Record STI Levels Prompt Urgent Public Health Response
Europe is confronting a sharp rise in sexually transmitted infections, with gonorrhoea and syphilis reaching unprecedented heights in 2024 according to fresh surveillance data. This development underscores the need for renewed focus on sexual health across the continent.
The European Centre for Disease Prevention and Control released its latest findings this week, revealing sustained transmission that has now hit the highest points in more than a decade. Health authorities are urging immediate steps to curb further spread, particularly among groups showing the steepest increases.
Understanding Gonorrhoea and Syphilis
Gonorrhoea is a bacterial infection caused by Neisseria gonorrhoeae. It often presents with symptoms such as painful urination, unusual discharge from the genitals, or in some cases no symptoms at all. The infection can affect the urethra, cervix, rectum, throat, and eyes. If left untreated it may lead to serious complications including pelvic inflammatory disease and infertility.
Syphilis, caused by the bacterium Treponema pallidum, progresses through distinct stages if not treated. Early symptoms include a painless sore known as a chancre, followed by a rash and flu-like symptoms in the secondary stage. Later stages can damage the heart, brain, and nervous system. Both infections spread primarily through vaginal, anal, or oral sex with an infected person.
These bacterial STIs are curable with antibiotics when detected early, yet rising case numbers highlight ongoing challenges in diagnosis and treatment access.
Latest Surveillance Data Reveals Record Highs
Across the European Union and European Economic Area, gonorrhoea notifications totalled 106,331 confirmed cases in 2024. This marks a 303 percent increase compared to 2015 levels and a 4.3 percent rise from the previous year. The crude notification rate stood at 26.9 cases per 100,000 population, the highest since systematic surveillance began.
Syphilis cases reached 45,577 in 2024, more than doubling since 2015. Chlamydia remained the most commonly reported STI with 213,443 cases. Lymphogranuloma venereum, a specific strain of chlamydia, also showed ongoing transmission with 3,490 reports.
Seventeen countries recorded increases in gonorrhoea between 2023 and 2024, with particularly notable rises in several nations exceeding 20 percent.
Populations Experiencing the Greatest Impact
Men who have sex with men continue to bear the highest burden, accounting for the majority of long-term increases in both gonorrhoea and syphilis. Rates among this group have climbed dramatically over the past decade.
However, the data also show growing numbers among heterosexual populations. Syphilis notifications have risen notably among women of reproductive age. This shift has contributed directly to higher rates of mother-to-child transmission.
Young adults in the 20-34 age bracket appear especially affected in several countries, reflecting broader changes in social and sexual networks.
Key Drivers Behind the Ongoing Increase
Multiple interconnected factors explain the sustained upward trend. Gaps in testing and prevention services have widened in many areas. Thirteen countries still require out-of-pocket payments for basic STI tests, creating financial barriers for some individuals.
Post-pandemic behavioural shifts play a significant role. Increased use of dating applications has facilitated more casual encounters and a higher number of partners for many people. Reduced perceived risk following advances in HIV treatment has also contributed to lower consistent condom use in some communities.
National STI strategies in several countries have not kept pace with these changes, leaving prevention efforts less effective than they could be. Antimicrobial resistance adds another layer of complexity, particularly for gonorrhoea treatment options.
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Health Consequences of Untreated Infections
When gonorrhoea goes untreated it can cause chronic pelvic pain, infertility in women, and epididymitis in men. It also raises the risk of HIV acquisition. Syphilis in its later stages may damage major organs, leading to cardiovascular problems, neurological issues, and in severe cases blindness or deafness.
Both infections increase susceptibility to other STIs and can complicate existing health conditions. Early detection remains critical because symptoms are often mild or absent in the initial phases.
Rising Concern Over Congenital Syphilis
One of the most alarming developments involves congenital syphilis, where the infection passes from mother to baby during pregnancy. Cases nearly doubled from 78 in 2023 to 140 in 2024 across the 14 countries providing data.
Newborns affected by congenital syphilis may experience low birth weight, skin rashes, bone deformities, or more severe lifelong complications including developmental delays and hearing loss. Missed opportunities in antenatal screening and follow-up care have been identified as major contributors.
Health experts stress the importance of routine syphilis testing for all pregnant women, with repeat tests recommended in higher-risk situations to protect both mother and child.
Regional Differences Across Europe
Notification rates vary widely between countries. Spain recorded the highest absolute numbers, with 37,169 gonorrhoea cases and 11,556 syphilis cases in 2024. Other nations showed lower rates but still experienced significant percentage increases over time.
Countries with stronger testing infrastructure and free or low-cost services generally report higher case detection, while under-testing in some regions may mask the true scale of transmission.
Current Prevention Measures and Responses
Proven interventions include consistent condom use, regular testing for sexually active individuals, and prompt antibiotic treatment for confirmed cases. Partner notification helps break chains of transmission.
The United Kingdom introduced the world’s first gonorrhoea vaccine programme in 2025 following its own record case numbers. Doxycycline post-exposure prophylaxis is available in some settings for high-risk groups, though experts caution against broad use due to resistance concerns.
Public health campaigns promoting sexual health education and accessible services continue in various member states.
Challenges Facing Healthcare Systems
Outdated national strategies, inconsistent surveillance, and uneven access to care hinder progress. Many countries report difficulties in reaching key populations with targeted messaging and services.
Antimicrobial resistance monitoring remains essential, as gonorrhoea has shown resistance to multiple antibiotic classes over the years. Strengthening laboratory capacity and data sharing across borders will support more effective responses.
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Practical Steps for Individuals
Anyone who is sexually active can reduce risk by using condoms correctly with new or multiple partners. Regular sexual health check-ups, especially after changing partners or noticing symptoms, allow early intervention.
Open conversations with healthcare providers about sexual history and testing options help tailor prevention plans. Those with higher exposure risks should discuss additional measures such as vaccination where available or post-exposure options with a doctor.
Community organisations and sexual health clinics often provide confidential, low-cost or free services across Europe.
Future Outlook and the Path Forward
Without accelerated action, current trends are expected to continue, leading to greater health burdens and widening inequalities. Updating national strategies, expanding free testing, and integrating digital tools for education represent promising directions.
Coordinated European efforts combined with strong local implementation offer the best chance of reversing the rise in bacterial STIs. Public awareness and personal responsibility remain central to protecting sexual health for everyone.