Report on sexually transmitted infections in Canada, 2017

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Organization: Public Health Agency of Canada

Published: 2019-11-12

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Table of contents

Foreword

The Centre for Communicable Diseases and Infection Control at the Public Health Agency of Canada (PHAC) is pleased to present the Report on Sexually Transmitted Infections in Canada, 2017. This report is intended to provide information on trends in cases and rates of chlamydia, gonorrhea, infectious syphilis and congenital syphilis from 2008 to 2017 to those who require surveillance data including program managers, policy makers, researchers, and others.

Chlamydia, gonorrhea and syphilis are notifiable sexually transmitted infections in Canada. The rates of these three infections have been rising since the late 1990s and continue to be a significant public health concern in Canada. Sexually transmitted infections may have serious consequences on the sexual, reproductive and overall health of individuals and can represent an important burden on the healthcare system.

The Report on Sexually Transmitted Infections in Canada, 2017 is based on surveillance data reported to the Canadian Notifiable Disease Surveillance System (CNDSS) by provincial and territorial health authorities.

Any comments and suggestions that would improve the usefulness of future publications are appreciated and should be sent to the attention of the program staff of the Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada at PHAC.STI-hep-ITS.ASPC@canada.ca.

Acknowledgements

The publication of this report would not have been possible without the collaboration of epidemiological units in all provinces and territories, whose continuous contribution to national sexually transmitted infection surveillance is gratefully appreciated.

This report was prepared by the Centre for Communicable Diseases and Infection Control, Infectious Disease Prevention and Control Branch, Public Health Agency of Canada.

Abbreviations

AB
Alberta
BC
British Columbia
CNDSS
Canadian Notifiable Disease Surveillance System
gbMSM
Gay, bisexual and other men who have sex with men
MB
Manitoba
NAAT
Nucleic Acid Amplification Test
NB
New Brunswick
NL
Newfoundland and Labrador
NS
Nova Scotia
NT
Northwest Territories
NU
Nunavut
ON
Ontario
PE
Prince Edward Island
PHAC
Public Health Agency of Canada
PrEP
Pre-exposure prophylaxis
QC
Quebec
SK
Saskatchewan
STBBI
Sexually Transmitted and Blood-borne Infection
STI
Sexually Transmitted Infection
YK
Yukon
WHO
World Health Organization

List of Figures and Tables

1. Key Messages

Figure 1. Percent change relative to the reference year of 2008 of STI rates in Canada, 2008-2017
Figure 1. Percent change relative to the reference year of 2008 of STI rates in Canada, 2008-2017

Year Relative Change from Reference Year of 2008 (%)
Chlamydia Gonorrhea Syphilis
2008 0% 0% 0%
2009 4% -13% 12%
2010 12% -12% 19%
2011 19% -8% 22%
2012 22% -1% 41%
2013 21% 7% 51%
2014 24% 21% 62%
2015 31% 46% 114%
2016 35% 73% 156%
2017 39% 109% 167%

2. Introduction

Sexually transmitted infections (STIs) continue to be a significant public health concern in Canada. The rate of reported cases of STIs has been steadily increasing since 1997 for chlamydia and gonorrhea and since 2001 for syphilis due to a variety of reasons including improved screening and testing as well as changes in behaviours and in social norms (1-3).

The World Health Organization (WHO) published the Global health sector strategy on sexually transmitted infections, 2016-2021 and set out global targets for ending the STI epidemic as a public health problem (4). The Government of Canada supports the goals and targets of the Global health sector strategy. In June 2018, the Pan-Canadian Sexually Transmitted and Blood-borne Infection Framework for Action was approved and released at the Health Minister's Meeting by federal, provincial, and territorial Ministers of Health (5). The Framework provides an overarching and comprehensive approach to address STBBI, specifying a vision for Canada where new infections are rare and people living with STBBI receive the care, treatment, and support they need (5). The strategic goals of the Framework include: reducing the incidence of STBBIs in Canada; improving access to testing, treatment, and ongoing care and support; and reducing stigma and discrimination that create vulnerabilities to STBBIs (5).

In response to the Framework, the Government of Canada launched its Five-Year Action Plan on STBBI in July 2019 (6). The Action Plan highlights concrete actions to be undertaken over the next five years to move us closer to achieving the strategic goals of the Framework (6). This will be aided by the development of made-in-Canada indicators and targets to drive our domestic actions and unify us in our commitment to specific results (6). Strengthening national surveillance systems is also a key commitment to the Action Plan, given the importance that monitoring and reporting on surveillance data has on measuring the success of our actions (6).

Using data up to 2017, this report provides an update on the three nationally notifiable STIs in Canada: chlamydia, gonorrhea and infectious syphilis. Congenital syphilis data are also presented. This report describes trends in the number of reported cases and rates by age group, sex and province and territory from 2008 to 2017, with a particular focus on the past five years (2013 to 2017) as well as 2017, which is the most recent year for which data are available.

3. Methods

3.1 Data Sources

Provincial and territorial health authorities provide non-nominal data on laboratory-confirmed cases to PHAC through the Canadian Notifiable Disease Surveillance System (CNDSS). Chlamydia has been nationally notifiable since 1991 while gonorrhea and syphilis have been notifiable since 1924. All cases adhered to national case definitions (1-3). Variables submitted along with the diagnosis include age at time of diagnosis, sex, year of diagnosis and province/territory of diagnosis. The received data are validated in collaboration with the corresponding province or territory. Data from January 1 to December 31, 2017, were available from all provinces and territories and were extracted from the CNDSS in April 2019, along with updated historical data from 2008 to 2016.

3.2 Data Analysis

Descriptive analysis was performed using SAS and Microsoft Excel. All stages of syphilis are notifiable but only infectious stages (primary, secondary, and early latent) and congenital syphilis were included in this summary. National annual rates of reported cases of chlamydia, gonorrhea and infectious syphilis were computed using the number of cases from the CNDSS as numerators, and Statistics Canada July 2018 yearly population estimates as denominators. Age group, sex and province/territory-specific incidence rates were also calculated. For all years, incidence rates were reported per 100,000 population. For congenital syphilis, rates were reported per 100,000 live births. Rates, percentages, and change in rates were calculated using unrounded numbers. No statistical procedures were used for comparative analyses. Previous reports may present different rates for some years due to reporting delays, data being updated from provinces and territories or improvements in data cleaning and validation. Rates of chlamydia, gonorrhea and infectious syphilis by age group and sex over time can be retrieved from the Notifiable Disease Online website (7).

4. Chlamydia

The number and rate of reported chlamydia cases are increasing. In 2017, 126,322 cases of chlamydia were reported nationally, corresponding to a national rate of 345.7 cases per 100,000 population. To date, this is the highest number of chlamydia cases ever reported in Canada since the disease was declared notifiable in 1991. Since 2008, the number of chlamydia cases increased by more than 43,000 cases and the rate increased by 39% (248.8 to 345.7 cases per 100,000 population) (Figure 2).

4.1 Sex

In 2017, females comprised 60% of all reported cases of chlamydia (75,992 cases). The proportion of female cases has been steadily decreasing over time, from 66% in 2008 to 60% in 2017. This is due to male rates increasing faster than female rates.

Although females had higher rates of reported chlamydia compared to males every year since 2008, the gap between male and female rates is narrowing. Since 2013, the male rate is increasing an average of 13.8 cases per 100,000 population each year, and the female rate is increasing an average of 8.9 cases per 100,000 population per year.

In 2017, the female rate was approximately 50% higher than the male rate, with 412.8 cases per 100,000 population compared to the male rate of 279.5 cases per 100,000 population (Figure 2).

Figure 2. OverallFootnote a, sex specific rates and number of cases reported for chlamydia in Canada, 2008-2017
Figure 2. OverallFootnote a, sex specific rates and number of cases reported for chlamydia in Canada, 2008-2017

Year Reported Rates per 100,000 population Total Cases
Male Female Overall
2008 168.9 326.8 248.8 82,708
2009 176.1 341.0 259.5 87,283
2010 190.4 364.6 278.5 94,716
2011 203.7 384.6 295.3 101,393
2012 215.3 389.3 303.3 105,281
2013 221.3 377.3 300.2 105,323
2014 231.2 383.7 308.4 109,286
2015 249.9 400.3 326.2 116,451
2016 261.9 407.5 335.7 121,236
2017 276.5 412.8 345.7 126,322

4.2 Age Group

In 2017, more than three quarters (76%) of reported chlamydia cases were among people 15 to 29 years of age. The highest rates of reported chlamydia cases were among the 20 to 24 year age group (1,870.5 cases per 100,000), followed by the 15 to 19 and 25 to 29 year age groups (1,209.0 and 1,024.8 cases per 100,000, respectively). Since 2008, all age groups experienced an increase in rate except those under 15 years of age (Figure 3).

Figure 3. Rates of reported chlamydia cases in Canada, by age group and year, 2008-2017
Figure 3. Rates of reported chlamydia cases in Canada, by age group and year, 2008-2017
Year Age groups
<15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 10.6 999.8 1,345.7 650.5 223.9 40.0 2.7
2009 11.5 1,052.1 1,391.8 675.5 236.7 43.7 3.4
2010 11.3 1,097.7 1,498.9 731.2 263.6 49.0 4.2
2011 11.7 1,145.9 1,607.6 774.5 285.6 53.5 4.4
2012 10.8 1,137.9 1,633.5 833.7 307.8 58.8 4.6
2013 11.3 1,101.0 1,613.2 849.4 317.5 60.1 4.9
2014 10.5 1,092.1 1,661.1 900.9 341.0 64.9 5.9
2015 11.0 1,133.9 1,766.6 964.4 376.5 73.5 6.4
2016 10.2 1,172.3 1,815.6 995.2 395.4 81.4 7.1
2017 9.7 1,209.0 1,870.5 1,024.8 413.1 84.5 7.9

Although all age groups experienced a rate change over time, the magnitude of this change varied by age group. People in the 20 to 24 year age group had the largest absolute rate difference, increasing by 257.4 cases per 100,000 population (16% increase) since 2013.

Older cohorts (those 30 years of age and over) had the lowest rates but experienced the largest relative change in rate in the past five years. As shown in Figure 4, the relative rate change increased with increasing age. For example, between 2013 and 2017, people 60 years of age and older had the largest relative increase in rate (62%), from 4.9 to 7.9 cases per 100,000 population (Appendix A). People in the 40 to 59 year age group had the next largest increase (40%), going from 60.1 to 84.5 cases per 100,000 population.

