A medieval disease is making a comeback in England, with cases rising across the country. According to the figures, there were 60 cases of syphilis in Nottinghamshire, the ancient sexually transmitted disease, in 2022 – a rate of 7.3 cases per 100,000 people.
Nationwide, cases rose 15 percent to nearly 8,700 diagnoses last year — the highest annual number since 1948. A decade ago there were 3,000 diagnosed cases of syphilis in England, just over a third more than last year, while the infection rate tripled from 5.6 syphilis cases per 100,000 population in 2012 to 15.4 last year .
Dr Hamish Mohammed, consultant epidemiologist at the UK Health Safety Agency (UKHSA), said: “Increased testing is likely to have played a role in the rise in gonorrhea and syphilis diagnoses, but the scale of the increase strongly suggests that there is more transmission of these STIs in the population. There is some evidence to suggest that this may be due to more people having sex without a condom with new or casual partners.
UKHSA figures show that syphilis disproportionately affects gay, bisexual and other men who have sex with men (GBM). Seven out of 10 of the cases diagnosed last year (69 percent) were in GBM.
The UK Health Safety Agency (UKHSA) says syphilis cases have fluctuated over the past 100 years, rising after the two world wars but then falling in the late 1940s and 1950s century due to the effective treatment with penicillin and the greater availability of condoms.
It re-emerged in the 1960s, but then declined in the 1980s, possibly due to behavioral changes brought about by the emergence and awareness of the HIV virus and AIDS.
But since the early 2000s, syphilis – and gonorrhea – have re-emerged as major public health problems. Using our interactive map below, you can see how Nottinghamshire’s syphilis rate compares to other counties.
Syphilis is much more common in London than anywhere else in England. The infection rate in the capital is 44.9 infected per 100,000 of the population. This is more than three times the next highest regional ratio in the North East (14.8).
Outside London, the highest rates are in Brighton and Hove (53.9), Salford (45.4), Middlesbrough (44.5) and Manchester (42.9). Syphilis was first documented in Europe 500 years ago during the French invasion of Naples in 1495.
Because it was thought to have been spread by the invading troops, it was known in some parts of Europe – including the UK – as the “French disease”. Considering the stigma, however, the French called it the “Neapolitan disease.”
It is estimated that up to five million people died across Europe during this epidemic, which left victims with bursting boils and rotting flesh.
Today, syphilis is completely curable.
Symptoms include sores and white or gray warty growths on the genitals or bottom, sores in other areas including the lips, mouth, and hands, a rash, flu-like symptoms, swollen glands, and possibly patches of hair loss on the head, beard, and eyebrows. In extreme cases, it can cause serious and potentially life-threatening complications if left untreated. But these are rare.
The latest government figures show that 30 deaths were caused by syphilis in England between 2013 and 2021. The UKHSA says condoms are the best form of protection against sexually transmitted infections such as syphilis.
It urges anyone who has sex without a condom with new or casual partners to get tested, which is free and available at sexual health clinics. To find your nearest sexual health clinic, visit: www.nhs.uk/service-search/find-a-sexual-health-clinic