M2M Health Notices

Important Health Information for M2M

 Health ALERT:  Durham M2M Syphilis Rates are Among the Highest in Ontario

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Hepatitis C increasing among (MSM) Men who have Sex with Men

May 31, 2011 - CATIE (Canadian AIDS Treatment Information Exchange)

An epidemic of sexually transmitted HCV (Hepatitis C) is occurring across high-income countries among some gay and bisexual men, particularly those who are HIV positive and who do not inject substances.  According to an internation team of researchers, this route of transmission appears to have begun in the mid - 1990's.  Furthermore, researchers in Canada, Australia and Western Europe have found that the spread of HCV co-infection among HIV-positive men appears to have accelerated after the year 2000. 

Scientists at research centres in Berlin, Bonn and other German cities have collaborated to investigate the spread of HCV co-infection among gay men in that country.  Their results suggest that "sexual practices leading to rectal bleeding, and snorting drugs (among people who have high rates of HCV infection) are risk factors for [the further spread of HCV]." Under such circumstances, condoms and gloves may not provide sufficient protection "if they are contamined with blood," noted the German team.  Common sexually transmitted infections such as gonorrhea, syphilis and genital warts also play a role in helping HCV (and HIV) to spread. 

Statistical analysis revealed that any of the following behaviours were linked to the transmission of HCV:

  • rectal trauma with bleeding
  • frequent receptive fisting without the use of gloves
  • group sex
  • nasally-administered drugs

German researchers also found that men in their study had many sexual partners and this increases the risk of exposure to HCV.  Another factor not taken into account is that at room temperature HCV can be infectious for up to 16 hours.  If sharing equipment (such as straws to inhale drugs) or sex toys occurs, HCV can be transmitted.
 
The German team summarized its findings with this statement:
"We suggest that blood rather than semen is the critical medium.  An insertive partner's fist (or penis), contaminated with blood, might serve as a vector for subsequent receptive partners in a group sex session, when condoms or gloves are either not applied or not changed for every new partner - particularly when using a collective supply of lubricant.  Lesions in both the ano-rectal mucosa - from fisting, prolonged anal intercourse or rectal STIs (Sexually transmitted infections) - could serve both as a portal of entry and as a source of infection."
 
 

       

         

       

      SURVEILLANCE ALERT ISSUED BY

       

      December 31, 2009

      Increase in Shigella cases among Toronto males

      A cluster of Shigella cases among males living in Toronto has recently been identified.

      Thirteen cases of shigellosis due to infection with Shigella flexneri, and two cases with

      an unspecified Shigella species, have been reported to Toronto Public Health (TPH)

      since the beginning of November, 2009. All 15 cases were male, with a mean and

      median age of 39 years; 12 (80%) of the cases live in the downtown area.

      Although infection with Shigella is more commonly reported among males in Toronto,

      the number of cases in the last two months is disproportionately high in this group. The

      proportion of cases resulting from infection with S. flexneri is also much higher than

      previously reported. Six of the cases reported engaging in sexual activity (oral-anal

      contact) as the main risk for infection.

       

      Singella bacteria can be transmitted through ingestion of contaminated food or water, or passed from person-to-person, typically through sexual contact. A low infectious dose

      is sufficient to cause infection. Symptoms of shigellosis usually begin within one to

      three days after being exposed to the bacterium. Infection can cause diarrhea (which

      may be bloody), fever, nausea, and vomiting, and illness can last from four to 14 days.

      The very young and elderly and those with compromised immune systems are at higher

      risk for complications and may experience more severe and longer lasting diarrhea.

      Toronto Public Health is requesting clinicians to consider shigellosis in the differential

      diagnosis of those presenting with gastroenteritis, inquire about recent sexual activity as

      a possible risk factor and request the appropriate diagnostic testing (stool culture).

      Patients with symptoms should be advised to refrain from sexual activity that may cause

      transmission of infection to others as well as food preparation for others for the duration

      of illness. Shigella can be carried asymptomatically and persons who engage in sexual

      activity that could expose them or their partners to fecal material should be counselled

      to wash their hands and genital/anal areas thoroughly before and after engaging in

      sexual activity. Use of protective barrier equipment also reduces the risk of enteric

      sexually transmitted infections.

       

      Shigellosis is a reportable communicable disease. Please report all suspect and

      confirmed cases of shigellosis to Toronto Public Health immediately by calling

      416-392-7411 (during work hours) and 416-690-2142 (after hours).

      For more information see the TPH fact sheet and background materials on shigellosis at: http://www.toronto.ca/health/cdc/factsheets/shigellosis.htm#04

       

      ALERT ISSUED BY: The Ontario Ministry of Health and Long-Term Care 

      Infectious Syphilis on the Increase in Ontario

      The Ministry of Health and Long-Term Care has informed us of a recent increase in infectious syphilis (Treponema Pallidum) cases in Ontario. 

      The Ministry has identified the following trends through analysis of provincial data:

      • More than half (18 out of 36) public health units in Ontario have reported increases in infectious syphilis cases during the first 8 months of 2009 as compared to 2008.
      • The increase in cases is occuring predominantly within the male population.
      • Of reported male cases with risk factor information available, 85% identify as men who have sex with men (MSM).
      • The largest number of cases occur among males aged 40 to 44 years; and the largest increase in recent cases is seen in males between the ages of 15 to 34.
      • 45% of cases are reported to be co-infected with HIV.
      Therefore, men who have sex with men (MSM) with the following risk factors should be made aware of the increase in infectious syphilis cases, advised to speak with their doctor or sexual health clinic and get tested:
      • Having had unprotected oral or anal sex
      • Having a history of syphilis infection, HIV or other sexually transmitted infections
      • Having multiple sex partners or a partner with multiple sex partners, within the last year.
        •  

        Accurate diagnosis and treatment of syphilis requires clinical evaluation, and is supported by laboratory data.  Syphilis treatment recommendations are based on the staging of the disease.  Timely staging and treatment diminishes the risk of long-term negative outcomes and further infectious syphilis transmission.

        For more detailed information on Syphilis CLICK HERE

        For information on Durham Region Sexual Health Clinics CLICK HERE