Figure 4. Relative change in rate of reported chlamydia cases in Canada, by age group, 2013-2017
Figure 4. Relative change in rate of reported chlamydia cases in Canada, by age group, 2013-2017

Age groups Relative Change from Reference Year 2013 (%)
<15 years -14%
15-19 years 10%
20-24 years 16%
25-29 years 21%
30-39 years 30%
40-59 years 40%
60+ years 62%

In terms of sex, in 2017, the proportion of cases attributed to males increased with increasing age. Males comprised 12% of the cases among those younger than 15 years of age and 74% of the cases among those 60 years of age and older (Figure 5)

Figure 5. Proportion of total reported chlamydia cases in Canada, by sex and age group, 2017
Figure 5. Proportion of total reported chlamydia cases in Canada, by sex and age group, 2017

Age groups Proportion of Cases (%) Overall Cases
Male Female
<15 years 12 88 574
15-19 years 24 76 25,244
20-24 years 36 64 44,871
25-29 years 46 54 25,737
30-39 years 51 49 20,462
40-59 years 60 40 8,548
60+ years 74 26 671

For every year between 2008 and 2017, female rates were higher than male rates among people younger than 30 years of age. Accordingly, male rates were consistently higher than female rates among people over 40 years of age (Appendix A). In 2017, male rates were only slightly higher than female rates among those 30-39 years of age (Figure 6).

Figure 6. Rates of reported chlamydia cases in Canada, by sex and age group, 2017
Figure 6. Rates of reported chlamydia cases in Canada, by sex and age group, 2017

Age groups Reported Rates per 100,000 population
Male Female
<15 years 2.3 17.5
15-19 years 562.3 1,891.7
20-24 years 1,287.8 2,499.4
25-29 years 918.0 1,136.3
30-39 years 420.0 403.6
40-59 years 102.0 66.9
60+ years 12.5 3.8

4.3 Geographic Distribution

4.3.1 Overall rates by province/territory

Rates of reported chlamydia cases varied by province and territory. In 2017, rates ranged from 181.2 in Newfoundland to 3,887.9 cases per 100,000 in Nunavut. The highest rates were among people from the Canadian territories, with rates of 757.0 cases per 100,000 (Yukon), 1,942.8 cases per 100,000 (Northwest Territories) and 3,887.9 cases per 100,000 (Nunavut) (Figure 7). These three territories have held the highest rates across Canada over the past decade (Appendix D). Also, Saskatchewan and Manitoba reported rates above the Canadian average (564.2 and 542.8 per 100,000, respectively).

Figure 7. Rates of reported chlamydia cases in Canada, by province/territory, 2017
Figure 7. Rates of reported chlamydia cases in Canada, by province/territory, 2017

Province or Territory Reported Rates per 100,000 population
British Columbia 318.8
Alberta 390.8
Saskatchewan 564.2
Manitoba 542.8
Ontario 317.3
Quebec 320.9
New Brunswick 276.3
Nova Scotia 314.0
Prince Edward Island 218.5
Newfoundland and Labrador 181.2
Yukon 757.0
Northwest Territories 1,942.8
Nunavut 3,887.9
Canada 345.7

Although the highest rates were among those in the three territories, the largest relative increases in rate since 2013 are occurring elsewhere in Canada. Prince Edward Island had the largest relative rate increase (30%), from 167.9 to 218.5 cases per 100,000, and Ontario had the second largest increase (24%) from 256.7 to 317.3 cases per 100,000 population (Figure 8). Notably, the rates in the Northwest Territories and Nunavut appear to be decreasing, dropping 2% in the Northwest Territories and 7% in Nunavut since 2013.

Figure 8. Relative change in rate of reported chlamydia cases in Canada, by province/territory, 2013-2017
Figure 8. Relative change in rate of reported chlamydia cases in Canada, by province/territory, 2013-2017

Province or Territory Relative Change from Reference Year 2013 (%)
British Columbia 21%
Alberta -3%
Saskatchewan 8%
Manitoba 7%
Ontario 24%
Quebec 17%
New Brunswick 18%
Nova Scotia 20%
Prince Edward Island 30%
Newfoundland and Labrador 19%
Yukon 16%
Northwest Territories -2%
Nunavut -7%
Canada 15%

4.3.2 Distribution of cases by sex across provinces and territories

Amongst all provinces and territories, the majority of cases were female. In 2017, the province with the lowest proportion of female cases was British Columbia with 57% of cases being female. The provinces with the highest proportion of female cases were Nova Scotia and Prince Edward Island, with 67% of cases being female. Overall, the proportion of cases by sex in provinces and territories remained fairly close to the national proportion of 60% female cases and 40% male.

4.3.3 Distribution of cases by age group across provinces and territories

In all provinces and territories, rates of reported cases of chlamydia were higher among those aged 20-24 years in 2017 (Table 1).

Table 1. Rates of reported chlamydia cases, by age group and by province/territory, 2017
Jurisdiction Age groups (in years)
<15 15-19 20-24 25-29 30-39 40-59 60+
BC 6.2 868.9 1,573.3 1,000.2 455.6 113.8 13.1
AB 13.6 1,407.6 1,965.7 1,047.7 436.6 91.9 9.9
SK 30.8 2,478.7 2,970.5 1,478.1 566.8 86.6 6.5
MB 28.1 2,079.5 2,545.9 1,534.1 631.7 95.2 4.3
ON 4.4 956.0 1,688.0 950.9 390.3 81.1 7.7
QC 10.1 1,331.6 1,909.8 954.8 364.2 77.9 6.5
NB 6.3 1,125.3 2,145.7 882.6 295.3 34.6 0.9
NS 6.7 1,353.2 2,252.0 916.5 265.8 27.2 3.4
PE 0.0 543.9 1,470.9 952.1 222.8 40.3 0.0
NL 5.4 702.8 1,392.2 635.3 176.7 30.7 0.7
YT 45.2 3,352.2 3,962.6 2,597.0 750.9 100.4 0.0
NT 131.4 6,787.5 8,686.4 4,894.2 1,748.6 517.4 70.3
NU 141.5 12,740.5 13,642.3 9,522.4 3,931.5 932.0 286.3
Canada 9.7 1,209.0 1,870.5 1,024.8 413.1 84.5 7.9

5. Gonorrhea

The number and rate of reported gonorrhea cases are increasing. In 2017, 29,034 cases of gonorrhea were reported nationally, corresponding to a national rate of 79.5 cases per 100,000 population. The number and rate were relatively stable between 2008 and 2013. Since 2013, the number of gonorrhea cases has more than doubled and the rate increased by 96% (40.6 to 79.5 cases per 100,000), the highest relative increase of all three STIs (Figure 9).

5.1 Sex

Since 2008, males comprised the majority of reported gonorrhea cases in Canada. In 2017, males comprised 65% of all reported cases of gonorrhea (18,734 cases). Compared to females, males had higher rates of reported gonorrhea in all years since 2008. In 2017, the male rate was nearly twice as high as the female rate, with 103.3 cases per 100,000 population compared to the female rate of 55.6 cases per 100,000 population (Figure 9). Male rates are also increasing more quickly than female rates, creating a wider gap between male and female rates. Since 2013, the male rate increased by an average of 13.8 cases per 100,000 population per year, compared to the female rate which increased by an average of 5.7 cases per 100,000 population per year.

Figure 9. TotalFootnote a number and sex-specific rates of reported gonorrhea cases in Canada, 2008-2017
Figure 9. TotalFootnote a number and sex-specific rates of reported gonorrhea cases in Canada, 2008-2017

Year Reported Rates per 100,000 population Total Cases
Male Female Overall
2008 42.6 33.5 38.0 12,634
2009 36.7 29.6 33.2 11,156
2010 37.8 29.1 33.5 11,381
2011 40.2 29.6 34.9 11,981
2012 42.6 32.5 37.5 13,027
2013 48.2 32.9 40.6 14,228
2014 58.8 33.0 45.9 16,264
2015 70.3 40.8 55.5 19,817
2016 84.4 47.0 65.7 23,709
2017 103.3 55.6 79.5 29,034

5.2. Age Group

In 2017, the highest rates of reported gonorrhea cases were among the 20 to 24 year and 25 to 29 year age groups, with 272.0 and 263.7 cases per 100,000 population, respectively. Since 2008, all age groups experienced an overall increase in rate (Figure 10).

Figure 10. Rates of reported gonorrhea cases in Canada, by age group and year, 2008-2017
Figure 10. Rates of reported gonorrhea cases in Canada, by age group and year, 2008-2017

Year Age groups
<15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 1.9 118.2 165.8 101.3 48.8 14.8 2.0
2009 1.7 103.3 146.9 87.4 41.3 13.4 1.7
2010 1.8 101.4 141.4 92.2 42.8 14.1 2.3
2011 1.6 100.7 147.1 97.0 45.6 15.9 2.2
2012 1.7 106.1 158.0 111.4 50.8 16.1 2.1
2013 2.1 109.3 164.4 121.2 59.9 18.3 2.1
2014 1.5 102.8 184.0 142.1 72.8 23.3 3.0
2015 1.7 113.6 210.5 179.1 99.4 28.1 3.3
2016 1.7 125.5 235.8 212.8 121.6 36.8 4.8
2017 2.2 150.5 272.0 263.7 152.3 45.0 5.4

The magnitude of the change in rate over time varied by age group. The 25 to 29 year age group increased the most, up 142.5 cases per 100,000 population since 2013 (Appendix B). Notably, compared to 2013, all age groups above 24 years of age more than doubled in rate (Figure 11).

Figure 11. Relative change in rate of reported gonorrhea cases in Canada, by age group, 2013-2017
Figure 11. Relative change in rate of reported gonorrhea cases in Canada, by age group, 2013-2017

Age groups Relative Change from Reference Year 2013 (%)
<15 years 5%
15-19 years 38%
20-24 years 65%
25-29 years 118%
30-39 years 154%
40-59 years 145%
60+ years 150%

In terms of sex, in 2017, the proportion of cases attributed to males increased with increasing age. Males comprised 17% of the cases among those younger than 15 years of age and 89% of the cases among those 60 years of age and older (Figure 12).

