Syphilis Cases Surge Across Australia, Leading to Infant Deaths and National Health Response
"A health disaster and a tragedy" – Professor Kelly Hosking, NT Health's incident controller for syphilis.
A marked increase in syphilis notifications has been recorded across Australia over the past decade, alongside a number of infant deaths attributed to the infection. The outbreak has been classified as a national public health concern, with specific disparities noted among Indigenous populations and challenges in healthcare screening practices.
Case Numbers and Demographics
According to government health data, syphilis notifications in Australia rose from 4,773 cases in 2015 to 8,993 in 2025. From 2016 to 2025, there were at least 130 cases of congenital syphilis—which occurs when the infection is transmitted from a pregnant mother to a child—resulting in at least 42 infant deaths.
Reports indicate that 60% of these infant deaths involved Aboriginal and Torres Strait Islander children. Data also shows that Aboriginal and Torres Strait Islander people are infected at a rate seven times higher than non-Indigenous Australians. The Northern Territory recorded the highest notification rate at 169 per 100,000 people, compared to the national average of 23 per 100,000.
Background on the Disease
Syphilis is a bacterial infection caused by Treponema pallidum. It is primarily transmitted through sexual contact or from a mother to her child during pregnancy or birth. Early symptoms may include painless sores that can go unnoticed.
The infection is curable with penicillin, particularly when detected in its early stages.
If left untreated, syphilis can cause severe damage to the heart, brain, bones, and other organs, and can be life-threatening. In pregnancy, congenital syphilis can lead to miscarriage, stillbirth, or neonatal death.
Public Health Classification and Response
In 2019, Australia's Chief Medical Officer declared the outbreak a Communicable Disease Incident of National Significance. The Northern Territory established an Incident Management Team (IMT) focused on culturally-led healthcare, involving Aboriginal health workers. These workers are trained to administer penicillin injections and conduct testing in remote communities.
Health officials have stated that achieving testing rates of 70-80% could control the outbreak. The Northern Territory government estimates that $25–30 million over five years is required for this effort. The federal government has committed $132.5 million over four years for programs including STI reduction initiatives.
Healthcare Worker Screening Practices
A survey by the organization ASHM of 819 Australian healthcare workers found that 54% reported low confidence in when to test for or refer syphilis cases. Only 38% of respondents stated they considered it their responsibility to raise the topic of sexual health with patients.
The survey also noted that up to half of syphilis cases are asymptomatic, meaning a blood test is often necessary for diagnosis. Some clinicians reportedly perform partial STI testing (e.g., for chlamydia and gonorrhea) without including syphilis or HIV serology.
Expert Statements
Professor Kelly Hosking, NT Health's incident controller for syphilis, described the number of congenital syphilis cases as a "health disaster and a tragedy," noting the condition is entirely preventable and treatable in pregnant individuals.
Dr. Paul Burgess, NT's Chief Health Officer, stated that the outbreak can be controlled with sustained investment and community buy-in.
"Many infected individuals are asymptomatic." – Aboriginal health worker Patricia Nundhirribala, emphasizing the importance of widespread testing.
Professor Maciej Henneberg, a bioarchaeologist at the University of Adelaide, noted that before penicillin became available in the 1940s, syphilis affected up to 10% of Australia's colonial population, causing characteristic bone damage.
Healthcare provider Teresa De Santis urged the public to get tested, stating that treatment is straightforward and that individuals should not feel ashamed.