Bacterial STIs reach record highs in Europe, as congenital syphilis cases nearly double

The latest Annual Epidemiological Reports from ECDC indicate a surge in bacterial sexually transmitted infections (STIs) across Europe. In 2024, notifications of gonorrhoea and syphilis, alongside congenital syphilis, reached their highest levels in over a decade, reflecting sustained transmission across multiple countries.

The data for 2024 show that gonorrhoea cases reached 106 331, representing a 303% increase since 2015. Syphilis cases more than doubled over the same period to 45 577 cases. Chlamydia remains the most frequently reported STI with 213 443 cases. Lymphogranuloma venereum (LGV) also continued to see ongoing transmission, with 3 490 reported cases. 

‘Sexually transmitted infections have been on the rise for 10 years and reached record high levels in 2024. Untreated, these infections can cause severe complications, such as chronic pain and infertility and, in the case of syphilis, problems with the heart or nervous system. Most distressingly, between 2023 and 2024, we have seen a near doubling of congenital syphilis, where infections pass directly to newborns, leading to potentially lifelong complications’, says Bruno Ciancio, Head of Unit, Directly Transmitted and Vaccine-Preventable Diseases. 'Protecting your sexual health remains straightforward. Use condoms with new or multiple partners, and get tested if you have symptoms, such as pain, discharge or an ulcer’.

Transmission trends vary significantly across different population groups. Men who have sex with men remain the most disproportionately affected group, with the steepest long‑term increases in gonorrhoea and syphilis. Among heterosexual populations, syphilis is rising, particularly among women of reproductive age, the consequences of which are a near doubling of congenital syphilis cases from 78 in 2023 to 140 in 2024 across 14 countries reporting data. 

These figures align with findings from ECDC’s monitoring report on congenital syphilis, which highlights missed prevention opportunities, such as gaps in antenatal screening, lack of follow-up and repeat testing, and treatment. The monitoring report also identified broader hurdles to testing and prevention that require action. Thirteen of 29 reporting countries still charge out-of-pocket costs for basic STI tests. Uneven implementation of services and outdated national strategies limit the impact of proven interventions, as many national prevention strategies fail to account for post-pandemic behavioural changes. ECDC recommends that European countries improve antenatal screening protocols to ensure that syphilis is diagnosed and treated promptly and correctly according to the stage of infection, to prevent transmission to the foetus during pregnancy.

In addition, in January 2026, ECDC provided specific guidance on the use of doxycycline for post-exposure prophylaxis (doxy-PEP) to support STI prevention efforts. People facing higher exposure risks should consult their doctor or other healthcare provider about tailored prevention options. ECDC does not recommend widespread use of doxy-PEP for gonorrhoea due to high levels of antimicrobial resistance and the risk for further acceleration of resistance development.

Reversing increasing trends in STI cases requires accessible prevention services, easier access to testing, faster treatment, and stronger partner notification to stop onward transmission. ECDC urges public health authorities to urgently update national STI strategies and strengthen surveillance systems to better monitor the impact of prevention efforts. Without decisive action, current trends are likely to continue, increasing negative health consequences and widening inequalities in access to care.