Record surge in sexually transmitted bacterial infections reported in Europe

The European Centre for Disease Prevention and Control (ECDC) published data for 2024, recording the highest levels of gonorrhea and syphilis in EU/EEA countries in a decade. Of particular concern is the nearly twofold increase in cases of congenital syphilis — transmission of the infection from mother to child.

In Brief

• In 2024, gonorrhea cases reached 106,331 — a 303% increase since 2015. Syphilis cases more than doubled over the same period, to 45,577.
• Chlamydia remains the most frequently reported STI — 213,443 cases. 3,490 cases of lymphogranuloma venereum (LGV) were recorded.
• Congenital syphilis cases nearly doubled, from 78 in 2023 to 140 in 2024 in the 14 countries that provided data. The rise in syphilis is particularly notable among women of reproductive age.
• Among men, gonorrhea cases increased by 7.9% year-on-year, with more than half of cases in 2024 occurring among men who have sex with men. Among women, gonorrhea rates conversely decreased by 8.6%.
• 13 out of 29 countries providing data still charge for basic STI diagnostics — a financial barrier that contributes to ongoing chains of infection transmission.

Decade-Long Trend Peaks

"Sexually transmitted infections have been rising for 10 years and reached record levels in 2024. Without treatment, such infections can cause severe complications — chronic pain and infertility, and in the case of syphilis, heart or nervous system problems," the ECDC noted.

The trend for gonorrhea is particularly telling: a steady threefold increase over a decade indicates not a one-time spike, but a systemic weakening of preventive mechanisms on the continent.

Why Congenital Syphilis is Rising

The most alarming aspect of the report is the increase in mother-to-child transmission. Uneven implementation of services and outdated national strategies limit the effectiveness of proven measures, as many national prevention programs do not account for post-pandemic changes in population behavior.

As a countermeasure, the ECDC recommends that European countries improve antenatal screening protocols to ensure timely and correct diagnosis and treatment of syphilis depending on the stage of infection — to prevent transmission to the fetus during pregnancy.

Barriers to Accessing Diagnostics

A structural problem highlighted by the report is unequal access to testing. Financial barriers discourage people from seeking timely help, contributing to ongoing chains of infection transmission.

According to the ECDC, reversing the rising STI trends requires accessible preventive services, simplified access to testing, faster treatment, and enhanced partner notification to stop further transmission. The agency separately clarifies its position on antibiotic prophylaxis: the ECDC does not recommend the widespread use of doxycycline for post-exposure prophylaxis of gonorrhea due to high levels of antimicrobial resistance and the risk of further accelerating its development.

Author's Conclusion

The ECDC data documents a systemic failure in European STI prevention that has been building for an entire decade. The rise in congenital syphilis is the most alarming indicator: it is directly linked to gaps in antenatal care and diagnostic accessibility. Regaining control over the epidemic will require not piecemeal measures, but a revision of national prevention strategies taking into account the changed post-pandemic behavior of the population.