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Overview (All Infections)

Current Situation At-A-Glance

Infection 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 Trend
CHLAMYDIA 1,579 1,633 1,737 1,610 1,800
CONGENITAL SYPHILIS 8 15 17 14 14
GONORRHEA 557 645 753 566 761
HEPATITIS B 58 53 47 36 51
HEPATITIS C 128 164 164 144 155
HIV 37 42 52 45 63
INFECTIOUS SYPHILIS 428 447 429 404 397
NON-INFECTIOUS SYPHILIS 204 217 276 316 300
1 The first quarter (Q1) gives the number of cases diagnosed between January 1 and March 31 of the given year.
The second quarter (Q2) gives the number of cases diagnosed between April 1 and June 30 of the given year.
The third quarter (Q3) gives the number of cases diagnosed between July 1 and September 30 of the given year.
The fourth quarter (Q4) gives the number of cases diagnosed between October 1 and December 31 of the given year.
2 Fluctuations in case numbers are expected as cases are investigated and their information is updated in PHIMS.
3 There are seasonal variations in diagnosis rates for many infections. E.g. Q1 case counts are often lower.

Epidemiologist’s Summary

From 2019 to 2021, the number of cases identified for most sexually transmitted and blood-borne infections (STBBIs), except for HIV, decreased, in Manitoba. This decrease was most evident during times of reduced access to care in months with the highest COVID-19 restrictions. The number of cases diagnosed in 2020 may be lower than the true number of cases infected in the province during that year. The continued decrease in 2021 may be associated with restricted visitation during the pandemic, resulting in reduced transmission and a decrease in the number of cases infected.

Evidence that the demand for, and delivery of, STBBI services and harm reduction services was impacted by COVID-19 in Canada was gathered through a national survey on the Impact of COVID-19 on the delivery of STBBI prevention, testing and treatment including harm reduction services in Canada conducted from November 7 to December 7, 2020:

  • Almost seven in 10 (66%) of the STBBI service providers interviewed reported that the demand for STBBI prevention, testing, and treatment services decreased since the start of the COVID-19 pandemic.

  • Approximately four in 10 (44%) of the STBBI service providers interviewed reported that their ability to deliver STBBI prevention, testing, and treatment services decreased since the start of the COVID-19 pandemic.

  • Harm reduction, substance use and treatment service providers reported an increase in drug use since the start of the pandemic (especially crystal meth, fentanyl, heroin, and other opioids).

  • Almost four in 10 (37%) harm reduction, substance use and treatment service providers reported that the distribution of safe drug supplies increased since the start of the pandemic. But, unfortunately, when access to clean drug supplies was disrupted, reuse and sharing of drug use equipment was reported.

Sharing injection drug use supplies increases the risk of HIV, hepatitis B, and hepatitis C transmission and may have contributed to the increase in HIV case diagnoses from 2019 to 2021. That said, hepatitis B and hepatitis C diagnoses decreased from 2019 to 2021. HIV is easier to transmit via sexual activity than hepatitis C is, so when HIV diagnoses are increasing, and hepatitis C diagnoses are decreasing, it suggests that transmission may be via sexual contact rather than injection drugs. Unfortunately, there is no way to definitively determine someone’s primary mode of acquiring the virus(es) if they had exposure to the infection(s) through both sexual activity and injection drugs.

Chlamydia, gonorrhea, and syphilis (infectious and non-infectious) are the most commonly reported STBBIs in Manitoba. Manitoba has some of the highest congenital syphilis rates in all of Canada, reflecting the province’s very high syphilis numbers.

STBBI cases per 100,000 population by sex in Manitoba

Congenital syphilis cases per 10,000 live births in Manitoba

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Chlamydia

Chlamydia is the most commonly reported STI in Manitoba and Canada.

From 2016 to 2021, the majority of chlamydia cases (a little more than six out of every 10 cases) were diagnosed among females, in Manitoba. This same trend is seen at the national level.

In 2019 (the most recent national data available), there were 370.8 chlamydia cases reported per 100,000 population in Canada. The territories had the highest crude rates, but Manitoba had the highest crude rate of the provinces with 601.0 chlamydia cases reported per 100,000 population.

In Manitoba, the number of people tested for chlamydia and gonorrhea has changed over time. When testing levels decrease, the identification of cases may also decrease. This can lead to under-counting the actual number new cases in the province. In 2018, 93,302 people were screened for chlamydia and gonorrhea, 99,318 people were screened in 2019, 87,906 people were screened in 2020, and 89,611 people were screened in 2021.

More information on chlamydia can be found here.

January 1-June 30, 2022

Number and Crude Rate

Proportion by Sex

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Gonorrhea

Gonorrhea is the second most commonly reported STI in Manitoba and Canada.

