Scientists are using genomic sequencing technology, like that used to tackle COVID-19 clusters, to track worsening syphilis outbreaks in Melbourne’s suburbs.

Scientists are using genomic sequencing technology, like that used to tackle COVID-19 clusters, to track worsening syphilis outbreaks in Melbourne’s suburbs.
Key points:

  • Doctors are particularly concerned by a rise in the infection among women of reproductive age
  • There has been an increase in people presenting with ocular syphilis, which can lead to vision loss or blindness
  • It is hoped the genomic tracking will help target prevention and diagnosis

Doctors and specialists have reported a dramatic rise in the sexually transmitted infection in recent years.
The Royal Victorian Eye and Ear Hospital has reported a 20-fold increase in patients presenting with ocular syphilis, from just two patients in 2006 to 21 in 2019.
While syphilis outbreaks have previously been found in the Northern Territory and in Western Australia, sexual health physician Marcus Chen said what was happening in Melbourne was distinct.
“Syphilis is spreading through the community into areas it wasn’t present in before,” he said.
Dr Chen said suburbs in the outer north-west and outer south-east of Melbourne had been identified as hotspots for the infection.
The Monash University adjunct professor and Melbourne Sexual Health Centre doctor said the rise among women was particularly concerning.
“Some of these women are getting infection during pregnancy, and that’s resulting in infection of babies,” he said.
Better Health Victoria data shows since 2002, the number of people with infectious syphilis has been rapidly increasing, mainly among men who have sex with men.
Since 2017, a rise in women contracting the infection has led to the re-emergence of congenital syphilis in the state.
Syphilis is easily detected through sexual health tests and can be quickly treated if caught in time.(Flickr: NIAID
“Syphilis is what a lot of people sort of call the great masquerader, in that it can actually mimic a whole lot of different diseases or problems within the body from the actual infection itself,” said ophthalmologist Lyndell Lym.
The infection can be difficult to notice when it first appears as it is usually painless and can often present with only one sore.
Left untreated, the infection can cause vision loss, lesions, neurological disorders and memory loss.
People presenting at the Eye and Ear Hospital with impaired vision often did not know they had been infected, Dr Lim said.
Other STIs on the rise
Dr Lim told ABC Radio Melbourne the rise in ocular syphilis was “an offshoot from the syphilis epidemic that we’re actually having here in Australia”.
It has been happening alongside a rise in a number of other sexually transmitted infections in high-income countries over the past decade.
Deborah Williamson, professor of microbiology at the Peter Doherty Institute for Infection and Immunity, said a “complex suite” of factors were driving the resurgence of sexually transmitted infections.
Those include the use of online dating apps, a reduced fear of HIV and access to treatment.
Now, scientists are using genomic sequencing technology to analyse the genetic codes associated with the epidemic.
Professor Williamson is working with the Melbourne Sexual Health Clinic and Victorian Department of Health to analyse samples from syphilis patients.
“We really hope that it will enable us to track strains of syphilis as they as they emerge,” Professor Williams told PM.
The COVID-19 pandemic drew public attention to the use of genomic sequencing in outbreaks.
Professor Williams said scientists hoped to have some initial results in a few months’ time.
In the meantime, she said early testing and screening for sexually transmitted infections would be key to preventing greater spread.
“It comes back to timely access to testing and treatment, access to health care, health literacy, improved antenatal testing, you know, there’s a whole raft of different things,” she said.
“These aren’t new things. They just need to be implemented systematically. And to do that requires resource.”