“Without a doubt, we are not in front of this outbreak.”

So says Lisa Bastian, manager of the Sexual Health and Blood Borne Virus program, who warns Western Australia is battling a significant health problem: syphilis.

According to the WA Department of Health, the state has reached a 10-year high in recorded cases, sparking an urgent roll-out of public health campaigns.

Ms Bastian says the demographics of people being infected are rapidly changing, resulting in a larger number of vulnerable groups.

“It’s diversifying, the epidemiology and the people at risk are diversifying.”

“In rural and remote areas to this date, it has been young Aboriginal people, both men and women, and that was when the outbreak started,” she says.

“It was people under 30 years of age, but that age range has now widened up to late 30’s.”

Ms Bastian says the most vulnerable groups now also include gay men and men who have sex with men, women of reproductive age, people of linguistically diverse backgrounds, and injecting drug users.

“It has become a more complex epidemiological picture that we are dealing with.”

Ms Bastian says the sometimes asymptomatic nature of syphilis means many people are unaware they have it and are spreading it.

“While it’s highly infectious, the symptoms can look innocuous, or they resolve spontaneously so people don’t worry about them,” she says.

“That disincentivises people from going to a doctor and getting tested.”

Ms Bastian says people may experience a painless ulcer within three months of being infected which lasts around six weeks before clearing up.

“What is happening is possibly because that symptom goes away, they think the problem has resolved and they don’t go and seek testing,” she says.

Sexuality Education Counselling and Consultancy Agency (SECCA) education director Jordina Quain says a lack of education and understanding is also contributing the current outbreaks.

“It’s a really interesting case in the sense that most people don’t think of syphilis when we think of STI’s, you know we’re taught about chlamydia or gonorrhoea or herpes, things like that,” she says.

“When it comes to syphilis specifically, the GPs or the sexual health professionals are needing to be aware of an outbreak.”

“A lot of people don’t know that when you ask for an STI test they’re not actually testing you for every single STI under the sun, they’re mainly testing you for the most common ones based on your sexual practices.”

Ms Quain says stigma and shame are also barriers to preventing the spread of syphilis.

“People can be really uncomfortable to actually go to a GP or a sexual health clinic, to actually get a test, and that fear of being uncomfortable in that moment can sometimes be enough to stop somebody going to get a test,” she says.

“I think with tackling something as big as sexuality shame it’s going to take a lot of different target strategies but campaigns are definitely one of those pieces.”