Syphilis, one of the oldest known sexually transmitted infections, is resurging globally at an alarming rate. In the US, cases reached their highest levels in over a decade in 2022, with more than 203,500 reported cases — nearly double the number in 2018. The Centres for Disease Control and Prevention (CDC) warns the epidemic shows no signs of slowing, with cases increasing by 17% between 2021 and 2022 and surging 32% between 2020 and 2021, the highest in 70 years.
The UK is also seeing a sharp rise, with syphilis cases in 2022 reaching their highest level since 1948. Jodie Crossman, co-chair of the STI Foundation, notes that city clinics now see two or three patients per day for treatment, compared to rare cases when she started nursing in 2005. Globally, there were 7.1 million new cases in 2020, according to the World Health Organization.
Congenital syphilis — passed from mother to child during pregnancy — has risen particularly sharply. In the US, 3,755 cases were reported in 2022, a 30% increase from 2021 and more than double the 2018 figure. The infection can cause stillbirths, infant deaths, and lifelong health problems. Leandro Mena, director of the CDC's STI prevention division, says rates are now at levels not seen in 20 years, reversing earlier hopes of elimination.
Left untreated, syphilis can lead to long-term neurological and cardiovascular diseases, potentially fuelling a surge in heart attacks and strokes. Isaac Bogoch, an infectious diseases clinician at the University of Toronto, describes the trend as 'very concerning' given that syphilis is easily treatable with penicillin. He attributes the rise to a 'breakdown in public healthcare'. Canada saw a 389% increase in infectious syphilis between 2011 and 2019.
While cases have historically been concentrated among men who have sex with men, rates among women are now rising globally, driving higher congenital syphilis rates. Across the Americas, there were 30,000 cases of mother-to-child transmission. Tushar, a 33-year-old in Amsterdam who has had syphilis twice, notes that many people mistakenly believe it is incurable, leading to stigma and delays in treatment.