Figure 12. Proportion of total reported gonorrhea cases in Canada, by sex and age group, 2017
Figure 12. Proportion of total reported gonorrhea cases in Canada, by sex and age group, 2017

Age groups Proportion of Cases (%) Overall Cases
Male Female
<15 years 17 83 128
15-19 years 37 63 3,132
20-24 years 55 45 6,525
25-29 years 66 34 6,619
30-39 years 71 29 7,557
40-59 years 83 17 4,552
60+ years 89 11 456

For every year between 2008 and 2017, male rates were higher than female rates among people older than 20 years of age. In 2017, male rates for those above 29 years of age were more than double those among their female counterparts (Figure 13).

Figure 13. Rates of reported gonorrhea cases in Canada, by sex and age group, 2017
Figure 13. Rates of reported gonorrhea cases in Canada, by sex and age group, 2017

Age groups Reported Rates per 100,000 population
Male Female
<15 years 0.7 3.7
15-19 years 106.4 195.8
20-24 years 287.7 254.4
25-29 years 338.4 184.3
30-39 years 217.5 86.7
40-59 years 75.3 14.9
60+ years 10.3 1.1

5.3. Geographic Distribution

5.3.1 Overall rates by province/territory

Rates of reported gonorrhea cases varied by province and territory. In 2017, rates ranged from 5.3 cases per 100,000 population in Newfoundland to 1,451.3 cases per 100,000 in Nunavut. Since 2013, the highest rates have been among people from Nunavut and the Northwest Territories, both with rates above 1,000 cases per 100,000 population in 2017. Manitoba had the third highest rate with 250.0 cases per 100,000 population (Figure 14). The four Maritime Provinces (NB, NL, NS, and PE) have held the lowest rates of reported gonorrhea cases since 2013 (Appendix D).

Figure 14. Rates of reported gonorrhea cases in Canada, by province/territory, 2017
Figure 14. Rates of reported gonorrhea cases in Canada, by province/territory, 2017

Province or Territory Reported Rates per 100,000 population
British Columbia 66.9
Alberta 112.1
Saskatchewan 193.1
Manitoba 250.0
Ontario 55.8
Quebec 74.0
New Brunswick 7.6
Nova Scotia 24.4
Prince Edward Island 12.0
Newfoundland and Labrador 5.3
Yukon 194.3
Northwest Territories 1,061.5
Nunavut 1,451.3
Canada 79.5

The largest relative increase in rate since 2013 was observed in Yukon (up 610%, from 27.4 to 194.3 cases per 100,000 population in 2017) and the Northwest Territories (up 379%, from from 221.4 to 1,061.5 cases per population in 2017). Since 2013 and with the exception of Newfoundland, all provinces and territories increased in rate. Due to the consistency in high rates in Nunavut, it had the smallest relative rate increase (10%) in Canada between 2013 and 2017 (Figure 15).

Figure 15. Relative change in rate of reported gonorrhea cases in Canada, by province/territory, 2013-2017
Figure 15. Relative change in rate of reported gonorrhea cases in Canada, by province/territory, 2013-2017

Province or Territory Relative Change from Reference Year 2013 (%)
British Columbia 68%
Alberta 121%
Saskatchewan 75%
Manitoba 160%
Ontario 66%
Quebec 128%
New Brunswick 22%
Nova Scotia 137%
Prince Edward Island 187%
Newfoundland and Labrador -32%
Yukon 610%
Northwest Territories 379%
Nunavut 10%
Canada 96%

5.3.2 Distribution of cases by sex across provinces and territories

The proportion of male cases ranged from 42% to 79% across provinces and territories in 2017 (Figure 16). The majority of provinces and territories had a greater number of male cases than female: eight provinces and territories reported having a greater proportion of male cases, and four provinces and territories reported having a greater proportion of female cases. The Northwest Territories reported an even split between male and female cases. The provinces with the greatest proportion of male cases were Quebec and Newfoundland and Labrador, with 79% of reported cases being male. The territory with the greatest proportion of female cases was Nunavut, with 58% of reported cases being female. Overall, in Canada, the majority of reported gonorrhea cases were male, with 65% of proportion of cases reporting as male and 35% as female.

Figure 16. Proportion of total reported gonorrhea cases in Canada, by sex and by province/territory, 2017
Figure 16. Proportion of total reported gonorrhea cases in Canada, by sex and by province/territory, 2017

Province/Territory Proportion of Reported Cases (%)
Male Female
British Columbia 72 28
Alberta 57 43
Saskatchewan 46 54
Manitoba 47 53
Ontario 71 29
Quebec 79 21
New Brunswick 57 43
Nova Scotia 63 38
Prince Edward Island 67 33
Newfoundland and Labrador 79 21
Yukon 45 55
Northwest Territories 50 50
Nunavut 42 58
Canada 65 35

5.3.3 Distribution of cases by age group across provinces and territories

In all provinces and territories, rates of reported cases of gonorrhea were higher among those aged 20-29 in 2017 except in Newfoundland and Labrador where rates were higher in those aged 25-39 (Table 2).

Table 2. Rates of reported gonorrhea cases, by age group and by province/territory, 2017
Jurisdiction Age groups (in years)
<15 15-19 20-24 25-29 30-39 40-59 60+
BC 1.1 75.7 189.6 229.7 143.9 46.6 5.6
AB 3.4 207.7 369.6 344.6 202.4 54.9 6.0
SK 9.4 547.5 817.5 592.9 312.6 58.4 7.8
MB 11.9 671.4 1,042.8 772.7 394.2 76.1 6.8
ON 0.5 91.7 177.7 184.7 106.4 35.9 4.1
QC 1.5 108.0 241.3 241.5 151.3 55.9 7.8
NB 0.0 12.2 23.0 46.9 16.8 3.6 0.0
NS 0.0 36.6 100.0 112.7 47.7 11.8 0.4
PE 0.0 0.0 72.5 45.9 17.1 9.5 0.0
NL 0.0 7.2 6.9 23.3 13.0 5.6 0.0
YT 15.1 613.8 890.5 674.5 312.9 25.1 0.0
NT 10.9 2,452.0 3,238.5 3,227.5 1,597.1 471.1 17.6
NU 74.9 3,311.3 4,601.4 3,820.9 2,055.9 503.8 245.4
Canada 2.2 150.5 272.0 263.7 152.3 45.0 5.4

6. Infectious Syphilis

The number and rate of reported infectious syphilis cases are increasing. In 2017, 4,083 cases of infectious syphilis were reported nationally, corresponding to a national rate of 11.2 cases per 100,000 population. Since 2008, the number of infectious syphilis cases and the rates have more than doubled (1,393 cases and a rate of 4.2 per 100,000 in 2008) (Figure 17). Infectious syphilis had the highest increase in rates of all STIs with more than 167% increase over the past decade.

6.1 Sex

Since 2008, males comprised the large majority (>85%) of reported infectious syphilis cases every year in Canada. In 2017, males comprised 89% of all reported cases of infectious syphilis (3,622 cases). Since 2013, in absolute terms, the male rate increased by an average of 2.0 cases per 100,000 population per year (from 11.9 to 20.0 per 100,000), compared to the female rate which increased by an average of 0.4 cases per 100,000 population per year (from 0.8 to 2.4 per 100,000). The rate increase in males was particularly steep from 2014 to 2016 with an average 3.6% annual relative increase. The increase appeared to be slowing down in 2016-2017 (1% relative increase). Although male rates were higher and in absolute terms increased at a higher rate, the relative increase in rate was higher among females in the past 5 years (197% vs. 68%) (Figure 17). Compared to females, males had higher rates of reported infectious syphilis in all years since 2008. In 2017, the male rate was more than eight times higher than the female rate, with 20.0 cases per 100,000 population compared to the female rate of 2.4 cases per 100,000 population (Figure 17).

Figure 17. TotalFootnote a number and sex-specific rates of reported infectious syphilis cases in Canada, 2008-2017
Figure 17. TotalFootnote a number and sex-specific rates of reported infectious syphilis cases in Canada, 2008-2017

Year Reported Rates per 100,000 population Total Cases
Male Female Overall
2008 7.3 1.1 4.2 1,393
2009 8.6 0.9 4.7 1,584
2010 9.2 0.9 5.0 1,696
2011 9.6 0.7 5.1 1,749
2012 11.3 0.6 5.9 2,053
2013 11.9 0.8 6.3 2,215
2014 12.7 0.9 6.8 2,399
2015 17.0 1.0 9.0 3,199
2016 19.8 1.7 10.7 3,870
2017 20.0 2.4 11.2 4,083

6.2 Age Group

In 2017, the highest rates of reported infectious syphilis cases were among the 25 to 29 and 30 to 39 year age groups, with 26.7 and 24.5 cases per 100,000 population, respectively (Appendix C). People over 60 and under 20 years of age held the lowest rates (at or under 6 cases per 100,000) in all years since 2008. Since 2008, all age groups experienced an increase in rate (Figure 18). The 25 to 29 and 30 to 39 year age groups increased the most, each up about 13 cases per 100,000 since 2013 (Appendix C).

Figure 18. Rates of reported infectious syphilis cases in Canada, by age group and year, 2008-2017
Figure 18. Rates of reported infectious syphilis cases in Canada, by age group and year, 2008-2017

Year Age groups
<15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 0.0 1.6 6.4 8.1 7.9 6.2 0.9
2009 0.0 2.2 8.1 10.0 9.0 6.5 0.8
2010 0.0 2.7 8.2 9.0 8.7 7.4 1.2
2011 0.0 3.1 9.1 10.9 9.2 7.0 1.0
2012 0.0 4.0 12.2 11.7 10.7 7.8 1.4
2013 0.0 3.0 12.4 14.1 11.6 8.2 1.6
2014 0.0 3.1 12.1 14.1 13.3 9.3 1.4
2015 0.0 3.5 14.0 20.6 18.0 12.3 2.1
2016 0.0 4.7 17.4 23.9 21.5 14.9 2.5
2017 0.1 5.6 20.0 26.7 24.5 13.7 2.5

Compared to 2013, all age groups increased by 50% or more (Figure 19). The 30 to 39 year age group more than doubled since 2013, from 11.6 to 24.5 cases per 100,000 (Appendix C). Since 2008, only nine cases were reported among those aged 10 to 14 years old and no cases were reported among those under 10 years of age. Due to these smaller numbers, changes in rate should therefore be interpreted with caution for the under 15 years age group.

