operation from the public, the outbreak will be difficult to halt.

"It will be very hard to stop the outbreak if people don't come in and do their due diligence and get tested and get treated," she said.

White said syphilis is simple to treat, typically with a single-dose bicillin injection.

"You're zapped," she joked. "In the butt."

After treatment, patients are asked to refrain from sexual activity for a month and urged to practise protected sex.

White said the transmission rate for syphilis is very high.

"The risk of transmission with one (unprotected) sexual encounter is upwards of 60 or 70 per cent," she said.

Syphilis can be spread through anal, oral and vaginal sex, as well as through contact with skin sores and rashes.

If untreated, it can cause blindness, deafness, paralysis, brain or heart disease.

White said symptoms such as sores or lesions can disappear without treatment, but the "damage it does to your brain and heart will kill you over time."

In the early stage - where most of the cases in the NWT have been diagnosed - syphilis is most infectious. This stage lasts up to a year.

Corriveau said those mainly affected by the outbreak fall within the 19 to 29 age range and also engage in "high-risk" behaviour - meaning drug and alcohol users and people practising unprotected sex. White said the spread was happening mainly through heterosexual intercourse.

Corriveau said he believed the flurry of cases in the NWT are a symptom of Alberta's syphilis outbreak.

"It didn't come from nowhere," he said.

"Two of the early cases had been in Alberta for a while, so that is why we feel this is something that had been imported," he said.

"We really feel we are part of the Alberta outbreak. It sort of makes sense. We have a lot of interchange with Alberta."

White said the department was stepping up communication efforts with the public and doing front-line work - and even door-to-door campaigns - to educate at-risk individuals, specifically in the Tlicho and Fort Smith, where the rates are highest.

Corriveau, as chief medical health officer, has the authority to identify infected individuals by placing warnings outside their residences, if in the public interest, according to the Public Health Act.

When asked if he had considered that, Corriveau said the department was issuing warnings throughout the whole NWT.

"The identification of a single individual might make other people feel they are not at risk because they do not know that person and that would be counterproductive in the long-term," he said.

Corriveau said while the department is making an effort, the government could not do everything.

"There is a limit to how much government can achieve in this regard and the public themselves and people at risk have to do their share," he said.

Corriveau and White said of the territory's high rates of sexually transmitted infections, which has allowed syphilis to spread, means there are networks in place that could quickly spread other STIs. The main concern is a possible outbreak of the HIV virus.

"This concern about the lack of safe sex practices and our really high rates of (STIs) is ... it's a big worry if we start seeing HIV cases in the midst of all of this," said White.