Record Highs for Bacterial STIs in Europe, ECDC Reports

The European Centre for Disease Prevention and Control (ECDC) has reported that rates of bacterial sexually transmitted infections (STIs), including gonorrhea and syphilis, reached record highs in the European Union and European Economic Area (EU/EEA) in 2024. While chlamydia remains the most commonly reported STI, the data shows a significant increase in cases of gonorrhea and syphilis over the past decade.

Key Statistics

Chlamydia: 213,443 cases were reported in 2024, making it the most common bacterial STI in the region.

Gonorrhea: 106,331 cases were reported in 2024. This represents a 303% increase since 2015 and is the highest annual rate recorded since ECDC surveillance began in 2009.

Syphilis: 45,577 cases were reported in 2024, more than double the number reported in 2015.

Lymphogranuloma venereum (LGV): 3,490 cases were reported.
Congenital Syphilis: 140 cases were reported in 2024. This figure nearly doubled from 78 cases in 2023 and is the highest number reported since 2009.

Gonorrhea Trends

Between 2023 and 2024, the overall gonorrhea rate increased by 4.3%. When broken down by sex:

Men: The rate increased by 7.9%.
Women: The rate decreased by 8.6%.

The highest rates of gonorrhea were reported in Ireland, Malta, Iceland, Luxembourg, Denmark, and Spain.

Population Groups and Transmission

The ECDC reports that men who have sex with men (MSM) remain the population group most disproportionately affected, with steep increases observed in both gonorrhea and syphilis.

Syphilis is also rising among heterosexual populations, particularly in women of reproductive age. The ECDC states that this increase among women contributes directly to the rise in congenital syphilis cases.

Potential Factors and Prevention Gaps

The ECDC notes that increased testing and improved reporting may contribute to the higher case numbers. External sources cited decreased condom use and an increase in the number of sexual partners, particularly among younger populations.

Regarding prevention, the ECDC identified several missed opportunities for preventing congenital syphilis, including:

Gaps in antenatal screening
A lack of follow-up and repeat testing
Issues with treatment

An ECDC analysis of 29 countries found that 13 charge out-of-pocket costs for basic STI tests. The agency also stated that uneven implementation of services and outdated national strategies are hindering prevention efforts.

Recommendations

The ECDC recommends that countries improve antenatal screening protocols to ensure timely diagnosis and treatment of syphilis.

In January 2026, the ECDC issued guidance recommending against the widespread use of doxycycline post-exposure prophylaxis (doxy-PEP) for the prevention of gonorrhea due to concerns about antimicrobial resistance.

The agency also urges member states to update national STI strategies and strengthen their surveillance systems.