Figure 19. Relative change in rate of reported infectious syphilis cases in Canada, by age group, 2013-2017
Figure 19. Relative change in rate of reported infectious syphilis cases in Canada, by age group, 2013-2017

Age groups Relative Change from Reference Year 2013 (%)
<15 years 189%
15-19 years 86%
20-24 years 61%
25-29 years 90%
30-39 years 111%
40-59 years 66%
60+ years 50%

In terms of sex, in 2017, the proportion of cases attributed to males increased with increasing age. Males comprised 51% of the cases among 15 to 19 years of age and 97% of the cases among those 60 years of age and older. Of the three cases reported among people younger than 15 years of age, one was male and two were female (Figure 20).

Figure 20. Proportion of total reported infectious syphilis cases in Canada, by sex and age group, 2017
Figure 20. Proportion of total reported infectious syphilis cases in Canada, by sex and age group, 2017

Age groups Proportion of Cases (%) Overall Cases
Male Female
<15 years 33 67 3
15-19 years 51 49 117
20-24 years 80 20 478
25-29 years 85 15 669
30-39 years 91 9 1,211
40-59 years 94 6 1,384
60+ years 97 3 208

For every year between 2008 and 2017, male rates were higher than female rates among people 20 years of age and older. In 2017, the relative gap between male and female rates grew with increasing age. Specifically, male and female rates were similar for people younger than 20 years of age, then male rates were approximately 4-, 5-, 10, 17- and 38-times higher than their female counterpart rates, for age groups 20 to 24, 25 to 29, 30 to 39, 40 to 59, and 60 years of age and older, respectively (Figure 21).

Figure 21. Rates of reported infectious syphilis cases in Canada, by sex and age group, 2017
Figure 21. Rates of reported infectious syphilis cases in Canada, by sex and age group, 2017

Age groups Reported Rates per 100,000 population
Male Female
<15 years 0.0 0.1
15-19 years 5.6 5.6
20-24 years 30.7 8.2
25-29 years 44.2 8.1
30-39 years 44.2 4.5
40-59 years 26.0 1.5
60+ years 5.1 0.1

6.3 Geographic Distribution

6.3.1 Overall rates by province/territory

Rates of reported infectious syphilis cases varied by province and territory. In 2017, rates ranged from 2.5 to 234.3 cases per 100,000 in New Brunswick and Nunavut, respectively. Nunavut reported the highest rate in Canada every year since 2013, ranging from 139.8 cases per 100,000 in 2015 to 262.3 cases per 100,000 in 2016. For the past four years, Manitoba held the next highest rates, from 9.2 cases per 100,000 in 2014 and increasing to 18.8 cases per 100,000 in 2017. The Maritime Provinces had the lowest rates in Canada in 2016 and 2017 (Figure 22).

Figure 22. Rates of reported infectious syphilis cases in Canada, by province/territory, 2017
Figure 22. Rates of reported infectious syphilis cases in Canada, by province/territory, 2017

Province or Territory Reported Rates per 100,000 population
British Columbia 10.4
Alberta 12.6
Saskatchewan 10.4
Manitoba 18.8
Ontario 11.2
Quebec 11.0
New Brunswick 2.5
Nova Scotia 2.7
Prince Edward Island 2.7
Newfoundland and Labrador 7.4
Yukon 0.0
Northwest Territories 11.1
Nunavut 234.3
Canada 11.2

Due to the consistency in high rates in Nunavut, Nunavut reported one of the lowest relative increases in rate since 2013 (45%) (Figure 23). The highest increase was seen in Saskatchewan (575%), from 1.5 cases per 100,000 in 2013 to 10.4 cases per 100,000 population in 2017. On the other end, Nova Scotia experienced a 69% decrease. Since 2013, three provinces (NB, NS and PE) experienced a decrease in rate, and eight provinces and territories experienced an increase in rate (BC, AB, SK, MB, ON, QC, NL, NU) (Figure 23). Yukon reported 2 cases in 2013 and has not reported cases since then (Appendix D). In the past 5 years, the Northwest Territories only reported 1 case in 2015 and 5 in 2017 (Appendix D).

Figure 23. Relative change in rate of reported infectious syphilis cases in Canada, by province/territory, 2013-2017
Figure 23. Relative change in rate of reported infectious syphilis cases in Canada, by province/territory, 2013-2017

Province or Territory Relative Change from Reference Year 2013 (%)
British Columbia 6%
Alberta 305%
Saskatchewan 575%
Manitoba 303%
Ontario 102%
Quebec 43%
New Brunswick -45%
Nova Scotia -69%
Prince Edward Island -23%
Newfoundland and Labrador 386%
Yukon -
Northwest Territories -
Nunavut 45%
Canada 77%

6.3.2 Distribution of cases by sex across provinces and territories

The proportion of male/female syphilis cases was more heterogeneous across provinces and territories compared to chlamydia and gonorrhea (Figure 24). The majority of provinces and territories reported a greater proportion of cases being male. The Northwest Territories reported the greatest proportion of male cases, with all five cases reported as male. In contrast, Nunavut reported the smallest proportion of male cases, with 38% of syphilis cases reported as male. Nationally, 89% of reported syphilis cases were male, and 11% of cases female in 2017.

Figure 24. Proportion of total reported syphilis cases in Canada, by sex and by province/territory, 2017
Figure 24. Proportion of total reported syphilis cases in Canada, by sex and by province/territory, 2017

Province/Territory Proportion of Reported Cases (%)
Male Female
British Columbia 97 3
Alberta 77 23
Saskatchewan 93 8
Manitoba 62 38
Ontario 95 5
Quebec 93 7
New Brunswick 89 11
Nova Scotia 96 4
Prince Edward Island 50 50
Newfoundland and Labrador 87 13
Yukon - -
Northwest Territories 100 0
Nunavut 38 63
Canada 89 11

Note: Yukon reported 0 cases of syphilis in 2017.

6.3.3 Distribution of cases by age group across provinces and territories

In the vast majority of provinces and territories, rates of reported cases of infectious syphilis were higher among those aged 25-39 in 2017 (Table 3). However, cases reported in Manitoba, Prince Edward Island and Newfoundland and Labrador were slightly younger with the rates higher among the 20-29 age group. Also, both the Northwest Territories and Nunavut saw their highest rates among 15-19 years olds.

Table 3. Rates of reported infectious syphilis cases, by age group and by province/territory, 2017
Jurisdiction Age groups (in years)
<15 15-19 20-24 25-29 30-39 40-59 60+
BC 0.0 3.3 13.2 23.0 24.0 14.0 2.0
AB 0.2 7.7 22.9 30.6 23.7 14.2 3.4
SK 0.0 11.3 16.0 23.8 22.5 12.5 2.9
MB 0.0 12.6 45.7 65.3 37.4 17.3 2.5
ON 0.0 2.5 17.5 26.1 26.5 14.3 2.1
QC 0.1 4.5 22.1 23.5 23.3 14.2 3.4
NB 0.0 4.9 4.6 4.7 6.7 2.7 0.5
NS 0.0 0.0 5.0 5.0 9.0 2.9 0.8
PE 0.0 0.0 20.7 22.9 0.0 0.0 0.0
NL 0.0 7.2 27.6 20.0 4.9 11.3 1.4
YT 0.0 0.0 0.0 0.0 0.0 0.0 0.0
NT 0.0 35.5 0.0 26.5 27.5 7.7 0.0
NU 0.0 788.4 680.5 447.8 288.5 138.5 0.0
Canada 0.1 5.6 20.0 26.7 24.5 13.7 2.5

6.4 Congenital Syphilis

The number of confirmed congenital syphilis cases reported in Canada varied from one to ten cases per year from 2008 to 2017 (Table 4). Over the past decade, a downward trend was observed between 2009 and 2013-2014 (high of 10 cases in 2009 and low of one case reported both in 2013 and 2014) followed by an upward trend (up to seven cases in 2017). Changes in rate should be interpreted with caution due to low case numbers.

Table 4. Number of reported cases and rates of congenital syphilis in Canada, by year, 2008-2017
Indicator Year of Diagnosis
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number of cases 5 10 5 4 3 1 1 5 4 7
Rate per 100,000 live births 1.32 2.63 1.33 1.06 0.79 0.26 0.26 1.31 1.04 1.86

7. Discussion

Chlamydia continues to be the most commonly reported STIs with 126,322 cases reported across Canada in 2017. More than 29,034 cases were also reported for gonorrhea and 4,083 cases for syphilis in 2017. Over the past decade (2008-2017), rates for all STIs have increased dramatically. The high and increasing rates seen in the Canadian territories are also of continuing concern. Notably, Nunavut had the highest rates of all three STIs in 2017. In addition, other high-income countries such as the United States of America (USA), Australia and the United Kingdom have reported similar trends (8-10).

Several factors may help to explain the STI rate increases across Canada and internationally such as a true rise in incidence due to risky sexual behaviours and changing societal norms (e.g. use of geospatial dating applications, decline in condom use, etc.), as well as changes in diagnostic, screening, case finding and reporting practices. The Public Health Agency of Canada published three articles on surveillance of chlamydia, gonorrhea, and syphilis in Canada for 2010-2015 in February 2018 (1-3). These articles detail and expand on several possible reasons for increases in STIs.

There is an increased use of nucleic acid amplification testing (NAAT) for both gonorrhea and chlamydia infections in Canada which is a very sensitive diagnostic test and uses less invasive sample collection methods (using urine or vaginal swabs). Of all the gonorrhea cases reported in 2017 at the NML, more than 70% were diagnosed by NAAT (11). The use of NAAT resulted in a significant increase of the number of cases diagnosed, especially during the late 90s and early 2000s (12-14).

The burden of STIs varied by sex. From 2008 to 2017, rates for chlamydia were always higher among females compared to males. In contrast - for gonorrhea and infectious syphilis - rates were always higher among males compared to females. Notably, males comprised the vast majority of infectious syphilis cases in all years.

While absolute rates tell us one part of the story, the five-year relative increase shows how rates are changing over time by sex which differs for each STI. The gap is slightly narrowing for both syphilis and chlamydia: while the female rates for infectious syphilis are increasing at a much higher rate than that of males (197% vs. 68% for the relative increase between 2013-2017), it is the opposite for chlamydia (relative increase of 25% among males vs. 9% among females). For gonorrhea, the male rates are increasing more quickly than female rates, which is creating a wider gap between male and female rates. The improved screening coverage in men (higher extra-genital infection detections) may contribute to the recent male increase of chlamydial infections (15).

