Authorities have issued a public health alert amid a sharp rise in sexually transmitted infections (STI) and blood borne viruses (BBV) in the Mackay region.
Mackay Hospital and Health Service has diagnosed three times as many syphilis and gonorrhoea cases in the first seven weeks of this year compared to the same period last year.
There has also been a 55 per cent increase in cases of chlamydia.
Some of the cases causing concern include gonorrhoea in the eye and throat.
Health professionals have identified a link between increased gonorrhoea cases and a significant population of injecting drug users.
Arun Menon, the Sexual Health Services clinical director for Mackay, Townsville and Mt Isa, is asking all clinicians, including emergency department staff, to consider full STI and BBV screening for all sexually active patients.
He said there had been an increase in cases in all age groups and ethnicities.
"It's a much more diffused outbreak than we've ever seen before," Dr Menon said.
"There is concern about a significant number of undiagnosed syphilis, gonorrhoea and HIV infections in the community."
Responses 'inadequate'
STI numbers have been climbing every year in the area since 2019, prompting the Health Service to declare a gonorrhoea outbreak.
Dr Menon said cases of gonorrhoea presenting in the eye could be because people are having sex in more "diverse" ways.
"Our responses are completely inadequate because we don't have the workforce that's required to deal with these infections in Mackay, or indeed in any other hospital and health service," he said.
"The long-term effects of sexually transmitted infections are things like pelvic inflammatory disease, infertility, passing the infection onto babies and opening the door for infections like HIV.
"We're asking doctors to test everyone they possibly can … we can't control this outbreak with the present tools at our disposal."
Search for positive patients
Nurse Donna Pini from the Mackay Sexual Health Clinic said the data suggested a link between increased cases of gonorrhoea and the "injecting drug population".
She said the issue was taking up significant resources in the already under-resourced clinic as health workers tried to chase up patients without fixed addresses or phone numbers.
"Those people typically have reasonably chaotic lives and with that automatically comes an increased risk of sexual risk-taking behaviours," Ms Pini said.
Missions to track down a positive patient before they continue the spread can include sending a nurse out to knock on doors.
"You're tying up a health worker that would normally see two to three clients per hour and make phone calls," Ms Pini said.
She said a client might be difficult to find because they were a domestic violence victim, homeless, or dealing with intergenerational trauma.
"They don't particularly want to be found," Ms Pini said.
"They only come to us when there's a problem."
Ms Pini said HIV was the only STI that was not curable, but noted it was manageable.
But she said people in some demographics would not come in for routine testing.
"When these clients come to see us, if they have symptoms, we tend to treat them on the spot," Ms Pini said.
"Opportunistic work is very important, because if they leave us they may be lost to us for a follow-up."
Clinic workers also try to help people who have tested positive with contact tracing.
Push for syphilis testing
Yesterday Ms Pini and senior doctors in the emergency department at Mackay Base Hospital discussed testing everyone between the age of 15 and 40 for syphilis.
That would involve an additional test of blood samples, which Ms Pini said would cost about $22.50.
"We have to work out if we can justify [testing for] an outbreak, which could be worth half a million dollars plus when you go into a really big outbreak," she said.
Dr Menon said interventions were almost solely dependent on trying to "persuade" GPs and emergency departments to test more broadly.
