Infants born with an infection their mothers could have prevented
Two of humanity's oldest infectious adversaries — gonorrhoea and syphilis — have returned across Europe with a force not witnessed in over a decade, reaching record case counts in 2024 that expose the quiet erosion of public health infrastructure. The surge is not a mystery: testing has become less accessible, prevention has become less consistent, and the consequences of inaction are falling hardest on those least protected. What was once considered a managed problem has revealed itself to be an unfinished one.
- Gonorrhoea cases across Europe have surged 303% since 2015, reaching 106,331 in 2024 — numbers that shatter the assumption that these infections were under control.
- Congenital syphilis cases nearly doubled in a single year, meaning infants are being born into preventable suffering as transmission reaches their most vulnerable possible hosts.
- Heterosexual women of reproductive age are now showing sharp syphilis increases, widening a crisis that once appeared concentrated in a single demographic.
- Health officials are pointing directly at fractured testing infrastructure and prevention gaps — not the infections themselves — as the true engine of this resurgence.
- England launched a gonorrhoea vaccine in 2025 after recording 85,000 cases the prior year, yet transmission continues, signalling that no single intervention is sufficient.
- The path forward is deliberately unglamorous: condoms, routine testing, and early antibiotic treatment — tools that already exist but are not reaching everyone who needs them.
Across Europe, gonorrhoea and syphilis are spreading at rates unseen in more than a decade. In 2024, gonorrhoea reached 106,331 cases — a 303 percent rise since 2015 — while syphilis more than doubled to 45,557 over the same nine-year period. The European Centre for Disease Prevention and Control released the figures in May 2026, and they describe a public health system struggling to keep pace with transmission.
Bruno Ciancio, who leads the agency's unit on directly transmitted diseases, identified the core problem: widening gaps in testing and prevention. People are not being tested when they should be, and prevention tools are not reaching those who need them most. The infrastructure that once held these infections in check has quietly fractured.
What makes the surge especially alarming is what untreated infection produces. Both diseases can cause chronic pain, infertility, and damage to the heart and nervous system. Syphilis can pass to newborns during pregnancy — and between 2023 and 2024 alone, congenital syphilis cases nearly doubled. These are children born with an infection that was preventable.
The burden falls unevenly. Men who have sex with men remain the most heavily affected group, but heterosexual women of reproductive age are now seeing sharp syphilis increases — a shift that carries particular weight given the risk of congenital transmission. Spain recorded the highest confirmed case counts among tracked European nations, with 37,169 gonorrhoea cases and 11,556 syphilis cases in 2024.
In England, the picture is similarly stark. The UK Health Security Agency reported 71,802 gonorrhoea cases and 9,535 syphilis cases in 2024. A gonorrhoea vaccine was rolled out in 2025 following an 85,000-case alarm the prior year, yet transmission continues. Chlamydia, by contrast, declined 6 percent since 2015 — a reminder that prevention can work, but only when it reaches people consistently.
Health officials are calling for urgent action built around simple, available tools: condoms with new or multiple partners, and testing when symptoms appear. Both infections respond to antibiotics when caught early. The gap is not one of medicine — it is one of reach, awareness, and infrastructure. Closing it is the work that remains.
Across Europe, two of the oldest sexually transmitted infections are spreading at rates not seen in more than a decade. Gonorrhoea cases reached 106,331 in 2024, while syphilis hit 45,557—numbers that represent a staggering acceleration of a public health problem that many assumed was under control. The European Centre for Disease Prevention and Control, the continent's disease surveillance agency, released the figures in May 2026, and they paint a picture of a system struggling to keep pace with transmission.
The scale of the increase is difficult to ignore. Since 2015, gonorrhoea cases have climbed by 303 percent. Syphilis more than doubled in the same nine-year span. These are not marginal upticks or statistical noise. They are the kind of numbers that force health officials to reckon with what has gone wrong. Bruno Ciancio, who leads the agency's unit focused on directly transmitted and vaccine-preventable diseases, pointed to a specific culprit: widening gaps in testing and prevention. People are not getting tested when they should be. Prevention tools are not reaching those who need them. The infrastructure that once held these infections at bay has fractured.