In terms of age, the highest rates of chlamydia occurred among a younger cohort than those of gonorrhea and infectious syphilis. The highest rates of chlamydia were among the 15 to 24 year age groups, while the highest rates of gonorrhea occurred among the 20 to 29 year age groups and those of infectious syphilis occurred among the 25 to 39 year age groups. The high rates of STIs among young Canadians may reflect a number of barriers identified such as a lack of knowledge of STIs, lack of health care services, insufficient screening, embarrassment attached to seeking STI services, method of specimen collection, suboptimal risk awareness and poor knowledge of risk-reduction behaviours (16, 17). In addition, most rates increased over the past decade. These changes occurred dramatically for some groups, such as the absolute increase in chlamydia and gonorrhea rates among young adults, and the relative increase in rate observed among those 60 years of age and older.

The Canadian Guidelines on STIs include sexually active females under 25 years of age as an at-risk group for chlamydia which may translate into more frequent screening among this specific population (18). Several studies reported that there are biological, psychological, social and structural reasons why women had higher rates and were younger than men. In addition, younger women may be biologically more susceptible to chlamydia due to cervical ectopy (common physiological process that affects cells in the cervix) (19). The impact of STIs among young women is of concern as this may result in possible negative reproductive health consequences, which highlights the importance of ongoing and improved monitoring of those notifiable diseases across all Canadian jurisdictions.

For gonococcal infections, the emergence of reduced susceptibility and resistance to first-line medications may explain the current rate increase reported (20). Indeed, 63% of gonorrhea isolates tested in 2017 were resistant to at least one antibiotic (11). Of those, 13% were resistant to at least one first-line agent currently used to treat gonorrhea (either azithromycin; 11.7%, cefixime; 0.6% or ceftriaxone; 0.5%) based on 5,290 cultures tested in 2017 (11). Also, changes in prevalent strain type may be one reason for the increase (21). The National Microbiology Laboratory (NML) analyzed by molecular genotyping all N. gonorrhoeae isolates submitted and found that the strain types did vary in recent years (11). For example, strain type 12302 increased from 4.3% of all isolates in 2015 to 10.5% in 2016 and to 24.1% in 2017 (11). Continued surveillance for strain types and antimicrobial resistant gonorrhea is critical in Canada and remains a priority towards reducing the incidence of STIs as outlined in the Pan-Canadian Framework for Action (5).

This report highlights the sharp increase of reported cases of infectious syphilis over the past decade and therefore in the reported rates. This increase as well as the gonorrhea rate increase appears to be largely attributable to men and particularly among gay, bisexual and other men who have sex with men (gbMSM) (18). The use of social networking sites or mobile applications to find sex partners particularly among gbMSM appears to be linked to casual sexual partners and unsafe sex. Other behavioural factors such as increasing condomless anal sex and a higher number of sexual partners may have contributed to the increasing syphilis trend. Health Canada approved pre-exposure prophylaxis (PrEP) in February 2016 as part of a comprehensive HIV Prevention strategy (22). The study ENGAGE, which surveyed gbMSM across Canada showed that 7.4% (4.4-10.5%) used PrEP at least once in the past 6 months while this increased to 18.4% (11.5-25.2%) among those who had six or more sexual partners (23). A recent study conducted in Montreal observed an increased STI incidence while on PrEP, however, the effect was inconclusive after adjustment for the frequency of screening visits (24). Authors concluded that STI prevention, diagnosis and treatment should continue to be offered at regular intervals (24).

In 2018-2019, there have been reports of a rise in the number of infectious syphilis and congenital syphilis cases across Canada, with several jurisdictions reports outbreaks (e.g. Manitoba reported a significant increase in congenital syphilis cases in May 2019, Saskatchewan declared an outbreak in several First Nations communities in June 2019, and Alberta declared a province-wide outbreak in July 2019) (25-30). While PHAC's latest surveillance data cover up to 2017, an infographic presenting the national picture with preliminary 2018 data was developed in collaboration with provinces and territories and was published in the Canada Communicable Disease Report (31). It showed that the number of infectious syphilis cases as well as the number of congenital cases and corresponding rates in Canada continued to increase in 2018 (31).

Lastly, please note that this report is subject to some data limitations. Some number of cases were low such as congenital syphilis. This leads to less stable rates and therefore, variations in rates over time should be interpreted with caution. Also, data presented in this report likely underestimates the incidence rate of STIs from 2008 to 2017 in Canada as some infections may be asymptomatic, unscreened, undiagnosed or unreported. Screening, laboratory testing and reporting practices varied across provinces and territories. This means that direct comparison between provinces should be made with caution. In addition, information on risk factors is unavailable in the CNDSS, limiting our ability to identify factors associated with higher STI rates.

8. Conclusion

STIs remain a public health concern in Canada. The rates of reported chlamydia, gonorrhea and infectious syphilis increased substantially over the past decade. Between 2008 and 2017, the rates of chlamydia increased by 39%, gonorrhea by 109% and infectious syphilis by an alarming 167%. STIs also spanned all sexes, age groups, and provinces and territories. Ongoing monitoring of STIs and continued research will help to inform STI prevention and control activities.

References

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APPENDIX A - Rates of reported chlamydia cases per 100,000 population in Canada, by sex and age group, 2008-2017

Rates of reported chlamydia cases per 100,000 MALES, by age group in Canada, 2008-2017
Year Rate per 100,000 males
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 168.9 2.4 366.0 895.4 536.6 206.2 45.5 4.2
2009 176.1 2.5 401.9 924.1 562.2 210.9 47.1 4.9
2010 190.4 2.4 422.2 992.3 609.1 238.8 50.6 6.3
2011 203.7 2.2 446.7 1,078.4 651.9 252.9 56.1 6.0
2012 215.3 2.4 466.4 1,090.6 714.3 277.2 62.1 6.3
2013 221.3 2.3 455.4 1,095.6 744.0 300.4 66.8 7.7
2014 231.2 1.4 460.7 1,135.8 777.9 324.7 72.9 9.2
2015 249.9 1.9 503.7 1,207.8 838.8 362.6 83.2 10.2
2016 261.9 1.9 521.9 1,249.5 866.1 393.2 94.1 10.8
2017 276.5 2.3 562.3 1,287.8 918.0 420.0 102.0 12.5
Rates of reported chlamydia cases per 100,000 FEMALES, by age group in Canada, 2008-2017
Year Rate per 100,000 females
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 326.8 19.2 1,659.8 1,812.1 764.8 241.4 34.5 1.4
2009 341.0 20.9 1,729.2 1,874.5 788.2 262.0 40.1 2.2
2010 364.6 20.7 1,803.8 2,018.2 853.5 288.1 47.4 2.3
2011 384.6 21.8 1,879.8 2,150.1 896.7 317.9 50.6 3.0
2012 389.3 19.6 1,850.7 2,198.4 953.9 338.0 55.4 3.1
2013 377.3 20.7 1,789.3 2,158.6 956.6 333.9 53.5 2.4
2014 383.7 20.1 1,765.9 2,221.7 1,026.6 356.9 56.8 3.1
2015 400.3 20.5 1,804.7 2,367.7 1,093.8 389.7 63.9 3.1
2016 407.5 18.9 1,862.6 2,427.7 1,129.5 396.3 68.6 3.9
2017 412.8 17.5 1,891.7 2,499.4 1,136.3 403.6 66.9 3.8
Rates of reported chlamydia cases per 100,000 population OVERALLFootnote *, by age group in Canada, 2008-2017
Year Rate per 100,000 population - Overall
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 248.8 10.6 999.8 1,345.7 650.5 223.9 40.0 2.7
2009 259.5 11.5 1,052.1 1,391.8 675.5 236.7 43.7 3.4
2010 278.5 11.3 1,097.7 1,498.9 731.2 263.6 49.0 4.2
2011 295.3 11.7 1,145.9 1,607.6 774.5 285.6 53.5 4.4
2012 303.3 10.8 1,137.9 1,633.5 833.7 307.8 58.8 4.6
2013 300.2 11.3 1,101.0 1,613.2 849.4 317.5 60.1 4.9
2014 308.4 10.5 1,092.1 1,661.1 900.9 341.0 64.9 5.9
2015 326.2 11.0 1,133.9 1,766.6 964.4 376.5 73.5 6.4
2016 335.7 10.2 1,172.3 1,815.6 995.2 395.4 81.4 7.1
2017 345.7 9.7 1,209.0 1,870.5 1,024.8 413.1 84.5 7.9

APPENDIX B - Rates of reported gonorrhea cases per 100,000 population in Canada, by sex and age group, 2008-2017

Rates of reported gonorrhea cases per 100,000 MALES, by age group in Canada, 2008-2017
Year Rate per 100,000 males
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 42.6 0.7 71.6 166.2 121.6 67.5 24.3 4.0
2009 36.7 0.4 61.9 144.4 104.0 55.8 22.4 3.2
2010 37.8 0.8 60.9 140.6 113.6 59.3 23.0 4.3
2011 40.2 0.7 62.1 149.0 117.1 64.1 26.0 4.3
2012 42.6 0.6 62.8 154.7 136.4 70.1 25.8 3.7
2013 48.2 0.5 67.9 169.3 152.6 85.1 29.8 4.2
2014 58.8 0.3 70.8 199.6 190.1 107.3 38.4 5.8
2015 70.3 0.5 74.9 220.9 228.7 144.8 45.7 6.3
2016 84.4 0.4 83.0 251.6 269.8 174.7 60.3 9.3
2017 103.3 0.7 106.4 287.7 338.4 217.5 75.3 10.3
Rates of reported gonorrhea cases per 100,000 FEMALES, by age group in Canada, 2008-2017
Year Rate per 100,000 females
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 33.5 3.2 166.7 165.2 80.7 29.8 5.2 0.4
2009 29.6 3.0 146.2 149.2 70.5 26.6 4.4 0.4
2010 29.1 3.0 143.8 142.0 70.5 26.4 5.1 0.5
2011 29.6 2.5 141.0 144.9 76.6 27.1 5.7 0.5
2012 32.5 2.8 152.0 160.9 85.9 31.6 6.2 0.7
2013 32.9 3.7 153.4 158.8 88.5 34.8 6.9 0.3
2014 33.0 2.7 136.8 166.8 91.8 38.3 8.2 0.5
2015 40.8 2.9 154.6 198.8 127.0 54.3 10.5 0.7
2016 47.0 3.0 170.7 217.5 152.4 68.7 13.4 0.9
2017 55.6 3.7 195.8 254.4 184.3 86.7 14.9 1.1
Rates of reported gonorrhea cases per 100,000 population OVERALLFootnote *, by age group in Canada, 2008-2017
Year Rate per 100,000 population - Overall
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 38.0 1.9 118.2 165.8 101.3 48.8 14.8 2.0
2009 33.2 1.7 103.3 146.9 87.4 41.3 13.4 1.7
2010 33.5 1.8 101.4 141.4 92.2 42.8 14.1 2.3
2011 34.9 1.6 100.7 147.1 97.0 45.6 15.9 2.2
2012 37.5 1.7 106.1 158.0 111.4 50.8 16.1 2.1
2013 40.6 2.1 109.3 164.4 121.2 59.9 18.3 2.1
2014 45.9 1.5 102.8 184.0 142.1 72.8 23.3 3.0
2015 55.5 1.7 113.6 210.5 179.1 99.4 28.1 3.3
2016 65.7 1.7 125.5 235.8 212.8 121.6 36.8 4.8
2017 79.5 2.2 150.5 272.0 263.7 152.3 45.0 5.4