From 2016 to 2021, slightly more than half of gonorrhea cases were diagnosed among females, in Manitoba. This is opposite the trend seen at the national level, where case numbers were higher among males than females.

In 2019 (the most recent national data available), there were 94.3 gonorrhea cases reported per 100,000 population in Canada. Nunavut and Northwest Territories had the highest crude rates; Manitoba had the third highest crude rate with 272.7 gonorrhea cases reported per 100,000 population in 2019.

In Manitoba, the number of people tested for chlamydia and gonorrhea has changed over time. When testing levels decrease, the identification of cases may also decrease. This can lead to under-counting the actual number new cases in the province. In 2018, 93,302 people were screened for chlamydia and gonorrhea, 99,318 people were screened in 2019, 87,906 people were screened in 2020, and 89,611 people were screened in 2021.

More information on gonorrhea can be found here.

January 1-June 30, 2022

Number and Crude Rate

Proportion by Sex

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Hepatitis B

The rate of (acute, chronic, and unspecified) hepatitis B infection has remained fairly stable in Manitoba from 2016 to 2021.

In 2019 (the most recent national data available), there were 0.48 acute hepatitis B cases reported per 100,000 population and 10.2 chronic hepatitis B cases reported per 100,000 population, in Canada. It is difficult to compare the national rate to the provincial rates because each province reports acute and chronic infections differently and in Manitoba almost one in five hepatitis B cases were not staged as either acute or chronic in 2019.

More information on hepatitis B can be found here. Hepatitis B can be prevented through immunization. Manitoba has a provincial immunization program that provides free, publicly-funded hepatitis B vaccine to those who are eligible.

January 1-June 30, 2022

Number and Crude Rate

Proportion by Sex

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Hepatitis C

Hepatitis C (acute, chronic, and unspecified) infections have been steadily decreasing since 2018 in Manitoba while screening for hepatitis C infection has increased since 2018. There were 26,500 more people tested for hepatitis C virus in 2021 than in 2018. This means the decrease from 2018 to 2021 is likely a true decrease in cases and not the result of “missed” cases.

In 2019 (the most recent national data available), Manitoba had the highest crude rate of new hepatitis C diagnoses in Canada with 54.2 hepatitis C cases diagnosed per 100,000 population. In comparison, there were 30.4 hepatitis C cases diagnosed per 100,000 population in Canada.

More information on hepatitis C can be found here.

January 1-June 30, 2022

Number and Crude Rate

Proportion by Sex

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HIV

Human Immunodeficiency Virus (HIV) infections have been steadily increasing since 2017 in Manitoba. In 2017, females accounted for less than one-third of cases. In 2021, females accounted for almost half of cases.

In 2020 (the most recent national data available), there were 4.3 HIV cases newly diagnosed per 100,000 population in Canada. Manitoba had the second highest crude rate of all provinces and territories with 7.0 newly diagnosed HIV cases per 100,000 population, in 2020.

The national data only includes first ever diagnoses in the crude rate whereas this dashboard includes cases diagnosed for the first time ever in Manitoba (97 cases) and those previously diagnosed out of province that are new to care in Manitoba (19 cases). This is why the crude rate presented in this dashboard for 2020 (8.4 cases per 100,000 population) is higher than the rate presented in the national data.

More information on HIV can be found here.

January 1-June 30, 2022

Number and Crude Rate

Proportion by Sex

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Syphilis

The identification of infectious syphilis cases has been decreasing since 2019 in Manitoba, following a sharp increase. The case count for infectious syphilis in 2019 was 1,955, the highest number in more than 50 years. Conversely, the identification of non-infectious syphilis cases has been increasing since 2018 in Manitoba.

The decreased identification of infectious syphilis cases may be related to testing levels. Testing for infectious syphilis decreased in 2020 as a result of the COVID-19 pandemic but has since returned to pre-pandemic levels. That said, the test positivity in 2021 was more than double the test positivity in 2018 which means it is likely there are undiagnosed syphilis cases within the province.

The increased identification of non-infectious syphilis cases in 2021 may be result of interrupted access to care during the pandemic and people being diagnosed late (at least one year after initial infection).

Manitoba had the highest crude rate of infectious syphilis of all Canadian provinces with 136.7 infectious syphilis cases diagnosed per 100,000 population, in 2019 (the most recent national data available). Nationally, there were 24.6 infectious syphilis cases diagnosed per 100,000 population.

In Manitoba, females accounted for less than one-third of infectious syphilis cases, in 2017. By 2021, females accounted for almost half of infectious syphilis cases. At the national level, females continued to account for less than one-third of infectious syphilis cases in 2019.

More information on syphilis can be found here.

