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Rates of infectious sexual diseases on the decline in region

After reaching a 10-year high for cases of chlamydia, gonorrhea and syphilis in 2021, local numbers dropped slightly in 2022
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Unprotected sex with more than one partner in a six month period is the biggest risk factor behind a recent rise in syphilis cases in Waterloo region, according to a report on infectious disease trends from Region of Waterloo Public Health.

The annual infectious diseases surveillance report gathers and analyzes information on the infectious diseases that physicians, laboratories and hospitals are required to report to the region's public health unit in line with Ontario Public Health Standards.

Infectious diseases are illnesses caused by microorganisms such as bacteria, viruses, and parasites that have the potential to cause serious illness and outbreaks.

There were 116 reports of infectious syphilis in the region last year, a rate of 17.8 per 100,000 population compared to 23.1 across the province. The number is down from a high of 143 reported cases in 2021, and a rate of 22.2 per 100,000 that was higher than the provincial average of 20.6.

The report says rates of syphilis, while lower than the province, have increased substantially in recent years, especially among females. This trend has also been observed in the province, which suggests a shift in epidemiology and sexual health practices.

The most common sexually transmitted infections in Waterloo Region continue to be chlamydia and gonorrhea.

There were 1,388 cases of chlamydia reported across the region last year, a rate of 192.8 per 100,000 population compared to 255.9 provincially. That's down slightly from the age-standardized rate of 196.9 per 100,000 reported in 2021.

Gonorrhea case counts continued to spike across the province in 2022, while experiencing a slight decline in the rate of infection in Waterloo region.

Waterloo region reported 266 cases last year, a rate of 38.2 per 100,000. That's compared to 77.5 per 100,000 province-wide.

Across the board, the demographic with the highest number of cases of sexually transmitted infections locally and across the province is the 20 to 29 age group.

Mpox, previously known as monkeypox, was declared a disease of global public health concern and became a newly reportable disease in Ontario in 2022.

There were only four local cases of mpox last year. Public Health says it has been monitoring the situation, working with health care providers to provide up-todate treatment guidance, and providing mpox vaccines to high-risk individuals.

The mpox virus is most commonly spread to people through close, physical contact with an infected person.

Campylobacter enteritis and salmonellosis were the most common enteric diseases in Waterloo Region in 2022. The local rates for enteric diseases were similar to or lower than those of the province.

Risk factors for enteric illnesses such as Campylobacter enteritis and salmonellosis include consuming undercooked meats and unpasteurized dairy products, ingesting contaminated food or water, and contact with infected persons.

Rates of vaccine preventable diseases in Waterloo Region were similar to those of the province. The most common vaccine preventable diseases in Waterloo Region were pneumococcal disease and pertussis (whooping cough).

In 2022, as we returned to normal activities, we saw a return of circulating respiratory viruses including pertussis with rates higher than had been seen during the first two years of the pandemic.

Public Health says immunization is the best way to prevent whooping cough. Pneumococcal vaccine is also recommended for infants, older adults 65 years and older, and those at high risk from the infection.

Region of Waterloo Public Health undertakes a number of activities to prevent or reduce the burden of infectious diseases in the community.

Programs and services include case management, contacts and exposures for diseases of public health significance; inspections, investigations and outbreak management, including community outbreaks and those in institutions; health promotion activities and services for primary care providers, emergency service workers, childcare providers, and other community groups; and clinic-based services for sexual health, immunization, and tuberculosis screening and management.

Region of Waterloo Public Health says it will provide highlights of respiratory disease trends, including influenza, in a report to council this fall.