APPENDIX C- Rates of reported infectious syphilis cases per 100,000 population in Canada, by sex and age group, 2008-2017

Rates of reported infectious syphilis cases per 100,000 MALES, by age group in Canada, 2008-2017
Year Rate per 100,000 males
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 7.3 0.0 1.2 9.0 13.1 13.6 11.4 1.9
2009 8.6 0.0 3.4 12.7 17.0 16.4 12.3 1.7
2010 9.2 0.0 3.9 12.9 15.4 15.9 14.2 2.6
2011 9.6 0.0 4.5 16.1 19.8 17.3 13.6 2.1
2012 11.3 0.0 6.3 21.6 22.2 20.5 15.0 2.9
2013 11.9 0.0 4.0 20.9 25.7 21.8 16.0 3.4
2014 12.7 0.0 4.1 19.9 25.5 25.0 18.1 2.9
2015 17.0 0.0 5.3 23.9 36.5 34.2 24.0 4.4
2016 19.8 0.0 5.9 27.4 40.8 39.9 28.7 5.2
2017 20.0 0.0 5.6 30.7 44.2 44.2 26.0 5.1
Rates of reported infectious syphilis cases per 100,000 FEMALES, by age group in Canada, 2008-2017
Year Rate per 100,000 females
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 1.1 0.0 2.1 3.6 3.0 2.1 0.8 0.1
2009 0.9 0.0 0.9 3.3 2.9 1.6 0.7 0.1
2010 0.9 0.0 1.5 3.3 2.6 1.5 0.6 0.1
2011 0.7 0.0 1.7 2.0 1.9 1.2 0.4 0.0
2012 0.6 0.0 1.5 2.2 1.1 1.0 0.5 0.0
2013 0.8 0.0 2.0 3.1 2.1 1.5 0.4 0.1
2014 0.9 0.0 2.0 3.6 2.4 1.7 0.6 0.0
2015 1.0 0.0 1.7 3.4 3.9 2.0 0.6 0.0
2016 1.7 0.1 3.5 6.3 5.7 2.9 1.1 0.1
2017 2.4 0.1 5.6 8.2 8.1 4.5 1.5 0.1
Rates of reported infectious syphilis cases per 100,000 population OVERALLFootnote *, by age group in Canada, 2008-2017
Year Rate per 100,000 population - Overall
Overall <15 years 15-19 years 20-24 years 25-29 years 30-39 years 40-59 years 60+ years
2008 4.2 0.0 1.6 6.4 8.1 7.9 6.2 0.9
2009 4.7 0.0 2.2 8.1 10.0 9.0 6.5 0.8
2010 5.0 0.0 2.7 8.2 9.0 8.7 7.4 1.2
2011 5.1 0.0 3.1 9.1 10.9 9.2 7.0 1.0
2012 5.9 0.0 4.0 12.2 11.7 10.7 7.8 1.4
2013 6.3 0.0 3.0 12.4 14.1 11.6 8.2 1.6
2014 6.8 0.0 3.1 12.1 14.1 13.3 9.3 1.4
2015 9.0 0.0 3.5 14.0 20.6 18.0 12.3 2.1
2016 10.7 0.0 4.7 17.4 23.9 21.5 14.9 2.5
2017 11.2 0.1 5.6 20.0 26.7 24.5 13.7 2.5

APPENDIX D - Surveillance data by province/territory, year, infection and sex, 2013-2017

