Sexually transmitted infections in Europe are climbing to levels not seen in more than a decade, raising concern among health authorities across the continent.
New data from the European Centre for Disease Prevention and Control (ECDC), point to a particularly sharp rise in gonorrhea and syphilis in 2024, alongside a near doubling in reported cases of congenital syphilis, a condition in which the infection passes from a pregnant woman to the fetus and can cause severe and lasting complications in the newborn.
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Spain recorded the highest number of gonorrhea and syphilis cases. Pictured: Cibeles Fountain in Madrid
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According to the report, 106,331 cases of gonorrhea were reported in participating countries in 2024, a 303% increase since 2015 and the highest level since European monitoring of sexually transmitted infections began in 2009.
Spain reported the highest number of cases, with 37,169 diagnoses, followed by the Netherlands with 13,952, France with 13,533, Belgium with 7,623, Ireland with 5,832 and Denmark with 5,091.
When the figures are adjusted for population size, the picture changes. The highest rates were recorded in Ireland, with 109 cases per 100,000 people, followed by Malta with 89.6, Iceland with 88.1, Luxembourg with 86.6 and Denmark with 85.4.
Syphilis also rose sharply. The number of cases more than doubled since 2015, reaching 45,577 in 2024. Spain again stood out, with 11,556 cases, followed by Germany with 9,509, Belgium with 3,420, Italy with 3,088, Poland with 2,875, France with 2,486 and Portugal with 2,198.
Relative to population size, Malta recorded the highest rate, with 60.3 cases per 100,000 people, followed by Spain with 23.8, Portugal with 20.7, Hungary with 18 and Ireland with 17.6.
Chlamydia remained the most commonly reported bacterial STI in Europe, with 213,443 cases in 2024. However, the number of cases has fallen by about 6% since 2015. In absolute numbers, Spain reported 41,978 cases, Denmark 29,946, Sweden 26,331, Norway 23,100, France 22,231 and the Netherlands 20,174.
By rate per 100,000 people, the Nordic countries stood out: Denmark with 502.3 cases, Iceland with 489.1, Norway with 416.2, Finland with 258.5 and Sweden with 249.5.
Europe also reported 3,490 cases of lymphogranuloma venereum (LGV) in 2024, another bacterial STI caused by certain strains of chlamydia. According to the ECDC, the disease is less familiar to the general public but has also been rising in recent years. The European reports note that the Netherlands and Spain together account for most reported cases.
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Record-breaking rise in sexually transmitted infections across Europe
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The UK does not appear in the European reports since Brexit, but it is not absent from the broader crisis. It now publishes data separately, and has also recorded especially high numbers in recent years. In 2024, the UK reported 71,802 cases of gonorrhea and 9,535 cases of early syphilis. In 2025, it launched a vaccine against gonorrhea after recording more than 85,000 gonorrhea cases in 2023.
ECDC officials warn that the rise is not just a matter of numbers. “Sexually transmitted infections have been on the rise for 10 years and reached record high levels in 2024,” said Bruno Ciancio, head of the ECDC unit for directly transmitted and vaccine-preventable diseases. When these infections go untreated, he said, they can cause severe complications, including chronic pain, infertility and, in the case of syphilis, damage to the heart or nervous system.
One of the most worrying figures concerns congenital syphilis. Between 2023 and 2024, reported cases nearly doubled in countries that submitted data, from 78 to 140 cases across 14 countries.
Congenital syphilis occurs when a pregnant woman with undiagnosed or untreated syphilis passes the infection to the fetus. According to the ECDC, the rise points not only to the spread of syphilis in the general population, but also to missed opportunities within the health system, including insufficient screening during pregnancy, lack of follow-up, missed repeat testing or treatment that was not given in time.
The increase is not uniform across all populations. Men who have sex with men remain disproportionately affected, with the sharpest long-term increases in gonorrhea and syphilis recorded in that group. At the same time, the ECDC stresses that the rise is also expanding into the heterosexual population, especially among women of reproductive age, a trend that heightens concern over further increases in congenital syphilis.
Not only unprotected sex
The reasons for the surge are complex. According to the ECDC, part of the increase is linked to widening gaps in testing and prevention, but also to health services that are not accessible enough, uneven implementation of prevention programs across countries, outdated national strategies and behavioral changes that followed the COVID-19 pandemic.
The report notes that in 13 of 29 reporting countries, basic STI testing still requires out-of-pocket payment, a barrier that may keep people from seeking early testing.
Another issue worrying health authorities is antibiotic resistance, especially in gonorrhea. In January 2026, the ECDC published dedicated guidance on the use of doxycycline as post-exposure prophylaxis for people at high risk, but made clear that it does not recommend broad use of that approach against gonorrhea because of high levels of antibiotic resistance and concern that it could accelerate the development of further resistance.
