EUROPEAN UNION
Iyunade Grace
Cases of gonorrhea and syphilis have reached their highest levels in more than a decade across Europe, according to the latest data from the European Centre for Disease Prevention and Control. The agency’s figures show gonorrhea infections rose by 303% between 2015 and 2024, reaching 106,331 cases, while syphilis cases more than doubled in the same period to over 45,550. ECDC officials describe the surge as an STI explosion not seen since before 2015, with testing gaps and reduced condom use identified as key drivers behind the increase.
Spain has emerged as the continent’s hotspot, recording 37,169 gonorrhea cases and 11,556 syphilis infections in 2024 alone. The pattern is not uniform across Europe, but the upward trend is consistent in most EU and EEA countries. Men who have sex with men remain the most affected group, accounting for the majority of syphilis and gonorrhea diagnoses. However, recent data show a sharp rise among heterosexual women of childbearing age, particularly those aged 20 to 24, where gonorrhea notifications increased by nearly 200% between 2021 and 2023.
The rise in congenital syphilis is especially concerning for public health officials. Cases where the infection passes from pregnant mothers to newborns nearly doubled between 2023 and 2024 in participating countries. ECDC experts warn that untreated syphilis can cause severe complications including heart and nervous system damage, while gonorrhea can lead to chronic pain, pelvic inflammatory disease, and infertility. The agency stresses that many infections go undiagnosed due to lack of symptoms or limited access to testing, meaning the true scale of the outbreak is likely higher than reported numbers suggest.
Behavioral changes appear to be a major factor behind the surge. ECDC and WHO reports point to declining condom use among younger age groups, with 30% of sexually active 15-year-olds reporting no contraception use. At the same time, more people are reporting higher numbers of sexual partners. Increased testing explains part of the rise, but officials say it cannot account for the full magnitude of the increase. Antimicrobial resistance is adding another layer of concern, with growing resistance to azithromycin and ciprofloxacin complicating gonorrhea treatment.
The ECDC’s 2024 monitoring report found that most EU and EEA countries have national STI strategies, but many are outdated and not equipped to address post-pandemic behavioral shifts. Only 10 of 29 countries had updated their plans in the past five years. Barriers to care remain widespread, with 13 countries requiring out-of-pocket payments for basic STI tests and seven requiring parental consent for testing under 18. The agency warns that these gaps are undermining progress toward 2025 targets for controlling STI epidemics.
Health officials are calling for urgent action focused on testing, treatment, and prevention. ECDC Director Andrea Ammon has urged countries to expand access to free and confidential testing, prioritize sexual health education, and combat stigma that discourages people from seeking care. The UK has already rolled out a world-first gonorrhea vaccine in 2025 in response to record case numbers. For now, the ECDC’s message is straightforward: consistent condom use with new or multiple partners and prompt testing for anyone with symptoms remain the most effective tools to curb transmission.