January 1-June 30, 2022: Infectious Syphilis

January 1-June 30, 2022: Non-Infectious Syphilis

Number

Crude Rate

Proportion by Sex

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Congenital Syphilis

In 2015, the Manitoba government reported the first case of congenital syphilis in the province in over 30 years. In 2017, another case was identified. The number of congenital syphilis cases has risen rapidly since then, with case numbers doubling from 2018 to 2019, and doubling again from 2019 to 2021.

An article published in the Canadian Communicable Disease Report reported that in 2020, the majority (86%) of all confirmed early congenital syphilis cases were observed in the prairie provinces (Alberta, Manitoba and Saskatchewan).

More information on congenital syphilis can be found here.

January 1-June 30, 2022

Number and Crude Rate

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Data Notes

Data in Context

When interpreting the data within this dashboard, it is important to be mindful of the context in which the data are generated.

The data provided represent a snapshot of diagnosed cases at the time of reporting and the numbers are subject to change. Fluctuations are expected as cases are investigated and updated.

The case definition for each infection in this report can be found in the respective Communicable Disease Management Protocol.

Observed trends over time may be due to changes in the number of actual cases in the population but may also be due to changes in testing practices (e.g. increase or decrease in number of tests performed) or reporting patterns by care providers (e.g. how case definitions are applied). The amount of testing and reporting performed can be influenced by many factors including outbreaks and policy changes.

Biological sex (female, male, intersex, unknown) is used to report cases, rather than gender identity. A very small number of people reported a gender that differed from their biological sex. The numbers for females and males may not always equal the Manitoba total because the Manitoba total also includes those for whom their biological sex was intersex or unknown.

Unstaged syphilis cases are included in this report as non-infectious syphilis cases.

Provincial STBBI case data are reported annually to the Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada (PHAC) for inclusion in national surveillance reporting. Differences between provincial and national reports may be due to delays in reporting and the continuous updating of information in PHIMS.

The content and format of this dashboard are subject to change.

Data Sources

Public Health Information Management System (PHIMS)

PHIMS is a surveillance and reporting tool that brings together positive laboratory results for all notifiable diseases and case and contact investigation information from the regional health authorities and/or responsible organizations. Surveillance data in Manitoba are routinely collected under The Public Health Act. PHIMS securely houses information such as demographics (e.g. age, region of residence, and sex), risk factors, outcomes, and co-infections for people living in Manitoba with a notifiable disease. You can learn more about PHIMS at https://phimsmb.ca/.

Data from PHIMS is used to determine the number of cases of each infection by year, their sex, and their confirmed/probable status.

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Manitoba Health Insurance Registry

The Manitoba Health Insurance Registry contains all individuals who have been registered to receive health care through Manitoba Health at some point in time since 1970.

The population data used as the denominator for the crude rates in this dashboard are based on records of residents registered with Manitoba Health as at June 1 of the given year. For years where the population data is not available, the population from June 1 of the previous year is used. You can find the population reports here: https://www.gov.mb.ca/health/population/

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Vital Statistics

The Vital Statistics Agency maintains a registry of all vital events that occur within the province. It includes information such as registration of birth, registration of death, common-law relationship, common-law relationship dissolution, marriage, marriage dissolution, etc. You can learn more about the Vital Statistics Agency at https://vitalstats.gov.mb.ca/index.html

The Vital Statistics Agency’s provincial registry was used to determine how many live babies were to born to Manitoba residents, each year. The numbers of live births were used as the denominator for congenital syphilis crude rates.

Additional Resources

Government of Manitoba STBBI landing page: https://www.gov.mb.ca/health/publichealth/cdc/sti/index.html

Government of Manitoba Epidemiology and Surveillance reports: https://www.gov.mb.ca/health/publichealth/surveillance/reports.html

Government of Manitoba Communicable Disease Management Protocols: https://www.gov.mb.ca/health/publichealth/cdc/protocol/#S

Government of Canada publications on epidemiology of STBBIs and other notifiable diseases: https://www.canada.ca/en/services/health/publications/diseases-conditions.html

Government of Canada publications on surveys on impact of COVID-19 on STBBI: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/survey-impact-covid-19-delivery-stbbi-prevention-testing-treatment.html

Land Acknowledgement

We acknowledge we are gathered on Treaty 1 Territory and that Manitoba is located on the Treaty Territories and ancestral lands of the Anishinaabeg, Anishininewuk, Dakota Oyate, Denesuline and Nehethowuk Nations.

We acknowledge Manitoba is located on the Homeland of the Red River Métis.

We acknowledge northern Manitoba includes lands that were and are the ancestral lands of the Inuit.

We respect the spirit and intent of Treaties and Treaty Making and remain committed to working in partnership with First Nations, Inuit and Métis people in the spirit of truth, reconciliation and collaboration.

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Sexually Transmitted and Blood-Borne Infections (STBBI) Surveillance Report, Government of Manitoba. Data up to: Jun 30 2022, Date extracted: Nov 2 2022