The UK has also reported an increase in cases of gonorrhea resistant to ceftriaxone, one of the main antibiotics used to treat the disease.
Symptoms are not always clear. Gonorrhea can cause pain, unusual discharge and inflammation in the genital area, but in some cases causes no symptoms at all. Syphilis may appear as sores around the genitals or mouth, a rash on the palms, hair loss and flu-like symptoms, but it can also be difficult to detect in its early stages, and symptoms may appear and disappear.
Both diseases can be treated with antibiotics, but when they are not diagnosed and treated in time, they can cause significant damage.
The message from European health authorities is simple but urgent: use condoms with new or multiple partners, get tested if symptoms such as pain, discharge or sores appear, and seek treatment quickly after diagnosis.
The ECDC is also calling on European countries to urgently update their national STI prevention strategies, expand access to testing, strengthen monitoring and reporting systems, improve partner notification and ensure that screening tests for pregnant women are carried out on time.
Without decisive action, officials warn, the current trends are expected to continue, along with the health harm and gaps in access to treatment.
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Congenital syphilis passes from mother to baby, with cases doubling in recent years
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The Israeli picture
In Israel, too, some sexually transmitted infections have increased in recent years, said Dr. Eyal Peretz, a dermatologist and venereologist with Maccabi Healthcare Services in the Jerusalem and Shfela districts. But he said the increase in Israel is far more moderate than the surge now being reported across Europe.
“Broadly speaking, this is not the same level of increase,” he said. “With chlamydia, there has been more or less a slow upward trend over the years, and with gonorrhea, there has been an increase over the past decade.
When it comes to herpes, which is also a sexually transmitted disease, the situation is relatively stable. With syphilis, Israel has also seen a clear upward trend over the past decade, especially since 2015-2016, but not in numbers like those in Europe.”
Dr. Eyal PeretzAccording to Peretz, the main reasons for the increase are unprotected sex and screening tests that are not performed often enough, especially among young people. “In the end, not using protection is the most common reason, and another reason is that young people simply do not bother to undergo screening tests frequently enough,” he said.
“Even if you have no symptoms, you are contagious. You have sex with one partner, become infected and do not know you are sick, and then have sex with another partner and infect them too, without understanding that this is how you are spreading the disease.”
Peretz stressed that the issue is not only the responsibility of the health system, but also a matter of public awareness and behavior. “It is not only a matter for the Health Ministry, he said, but also one of public education,” he said. “Young people who have sex with many partners, or without using protection, need to receive information from the healthcare services s and from STI awareness campaigns. If they undergo screening tests often enough, the diseases can be detected even when they are dormant, when the patient has no symptoms but is still contagious.”
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STI screening tests. In Israel, too, testing is not frequent enough
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But the rise in infections is only part of the problem. With gonorrhea, one of the main drivers of Europe’s surge, there is an added concern: over time, the bacteria has developed resistance to some of the antibiotics once used to treat it. If treatment is inaccurate or ineffective, it may fail to clear the infection and allow the patient to keep carrying the bacteria and infecting others.
“We see this mainly with gonorrhea,” Peretz said. “Once unsuitable treatment is given, the phenomenon is not eradicated. That is not true to the same extent for chlamydia, mycoplasma or syphilis, but with gonorrhea it can definitely be significant. Gonorrhea resistance is known, and if doctors continue treating it with antibiotics to which gonorrhea has already developed resistance, the chance of eradicating it is low.”
The problem becomes more complicated when the patient has no symptoms. “When someone comes in with symptoms of gonorrhea, or suspected gonorrhea, or when he is a carrier and says his partner was diagnosed with gonorrhea in a urine test, he is supposed to receive effective treatment against gonorrhea,” Peretz said.
“If he was asymptomatic to begin with and had no complaints such as burning during urination or discharge, and he received unsuitable antibiotic treatment, then he was not actually treated properly.”
The risks of late diagnosis or untreated infection differ from one STI to another, but the consequences can be serious. “With chlamydia and gonorrhea, especially in women, the infections can eventually lead to pelvic inflammatory disease and, in some cases, harm fertility,” Peretz said.
“Syphilis is a much more complex disease. Late syphilis can damage the nervous system and the heart. Congenital syphilis can cause miscarriages and fetal damage. It is something much broader and much more complex.”
What is the practical message for the Israeli public?
“In the end, it is important to use protection, especially condoms. That is the most important message, particularly for preventing chlamydia, gonorrhea and syphilis,” Peretz said. “It is important to remember that a condom cannot completely prevent syphilis infection, because syphilis can also be transmitted through direct skin-to-skin contact.
“The second message is to get tested, especially if there are symptoms that may be related to sexually transmitted infections, such as burning during urination, penile discharge or a rash in the genital area. In addition, testing is important as a form of routine monitoring, especially for people who have sex with many partners and do not consistently use protection. Early detection is important to prevent carriers from spreading the infection to additional partners.”