Sexually transmitted infections in Europe 2012
This ECDC surveillance report on sexually transmitted infections in Europe covers the years 2003 to 2012 and describes the epidemiological features and basic trends of the five STIs under EU surveillance: chlamydia, gonorrhoea, syphilis, congenital syphilis and lymphogranuloma venereum.
Chlamydia remains the most frequently reported STI in Europe, accounting for the majority of all STI cases reported. In 2012, 385 307 cases of chlamydia were reported in 26 EU/EEA Member States, an overall notification rate of 184 per 100 000 population. Chlamydia was reported more frequently in women than in men, with a rate of 211 per 100 000 in women and 153 in men. The true incidence of chlamydia is likely to be considerably higher as differences in testing methods and coverage, screening programmes and surveillance systems across Europe mean that many diagnoses are not made or not reported; in fact, 84 % of all cases have been reported by four countries (Denmark, Norway, Sweden and the United Kingdom). More than two thirds (68 %) of all cases were reported in young people between 15 and 24 years of age, and 88 % of cases were reportedly due to heterosexual transmission. The age and gender distribution of cases is significantly affected by testing and screening practices in the United Kingdom, which reports 62 % of cases overall and targets young people in its screening programme. Overall, the number of chlamydia cases has increased over the last decade, while rates seem to have stabilised over the last four years. Among those countries that reported consistently between 2003 and 2012, the overall reporting rate has increased by 90 %, from 182 per 100 000 population in 2003 to 345 per 100 000 in 2012. This is most likely due to increased case detection, improved diagnostic tools, improved surveillance systems and the introduction of chlamydia screening programmes in a few countries. Decreasing or low rates may reflect changes in healthcare systems or the lack of accurate diagnostic tools or diagnostic capacity rather than a genuinely low prevalence of chlamydia.
In 2012, 47 387 gonorrhoea cases were reported in 29 EU/EEA Member States (no data were available from Germany and Liechtenstein), an overall notification rate of 15.3 per 100 000 population. As opposed to chlamydia, gonorrhoea was reported three times more often in men than in women, with a rate of 25.7 per 100 000 in men and 9.2 in women. Young people between 15 and 24 years of age accounted for 41 % of all gonorrhoea cases. More than a third of all gonorrhoea cases in 2012 (38 %) were reported in men who have sex with men (MSM). Since 2008, the overall rate has increased by 62 %, and trends show an increase for most EU/EEA Member States. Increasing rates appear to be mainly due to increased diagnoses among men and among MSM in particular.
Syphilis data were reported in 30 EU/EEA Member States in 2012 (no data available from Liechtenstein); 20 802 syphilis cases were reported resulting in an overall notification rate of 5.1 per 100 000 population. Syphilis was also reported almost four times more often in men than in women, with an overall rate of 7.7 per 100 000 in men and 1.7 in women. Only 15 % of cases reported in 2012 were among young people between 15 and 24 years of age; the majority of cases were reported in people 25 years and older. Close to half (48 %) of the syphilis cases were reported in MSM. After a long-term decreasing trend, overall rates are now stable but appear to have started increasing among males. A number of countries reported increasing trends between 2008 and 2012.