What makes this surge particularly troubling is not just the raw count but what happens when these infections go untreated. Gonorrhoea and syphilis can cause chronic pain, infertility, and damage to the heart and nervous system. Syphilis can pass directly to newborns during pregnancy, causing lifelong complications. Between 2023 and 2024 alone, congenital syphilis cases nearly doubled—infants born with an infection their mothers could have prevented or treated. These are not abstract epidemiological concerns. They are children born into preventable suffering.
The burden is not evenly distributed. Men who have sex with men remain the most heavily affected population, showing the steepest increases in both infections over the long term. But the data also reveals a shift: heterosexual women of reproductive age are seeing sharp rises in syphilis, a pattern that carries particular weight given the risk of congenital transmission. Spain reported the highest number of confirmed cases among European countries tracked by the agency, with 37,169 gonorrhoea cases and 11,556 syphilis cases in 2024.
In England specifically, the picture is similarly dire. The UK Health Security Agency reported 71,802 gonorrhoea cases in 2024, along with 9,535 syphilis cases. The country had already sounded an alarm in 2023 when gonorrhoea hit 85,000 cases, prompting the rollout of a gonorrhoea vaccine in 2025. Yet even with that intervention, the underlying transmission continues. Chlamydia, the most commonly reported bacterial STI overall, actually declined by 6 percent since 2015 to 213,443 cases—suggesting that prevention and treatment efforts have worked for some infections but not others.
The message from health officials is straightforward, almost defiantly simple: use condoms with new or multiple partners, and get tested if symptoms appear. Both infections are treatable with antibiotics when caught early. Neither requires exotic intervention. Yet the gap between what should happen and what is happening has widened enough to produce record numbers. Testing infrastructure has not kept pace with need. Prevention messaging has not reached everyone. Some people do not know they are infected because they have no symptoms. Others do not seek testing because they do not perceive risk. The result is a disease environment that has not existed in over a decade, and health agencies are calling for urgent action to reverse it.
Notable Quotes
These infections can cause severe complications, such as chronic pain and infertility and, in the case of syphilis, problems with the heart or nervous system.— Bruno Ciancio, European Centre for Disease Prevention and Control
Widening gaps in testing and prevention were partly behind the surge in transmission, and urgent action is needed.— European Centre for Disease Prevention and Control
The Hearth Conversation Another angle on the story
Why are these numbers climbing now, when we have antibiotics and vaccines?
The infections themselves are treatable, but the system that finds them and stops them from spreading has gaps. Testing is not reaching everyone who needs it. Prevention tools are not where they should be. It is not about the medicine failing—it is about the infrastructure failing.
You mentioned congenital syphilis nearly doubling. What does that mean in practical terms?
It means newborns are being born with an infection that their mothers could have been tested for and treated during pregnancy. These children face lifelong complications. It is preventable suffering that is happening because the testing and prevention system is not working.
Men who have sex with men are most affected. Is this a new pattern?
No, they have always been disproportionately affected. But what is new is the scale. The increases are steeper and the absolute numbers are higher than they have been in over a decade. And now we are also seeing sharp rises in heterosexual women of reproductive age, which is a different pattern emerging.
Spain has the highest numbers. Do we know why?
The data does not explain why Spain specifically is seeing higher rates. It could be testing differences, population density, sexual health infrastructure, or reporting practices. The numbers tell us where the problem is largest, but not always why.
If the vaccine rolled out in the UK in 2025, why are cases still so high?
A vaccine takes time to work through a population. You have to reach people, vaccinate them, and then wait for immunity to build. The cases we are seeing now were largely acquired before the vaccine was widely available. The real test of whether the vaccine works will come in the years ahead.