A mediaeval disease is making a comeback across England, with cases on the rise in across the country. According to data, there were 60 reported cases of syphilis in Nottinghamshire, the ancient sexually transmitted disease, in 2022 - with a rate of 7.3 cases per 100,000 people.
Across the country, cases have increased by 15 per cent to nearly 8,700 diagnoses last year - the largest annual number since 1948. A decade ago there were 3,000 cases of syphilis diagnosed in England, just over a third as many as last year, while the infection rate has trebled from 5.6 syphilis cases per 100,000 of the population in 2012 to 15.4 last year.
Dr Hamish Mohammed, Consultant Epidemiologist at the UK Health Security Agency (UKHSA), said: “Increased testing is likely to have played a part in the rise in gonorrhoea and syphilis diagnoses, but the scale of the increase strongly suggests that there is more transmission of these STIs within the population. There is some evidence to suggest that this may be due to more people having condomless sex with new or casual partners.”
UKHSA data shows syphilis disproportionally affects gay, bisexual, and other men who have sex with men (GBM). Seven in 10 of the cases diagnosed last year (69 per cent) were in GBM.
The UK Health Security Agency (UKHSA) says cases of syphilis have fluctuated over the last 100 years, spiking after the two world wars, but then declining in the late 1940s and 1950s due to effective treatment with penicillin, and greater availability of condoms.
It re-emerged in the 1960s but then fell into decline in the 1980s, probably due to behavioural changes brought about by the emergence and awareness of the HIV virus and Aids.
But since the early 2000s syphilis - and gonorrhoea - have re-emerged as major public health concerns. Using our interactive map below, you can see how the rate of syphilis in Nottinghamshire compares to other counties.
Syphilis is far more common in London than anywhere else in England. The infection rate in the capital is 44.9 infections per 100,000 of the population. That is more than triple the next highest regional rate, 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 believed to have been spread by invading troops, it was known in some parts of Europe - including the UK - as the “French disease”. Mindful of the stigma, the French, however, called it “the Neapolitan disease”.
It is thought up to five million people died across Europe during that outbreak, which left victims with bursting boils and rotting flesh.
Today syphilis is perfectly treatable.
Symptoms include ulcers and white or grey 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 patchy 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 30 deaths were caused by syphilis in England between 2013 and 2021. The UKHSA says condoms are the best form of defence against sexually transmitted infections such as syphilis.
It urges anyone having condomless sex with new or casual partners to undergo testing, which is free, and can be accessed at sexual health clinics. To find your nearest sexual health clinic visit: www.nhs.uk/service-search/find-a-sexual-health-clinic
