Number of cases of syphilis in Europe hits all-time high

Anne Gulland
The number of cases of syphilis has hit an all-time high in Europe - PA

Increasingly risky sexual health behaviour has been linked to the number of cases of syphilis in Europe hitting an all-time high, with the UK seeing one of the steepest rises.

A report by the European Centre for Disease Prevention and Control shows that in the UK the number of cases of the sexually transmitted infection (STI) – once thought to be consigned to history – more than doubled between 2007 and 2017.

There were 3,561 cases of syphilis in the UK in 2007 but by 2017 this number had rocketed to just over 7,798. This is equivalent to an increase from 5.8 cases per 100,000 people to 11.8 cases per 100,000.

Only Iceland – with a rate of 15.4 per 100,000 – and Malta with a rate of 13.5, had higher rates than the UK.

The UK was one of five countries – alongside Iceland, Ireland, Malta and Germany – which saw the number of cases of the disease more than double over the time period

The report comes amid a rise in STIs around the world, with the World Health Organization warning last month that a million new cases of STIs are contracted every day.

The rise in the number of cases of syphilis throughout Europe – from 19,000 in 2007 to 33,000 in 2017 – is mainly driven by men who have sex with men. The report showed that the UK has the second highest rate of syphilis among men in Europe with 22 cases per 100,000 people. 

The report put the increase in the number of cases down to men not using condoms, an increase in the number of sexual partners and the impact of pre-exposure prophlyaxis (PrEP), a pill taken before sex to reduce the risk of HIV infection.

Experts believe that this has led to more risky sexual behaviour as people are no longer concerned about contracting the virus.

The rise of “chemsex” – where people take drugs to heighten sexual pleasure and lose their inhibitions – and the use of apps to find sexual partners could also be behind a rise in the disease, the report said.

Andrew Amato-Gauci, head of the ECDC programme on HIV, STI and viral hepatitis, said there was a clear relationship between risky sexual behaviour and the rise of syphilis and other sexually transmitted diseases.

He said: "The increases in syphilis infections that we see across Europe, as well as other countries around the world, are a result of several factors such as people having sex without condoms and multiple sexual partners, combined with a reduced fear of acquiring HIV."

Syphilis is a bacterial infection and can be easily treated with a single shot of penicillin. Symptoms include sores on the genitals and mouth, a rash on the hands and feet, tiredness, headaches and joint pain.

It has three stages and if left untreated over many years it can spread to the brain and be fatal. The disease was almost eradicated in the UK in the 1980s but re-emerged at around the turn of the millennium.

Dr Patrick French, a consultant in sexual health and a spokesman for the British Association of Sexual Health and HIV, said that the UK had better surveillance for STIs than many other countries in Europe which could account for the rise.

But he said figures for the UK were “undoubtedly alarming”.

“When I started working in sexual health 20 years ago syphilis had been eradicated. But now it’s something I see commonly in my clinic and that’s an extraordinary change,” he said. 

He said that changes in the prevalence and incidence of STIs were related to changes in sexual behaviour driven by the huge drop in the number of new HIV infections in the UK.

“It looks like this might have contributed to the increase in cases of syphilis as people’s sexual behaviour has changed,” he said. 

But Dr French warned that the rise in cases was happening against the backdrop of cuts to sexual health services. 

“At a time when STIs are increasing STI services are declining,” he said.  

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