ALBERTA 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 6,122 6,272 6,756 6,525 6,455
Female chlamydia cases 9,958 10,348 10,792 10,103 10,129
Footnote *Total chlamydia cases 16,081 16,622 17,548 16,628 16,584
Male chlamydia rate per 100,000 303.1 302.7 321.8 308.0 301.9
Female chlamydia rate per 100,000 507.7 514.4 527.6 486.2 480.9
Footnote *Total chlamydia rate per 100,000 403.9 407.0 423.4 396.3 390.8
Gonorrhea
Male gonorrhea cases 1,122 1,124 1,896 2,107 2,705
Female gonorrhea cases 895 783 1,542 1,674 2,049
Footnote *Total gonorrhea cases 2,017 1,908 3,438 3,781 4,757
Male gonorrhea rate per 100,000 55.6 54.2 90.3 99.5 126.5
Female gonorrhea rate per 100,000 45.6 38.9 75.4 80.6 97.3
Footnote *Total gonorrhea rate per 100,000 50.7 46.7 83.0 90.1 112.1
Infectious Syphilis
Male infectious syphilis cases 100 145 350 356 412
Female infectious syphilis cases 24 12 19 52 123
Footnote *Total infectious syphilis cases 124 157 369 408 535
Male infectious syphilis rate per 100,000 5.0 7.0 16.7 16.8 19.3
Female infectious syphilis rate per 100,000 1.2 0.6 0.9 2.5 5.8
Footnote *Total infectious syphilis rate per 100,000 3.1 3.8 8.9 9.7 12.6
BRITISH COLUMBIA 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 4,497 5,176 5,578 6,086 6,662
Female chlamydia cases 7,737 8,264 8,774 9,129 9,003
Footnote *Total chlamydia cases 12,244 13,452 14,377 15,241 15,693
Male chlamydia rate per 100,000 195.7 221.8 235.8 253.0 273.5
Female chlamydia rate per 100,000 331.8 348.2 363.9 372.0 362.0
Footnote *Total chlamydia rate per 100,000 264.4 285.8 301.0 313.6 318.8
Gonorrhea
Male gonorrhea cases 1,304 1,505 2,373 2,508 2,364
Female gonorrhea cases 532 522 1,117 1,175 917
Footnote *Total gonorrhea cases 1,841 2,031 3,496 3,691 3,295
Male gonorrhea rate per 100,000 56.7 64.5 100.3 104.3 97.1
Female gonorrhea rate per 100,000 22.8 22.0 46.3 47.9 36.9
Footnote *Total gonorrhea rate per 100,000 39.8 43.1 73.2 76.0 66.9
Infectious Syphilis
Male infectious syphilis cases 447 413 598 577 489
Female infectious syphilis cases 6 18 10 13 16
Footnote *Total infectious syphilis cases 454 432 608 591 510
Male infectious syphilis rate per 100,000 19.5 17.7 25.3 24.0 20.1
Female infectious syphilis rate per 100,000 0.3 0.8 0.4 0.5 0.6
Footnote *Total infectious syphilis rate per 100,000 9.8 9.2 12.7 12.2 10.4
MANITOBA 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 2,255 2,271 2,310 2,633 2,689
Female chlamydia cases 4,165 4,023 4,229 4,565 4,560
Footnote *Total chlamydia cases 6,420 6,294 6,539 7,202 7,249
Male chlamydia rate per 100,000 358.6 356.9 358.9 401.7 403.3
Female chlamydia rate per 100,000 655.0 626.0 652.0 693.0 681.9
Footnote *Total chlamydia rate per 100,000 507.7 492.1 506.0 548.0 542.8
Gonorrhea
Male gonorrhea cases 536 509 480 1,040 1,572
Female gonorrhea cases 681 598 605 1,200 1,767
Footnote *Total gonorrhea cases 1,217 1,107 1,085 2,240 3,339
Male gonorrhea rate per 100,000 85.2 80.0 74.6 158.7 235.8
Female gonorrhea rate per 100,000 107.1 93.1 93.3 182.2 264.2
Footnote *Total gonorrhea rate per 100,000 96.2 86.6 84.0 170.5 250.0
Infectious Syphilis
Male infectious syphilis cases 53 102 155 158 156
Female infectious syphilis cases 6 16 50 74 95
Footnote *Total infectious syphilis cases 59 118 205 232 251
Male infectious syphilis rate per 100,000 8.4 16.0 24.1 24.1 23.4
Female infectious syphilis rate per 100,000 0.9 2.5 7.7 11.2 14.2
Footnote *Total infectious syphilis rate per 100,000 4.7 9.2 15.9 17.7 18.8
NEW BRUNSWICK 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 588 570 668 675 758
Female chlamydia cases 1,182 1,176 1,223 1,271 1,361
Footnote *Total chlamydia cases 1,770 1,746 1,891 1,946 2,119
Male chlamydia rate per 100,000 156.8 151.9 178.1 178.8 199.8
Female chlamydia rate per 100,000 308.2 306.5 318.7 329.4 351.2
Footnote *Total chlamydia rate per 100,000 233.3 230.0 249.2 254.9 276.3
Gonorrhea
Male gonorrhea cases 33 32 28 40 33
Female gonorrhea cases 14 12 22 33 25
Footnote *Total gonorrhea cases 47 44 50 73 58
Male gonorrhea rate per 100,000 8.8 8.5 7.5 10.6 8.7
Female gonorrhea rate per 100,000 3.7 3.1 5.7 8.6 6.5
Footnote *Total gonorrhea rate per 100,000 6.2 5.8 6.6 9.6 7.6
Infectious Syphilis
Male infectious syphilis cases 33 26 27 13 17
Female infectious syphilis cases 1 1 4 0 2
Footnote *Total infectious syphilis cases 34 27 31 13 19
Male infectious syphilis rate per 100,000 8.8 6.9 7.2 3.4 4.5
Female infectious syphilis rate per 100,000 0.3 0.3 1.0 0.0 0.5
Footnote *Total infectious syphilis rate per 100,000 4.5 3.6 4.1 1.7 2.5
NEWFOUNDLAND AND LABRADOR 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 268 296 328 340 338
Female chlamydia cases 533 575 635 624 620
Footnote *Total chlamydia cases 801 871 963 964 958
Male chlamydia rate per 100,000 102.9 113.3 125.4 129.5 129.0
Female chlamydia rate per 100,000 199.9 215.5 238.3 233.8 232.6
Footnote *Total chlamydia rate per 100,000 152.0 164.9 182.3 182.1 181.2
Gonorrhea
Male gonorrhea cases 22 41 25 25 22
Female gonorrhea cases 19 25 13 10 6
Footnote *Total gonorrhea cases 41 66 38 35 28
Male gonorrhea rate per 100,000 8.4 15.7 9.6 9.5 8.4
Female gonorrhea rate per 100,000 7.1 9.4 4.9 3.7 2.3
Footnote *Total gonorrhea rate per 100,000 7.8 12.5 7.2 6.6 5.3
Infectious Syphilis
Male infectious syphilis cases 7 24 33 21 34
Female infectious syphilis cases 1 0 1 2 5
Footnote *Total infectious syphilis cases 8 24 34 23 39
Male infectious syphilis rate per 100,000 2.7 9.2 12.6 8.0 13.0
Female infectious syphilis rate per 100,000 0.4 0.0 0.4 0.7 1.9
Footnote *Total infectious syphilis rate per 100,000 1.5 4.5 6.4 4.3 7.4
NORTHWEST TERRITORIES 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 311 314 361 351 352
Female chlamydia cases 559 512 525 533 521
Footnote *Total chlamydia cases 870 826 886 884 873
Male chlamydia rate per 100,000 1,385.8 1,397.5 1,595.7 1,528.5 1,522.8
Female chlamydia rate per 100,000 2,616.7 2,390.8 2,429.1 2,457.9 2,387.6
Footnote *Total chlamydia rate per 100,000 1,986.1 1,882.2 2,002.8 1,979.9 1,942.8
Gonorrhea
Male gonorrhea cases 36 114 174 242 240
Female gonorrhea cases 61 131 187 227 237
Footnote *Total gonorrhea cases 97 245 361 469 477
Male gonorrhea rate per 100,000 160.4 507.4 769.1 1,053.8 1,038.3
Female gonorrhea rate per 100,000 285.5 611.7 865.2 1,046.8 1,086.1
Footnote *Total gonorrhea rate per 100,000 221.4 558.3 816.1 1,050.4 1,061.5
Infectious Syphilis
Male infectious syphilis cases 0 0 1 0 5
Female infectious syphilis cases 0 0 0 0 0
Footnote *Total infectious syphilis cases 0 0 1 0 5
Male infectious syphilis rate per 100,000 0.0 0.0 4.4 0.0 21.6
Female infectious syphilis rate per 100,000 0.0 0.0 0.0 0.0 0.0
Footnote *Total infectious syphilis rate per 100,000 0.0 0.0 2.3 0.0 11.1
NOVA SCOTIA 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 737 843 934 983 998
Female chlamydia cases 1,727 1,783 1,898 1,954 1,985
Footnote *Total chlamydia cases 2,464 2,628 2,835 2,940 2,985
Male chlamydia rate per 100,000 160.0 183.6 204.1 213.4 214.8
Female chlamydia rate per 100,000 360.0 372.0 396.4 405.3 408.4
Footnote *Total chlamydia rate per 100,000 262.0 280.0 302.7 311.8 314.0
Gonorrhea
Male gonorrhea cases 59 80 78 131 145
Female gonorrhea cases 38 34 55 72 87
Footnote *Total gonorrhea cases 97 114 133 203 232
Male gonorrhea rate per 100,000 12.8 17.4 17.0 28.4 31.2
Female gonorrhea rate per 100,000 7.9 7.1 11.5 14.9 17.9
Footnote *Total gonorrhea rate per 100,000 10.3 12.1 14.2 21.5 24.4
Infectious Syphilis
Male infectious syphilis cases 80 61 38 17 25
Female infectious syphilis cases 3 3 5 0 1
Footnote *Total infectious syphilis cases 83 64 43 17 26
Male infectious syphilis rate per 100,000 17.4 13.3 8.3 3.7 5.4
Female infectious syphilis rate per 100,000 0.6 0.6 1.0 0.0 0.2
Footnote *Total infectious syphilis rate per 100,000 8.8 6.8 4.6 1.8 2.7
NUNAVUT 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 521 433 504 462 509
Female chlamydia cases 954 851 873 896 951
Footnote *Total chlamydia cases 1,475 1,284 1,377 1,358 1,460
Male chlamydia rate per 100,000 2,851.7 2,335.9 2,689.9 2,432.2 2,638.8
Female chlamydia rate per 100,000 5,589.7 4,881.3 4,918.0 4,983.3 5,207.2
Footnote *Total chlamydia rate per 100,000 4,174.1 3,569.5 3,773.8 3,672.8 3,887.9
Gonorrhea
Male gonorrhea cases 163 131 112 65 230
Female gonorrhea cases 302 195 190 122 315
Footnote *Total gonorrhea cases 466 326 302 187 545
Male gonorrhea rate per 100,000 892.2 706.7 597.7 342.2 1,192.4
Female gonorrhea rate per 100,000 1,769.5 1,118.5 1,070.4 678.5 1,724.8
Footnote *Total gonorrhea rate per 100,000 1,318.7 906.3 827.7 505.7 1,451.3
Infectious Syphilis
Male infectious syphilis cases 31 37 25 45 33
Female infectious syphilis cases 26 45 26 52 55
Footnote *Total infectious syphilis cases 57 82 51 97 88
Male infectious syphilis rate per 100,000 169.7 199.6 133.4 236.9 171.1
Female infectious syphilis rate per 100,000 152.3 258.1 146.5 289.2 301.2
Footnote *Total infectious syphilis rate per 100,000 161.3 228.0 139.8 262.3 234.3
ONTARIO 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 13,352 14,047 15,456 16,831 18,433
Female chlamydia cases 21,317 21,922 23,551 24,974 26,134
Footnote *Total chlamydia cases 34,684 35,987 39,044 41,854 44,651
Male chlamydia rate per 100,000 201.0 209.7 229.1 246.2 265.7
Female chlamydia rate per 100,000 310.4 316.9 338.4 354.8 366.3
Footnote *Total chlamydia rate per 100,000 256.7 264.3 284.8 301.6 317.3
Gonorrhea
Male gonorrhea cases 2,851 3,811 3,950 4,478 5,534
Female gonorrhea cases 1,685 2,020 1,982 2,296 2,281
Footnote *Total gonorrhea cases 4,542 5,840 5,939 6,785 7,845
Male gonorrhea rate per 100,000 42.9 56.9 58.5 65.5 79.8
Female gonorrhea rate per 100,000 24.5 29.2 28.5 32.6 32.0
Footnote *Total gonorrhea rate per 100,000 33.6 42.9 43.3 48.9 55.8
Infectious Syphilis
Male infectious syphilis cases 701 846 1,048 1,358 1,492
Female infectious syphilis cases 43 35 41 71 72
Footnote *Total infectious syphilis cases 746 882 1,092 1,437 1,571
Male infectious syphilis rate per 100,000 10.6 12.6 15.5 19.9 21.5
Female infectious syphilis rate per 100,000 0.6 0.5 0.6 1.0 1.0
Footnote *Total infectious syphilis rate per 100,000 5.5 6.5 8.0 10.4 11.2
PRINCE EDWARD ISLAND 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 86 72 88 84 109
Female chlamydia cases 156 182 139 205 220
Footnote *Total chlamydia cases 242 254 227 289 329
Male chlamydia rate per 100,000 122.7 102.5 125.0 117.2 148.0
Female chlamydia rate per 100,000 210.8 245.8 187.4 272.2 285.9
Footnote *Total chlamydia rate per 100,000 167.9 176.0 157.0 196.6 218.5
Gonorrhea
Male gonorrhea cases 2 3 7 8 12
Female gonorrhea cases 4 4 3 4 6
Footnote *Total gonorrhea cases 6 7 10 12 18
Male gonorrhea rate per 100,000 2.9 4.3 9.9 11.2 16.3
Female gonorrhea rate per 100,000 5.4 5.4 4.0 5.3 7.8
Footnote *Total gonorrhea rate per 100,000 4.2 4.9 6.9 8.2 12.0
Infectious Syphilis
Male infectious syphilis cases 3 8 7 2 2
Female infectious syphilis cases 2 1 2 0 2
Footnote *Total infectious syphilis cases 5 9 9 2 4
Male infectious syphilis rate per 100,000 4.3 11.4 9.9 2.8 2.7
Female infectious syphilis rate per 100,000 2.7 1.4 2.7 0.0 2.6
Footnote *Total infectious syphilis rate per 100,000 3.5 6.2 6.2 1.4 2.7
QUEBEC 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 7,708 8,245 8,989 9,566 10,340
Female chlamydia cases 14,486 14,985 15,303 15,760 16,210
Footnote *Total chlamydia cases 22,262 23,305 24,390 25,410 26,628
Male chlamydia rate per 100,000 191.2 203.4 221.0 233.6 250.1
Female chlamydia rate per 100,000 355.2 365.8 372.6 381.6 389.3
Footnote *Total chlamydia rate per 100,000 274.5 285.9 298.3 308.9 320.9
Gonorrhea
Male gonorrhea cases 1,733 2,361 2,832 3,752 4,810
Female gonorrhea cases 888 910 1,047 995 1,317
Footnote *Total gonorrhea cases 2,634 3,287 3,895 4,773 6,141
Male gonorrhea rate per 100,000 43.0 58.2 69.6 91.6 116.4
Female gonorrhea rate per 100,000 21.8 22.2 25.5 24.1 31.6
Footnote *Total gonorrhea rate per 100,000 32.5 40.3 47.6 58.0 74.0
Infectious Syphilis
Male infectious syphilis cases 597 542 707 922 846
Female infectious syphilis cases 28 33 25 41 68
Footnote *Total infectious syphilis cases 626 576 732 965 915
Male infectious syphilis rate per 100,000 14.8 13.4 17.4 22.5 20.5
Female infectious syphilis rate per 100,000 0.7 0.8 0.6 1.0 1.6
Footnote *Total infectious syphilis rate per 100,000 7.7 7.1 9.0 11.7 11.0
SASKATCHEWAN 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 1,967 2,031 2,188 2,281 2,377
Female chlamydia cases 3,804 3,775 3,903 3,961 4,155
Footnote *Total chlamydia cases 5,771 5,807 6,091 6,242 6,493
Male chlamydia rate per 100,000 355.3 362.1 387.5 398.7 410.0
Female chlamydia rate per 100,000 696.5 683.7 701.5 702.5 727.6
Footnote *Total chlamydia rate per 100,000 524.8 521.8 543.4 549.5 564.2
Gonorrhea
Male gonorrhea cases 532 604 458 686 1,032
Female gonorrhea cases 681 635 499 699 1,190
Footnote *Total gonorrhea cases 1,213 1,240 957 1,385 2,222
Male gonorrhea rate per 100,000 96.1 107.7 81.1 119.9 178.0
Female gonorrhea rate per 100,000 124.7 115.0 89.7 124.0 208.4
Footnote *Total gonorrhea rate per 100,000 110.3 111.4 85.4 121.9 193.1
Infectious Syphilis
Male infectious syphilis cases 12 28 20 79 111
Female infectious syphilis cases 5 0 4 6 9
Footnote *Total infectious syphilis cases 17 28 24 85 120
Male infectious syphilis rate per 100,000 2.2 5.0 3.5 13.8 19.1
Female infectious syphilis rate per 100,000 0.9 0.0 0.7 1.1 1.6
Footnote *Total infectious syphilis rate per 100,000 1.5 2.5 2.1 7.5 10.4
YUKON 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 96 86 106 110 117
Female chlamydia cases 143 124 177 168 183
Footnote *Total chlamydia cases 239 210 283 278 300
Male chlamydia rate per 100,000 515.3 454.8 552.9 561.3 580.4
Female chlamydia rate per 100,000 799.3 680.3 955.8 886.6 939.9
Footnote *Total chlamydia rate per 100,000 654.4 565.5 750.9 721.2 757.0
Gonorrhea
Male gonorrhea cases 1 28 39 37 35
Female gonorrhea cases 9 21 74 38 42
Footnote *Total gonorrhea cases 10 49 113 75 77
Male gonorrhea rate per 100,000 5.4 148.1 203.4 188.8 173.6
Female gonorrhea rate per 100,000 50.3 115.2 399.6 200.5 215.7
Footnote *Total gonorrhea rate per 100,000 27.4 131.9 299.8 194.6 194.3
Infectious Syphilis
Male infectious syphilis cases 2 0 0 0 0
Female infectious syphilis cases 0 0 0 0 0
Footnote *Total infectious syphilis cases 2 0 0 0 0
Male infectious syphilis rate per 100,000 10.7 0.0 0.0 0.0 0.0
Female infectious syphilis rate per 100,000 0.0 0.0 0.0 0.0 0.0
Footnote *Total infectious syphilis rate per 100,000 5.5 0.0 0.0 0.0 0.0
CANADA 2013 2014 2015 2016 2017
Number of cases and rates Chlamydia
Male chlamydia cases 38,508 40,656 44,266 46,927 50,137
Female chlamydia cases 66,721 68,520 72,022 74,143 75,992
Footnote *Total chlamydia cases 105,323 109,286 116,451 121,236 126,322
Male chlamydia rate per 100,000 221.3 231.2 249.9 261.9 276.5
Female chlamydia rate per 100,000 377.3 383.7 400.3 407.5 412.8
Footnote *Total chlamydia rate per 100,000 300.2 308.4 326.2 335.7 345.7
Gonorrhea
Male gonorrhea cases 8,394 10,343 12,452 15,119 18,734
Female gonorrhea cases 5,809 5,890 7,336 8,545 10,239
Footnote *Total gonorrhea cases 14,228 16,264 19,817 23,709 29,034
Male gonorrhea rate per 100,000 48.2 58.8 70.3 84.4 103.3
Female gonorrhea rate per 100,000 32.9 33.0 40.8 47.0 55.6
Footnote *Total gonorrhea rate per 100,000 40.6 45.9 55.5 65.7 79.5
Infectious Syphilis
Male infectious syphilis cases 2,066 2,232 3,009 3,548 3,622
Female infectious syphilis cases 145 164 187 311 448
Footnote *Total infectious syphilis cases 2,215 2,399 3,199 3,870 4,083
Male infectious syphilis rate per 100,000 11.9 12.7 17.0 19.8 20.0
Female infectious syphilis rate per 100,000 0.8 0.9 1.0 1.7 2.4
Footnote *Total infectious syphilis rate per 100,000 6.3 6.8 9.0 10.7 11.2
Footnote *

