Health Correspondent
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New instances of syphilis, a sexually transmitted infection, have increased in England, continuing a pattern that began in the early 2000s.
Although the total number of gonorrhoea diagnoses has decreased, there has been a notable rise in drug-resistant cases, according to recent data from the UK Health Security Agency (UKHSA).
Experts find this trend alarming, even though the number of drug-resistant cases remains relatively low.
The NHS has recently launched the world’s first vaccine initiative against gonorrhoea, targeting primarily gay and bisexual men.
In 2024, there were 9,535 early-stage syphilis diagnoses in England, representing a 2% increase from 2023.
The total count for syphilis, including late-stage cases and complications, rose by 5% to 13,030.
Gonorrhoea statistics present a more complex situation.
Overall, 2024 saw a 16% decline in gonorrhoea cases, with 71,802 diagnoses compared to 85,370 in 2023, particularly among individuals aged 15 to 24.
Giulia Habib Meriggi, a scientist specializing in surveillance and prevention of sexually transmitted infections at UKHSA, urged caution regarding the decline.
“This is the first year in recent years where the numbers have actually decreased,” she commented.
“However, it remains the third highest recorded annual total, so while it’s somewhat reassuring, it doesn’t guarantee a continued trend.”
“Regular testing and condom use with new partners are crucial.”
Conversely, there has been a surge in cases of antibiotic-resistant gonorrhoea.
Certain strains of the bacteria causing this infection no longer respond to ceftriaxone, the primary treatment.
The overall numbers remain low, with 14 cases reported in the first five months of 2025, compared to 13 for the entirety of 2024.
However, six of those 14 cases this year have shown extensive drug resistance to ceftriaxone as well as secondary treatment options.
Most ceftriaxone-resistant cases have been linked to travel to or from the Asia-Pacific region, where resistance levels are notably high.
UKHSA scientist Prarthana Narayanan describes this trend as “concerning.”
“Although the numbers are small, the concern lies in the potential for gonorrhoea resistance to become endemic, making it extremely challenging to treat, as ceftriaxone is our last first-line option,” she explained.
“We need to minimize the spread of resistant strains to prolong the effectiveness of ceftriaxone.”
What are the symptoms of syphilis and gonorrhoea?
- Syphilis may manifest as small sores or ulcers on and around the genitals, along with white or grey growths.
- Sores can also occur in other areas such as the mouth, lips, hands, or buttocks.
- A rash on the palms and soles can sometimes spread across the body.
- White patches may appear in the mouth.
- Symptoms can include flu-like issues such as fever, headaches, fatigue, and swollen glands.
- Patches of hair loss on the scalp, beard, or eyebrows may occur.
- Gonorrhoea may lead to discharge or fluid from the penis or vagina.
- A burning sensation can occur during urination.
- Women may experience pain in the lower abdomen, while men may have sore testicles.
UKHSA warns that rates of sexually transmitted infections remain high, particularly affecting individuals aged 15 to 24, gay and bisexual men, and specific minority ethnic groups.
The rise in drug-resistant gonorrhoea is particularly alarming, amidst broader concerns regarding antimicrobial resistance.
The World Health Organization identifies antimicrobial resistance as a global health threat and a major concern for public health.
This issue jeopardizes our ability to treat common illnesses and perform essential medical procedures such as chemotherapy, C-sections, hip replacements, organ transplants, and other surgeries.
Thus, even with just 14 instances of drug-resistant gonorrhoea noted this year, health specialists emphasize the importance of using condoms and regular testing for anyone engaging in sexual activity with new or casual partners, regardless of age or sexual orientation.