Total includes unspecified sex

Return to footnote * referrer

APPENDIX E - Population estimates by year by province/territory, 2008-2017

OVERALL population of provinces and territories in Canada by year, 2008-2017
Year 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
BC 4,349,336 4,410,506 4,465,546 4,502,104 4,566,769 4,630,077 4,707,103 4,776,388 4,859,250 4,922,152
AB 3,595,856 3,678,996 3,732,082 3,789,030 3,874,548 3,981,011 4,083,648 4,144,491 4,196,061 4,243,995
SK 1,017,404 1,034,819 1,051,443 1,066,026 1,083,755 1,099,736 1,112,979 1,120,967 1,135,987 1,150,782
MB 1,197,775 1,208,556 1,220,780 1,233,649 1,249,975 1,264,620 1,279,014 1,292,227 1,314,139 1,335,396
ON 12,883,583 12,998,345 13,135,778 13,261,381 13,390,632 13,510,781 13,617,553 13,707,118 13,875,394 14,071,445
QC 7,761,725 7,843,383 7,929,222 8,005,090 8,061,101 8,110,880 8,150,183 8,175,272 8,225,950 8,297,717
NB 746,877 749,956 753,035 755,705 758,378 758,544 758,976 758,842 763,350 766,852
NS 935,897 938,208 942,107 944,274 943,635 940,434 938,545 936,525 942,790 950,680
PE 138,749 139,891 141,654 143,963 144,530 144,094 144,283 144,546 146,969 150,566
NL 511,581 516,751 522,009 524,999 526,345 527,114 528,159 528,117 529,426 528,567
YT 33,083 33,731 34,596 35,411 36,234 36,521 37,137 37,690 38,547 39,628
NT 43,360 43,156 43,285 43,504 43,648 43,805 43,884 44,237 44,649 44,936
NU 31,892 32,597 33,352 34,192 34,672 35,337 35,971 36,488 36,975 37,552
Canada 33,247,118 33,628,895 34,004,889 34,339,328 34,714,222 35,082,954 35,437,435 35,702,908 36,109,487 36,540,268
MALE population of provinces and territories in Canada by year, 2008-2017
Year 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
BC 2,158,715 2,190,971 2,219,479 2,237,994 2,268,314 2,297,991 2,333,888 2,365,415 2,405,364 2,435,442
AB 1,829,978 1,872,056 1,895,063 1,920,282 1,963,473 2,019,495 2,071,960 2,099,166 2,118,319 2,137,885
SK 505,982 516,302 525,727 534,672 544,540 553,574 560,846 564,616 572,152 579,704
MB 594,632 599,761 605,520 611,938 620,820 628,768 636,367 643,603 655,392 666,695
ON 6,341,968 6,390,255 6,453,206 6,513,084 6,581,938 6,643,473 6,698,984 6,746,804 6,835,845 6,937,613
QC 3,843,579 3,887,035 3,931,753 3,971,988 4,003,669 4,032,124 4,053,655 4,067,889 4,095,582 4,133,887
NB 367,736 369,832 371,823 373,751 375,070 375,053 375,294 375,136 377,460 379,334
NS 456,244 458,098 461,382 463,317 462,838 460,746 459,203 457,662 460,665 464,664
PE 67,702 68,310 69,196 70,275 70,491 70,102 70,226 70,384 71,647 73,625
NL 251,722 254,398 257,473 259,089 259,953 260,496 261,359 261,594 262,513 261,970
YT 16,957 17,264 17,689 18,096 18,486 18,631 18,909 19,171 19,598 20,157
NT 22,416 22,245 22,253 22,340 22,391 22,442 22,469 22,624 22,964 23,115
NU 16,547 16,886 17,259 17,702 17,917 18,270 18,537 18,737 18,995 19,289
Canada 16,474,178 16,663,413 16,847,823 17,014,528 17,209,900 17,401,165 17,581,697 17,712,801 17,916,496 18,133,380
FEMALE population of provinces and territories in Canada by year, 2008-2017
Year 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
BC 2,190,621 2,219,535 2,246,067 2,264,110 2,298,455 2,332,086 2,373,215 2,410,973 2,453,886 2,486,710
AB 1,765,878 1,806,940 1,837,019 1,868,748 1,911,075 1,961,516 2,011,688 2,045,325 2,077,742 2,106,110
SK 511,422 518,517 525,716 531,354 539,215 546,162 552,133 556,351 563,835 571,078
MB 603,143 608,795 615,260 621,711 629,155 635,852 642,647 648,624 658,747 668,701
ON 6,541,615 6,608,090 6,682,572 6,748,297 6,808,694 6,867,308 6,918,569 6,960,314 7,039,549 7,133,832
QC 3,918,146 3,956,348 3,997,469 4,033,102 4,057,432 4,078,756 4,096,528 4,107,383 4,130,368 4,163,830
NB 379,141 380,124 381,212 381,954 383,308 383,491 383,682 383,706 385,890 387,518
NS 479,653 480,110 480,725 480,957 480,797 479,688 479,342 478,863 482,125 486,016
PE 71,047 71,581 72,458 73,688 74,039 73,992 74,057 74,162 75,322 76,941
NL 259,859 262,353 264,536 265,910 266,392 266,618 266,800 266,523 266,913 266,597
YT 16,126 16,467 16,907 17,315 17,748 17,890 18,228 18,519 18,949 19,471
NT 20,944 20,911 21,032 21,164 21,257 21,363 21,415 21,613 21,685 21,821
NU 15,345 15,711 16,093 16,490 16,755 17,067 17,434 17,751 17,980 18,263
Canada 16,772,940 16,965,482 17,157,066 17,324,800 17,504,322 17,681,789 17,855,738 17,990,107 18,192,991 18,406,888

Reference: Statistics Canada. Table 17-10-0005-01 Population estimates on July 1st, by age and sex

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