‘Concerning' rise of Victorian STI that can trigger heart disease, brain damage and death – are you at risk?
Symptoms of the historical STI explained - and how to protect yourself from infection
STI ALERT 'Concerning' rise of Victorian STI that can trigger heart disease, brain damage and death – are you at risk?
CASES of a sexually transmitted infection that was rampant during the Victorian era have seen a "concerning" surge in England.
Diagnoses of syphilis - which can trigger heart disease and brain damage in its later stages - have been on the upward trajectory, with 13,030 recorded in 2024.
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Syphilis diagnoses continued to rise between 2023 and 2024
This figure - which includes early and late-stage syphilis diagnoses and complications from the infection - marks a 5 per cent increase from 2023, when 12,456 syphilis diagnoses were detected.
Data published by the UK Health Security Agency (UKHSA) shows a 1.7 per cent rise in early-stage syphilis diagnoses between 2023 and 2024, jumping from 9,375 to 9,535.
"The number of syphilis diagnoses was the largest annual number reported since 1948," the health watchdog wrote in its report.
Early diagnoses of the historical STI decreased slightly among gay and bisexual men, from 6,435 to 6,330.
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But there was a sharp increase in infectious syphilis diagnoses among heterosexual men - rising by 23.8 per cent from 1,115 to 1,380.
"However, taking into account all diagnoses of syphilis - including late stage or complications such as ocular and otosyphilis - there were an additional 850 diagnoses amongst women who have sex with men, 931 diagnoses among heterosexual men and 1,172 diagnoses among gay and bisexual men," UKHSA said.
Syphilis is most commonly passed on through unprotected sex with someone who's infected.
You can get the infection if you come into contact with an ulcer on their penis, vagina, bottom, or inside their mouth.
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It's also possible for it to be transmitted from a mum to her baby through the womb, which can increase the risk of miscarriage, premature birth and stillbirth.
Symptoms of the STI can take about three weeks to appear after infection and can be subtle, coming and going over time, making them hard to spot.
What is Gonorrhoea
It can crop up as painless sores or grey-ish warty growths, most commonly on your penis, vagina or around your anus.
Syphilis can also cause a rash that spreads from the hands and feet to the rest of the body, as well as white patches in the mouth, flu-like symptoms and hair loss.
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Sometimes the symptoms can improve or go away completely, but if you have not been treated the infection is still in your body.
This means you can still pass it on and you're at risk of getting serious problems later on.
Drug-resistant gonorrhoea
UKHSA's report also included data on other STIs, including gonorrhoea.
The health watchdog said there was a 16 per cent drop in gonorrhoea cases, with 71,802 diagnoses of the infection in 2024, compared to 85,370 in 2023.
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The fall has been greatest in young people aged 15 to 24 years where there was a 36 per cent reduction in diagnoses - but UKHSA noted that it is too soon to conclude whether this trend will continue.
However, it flagged there has been "a concerning acceleration" in diagnoses of antibiotic-resistant gonorrhoea.
While most gonorrhoea infections can be treated effectively with antibiotics, certain strains don't respond to the drugs and "present significant treatment challenges".
The STI is usually treated with a single dose of the antibiotic ceftriaxone, given as an injection or tablets at GP surgeries or a sexual health clinics.
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But in some cases this isn't effective, as the bacteria has developed the ability to survive and multiply even when exposed to the antibiotic.
"Ceftriaxone resistance is particularly concerning as this antibiotic serves as the primary treatment for gonorrhoea infections," UKHSA noted.
Symptoms of syphilis and its stages
The symptoms of syphilis are often mild, making them difficult to spot.
They also tend to change over time, and come and go, so it is easy to presume you aren't infected, even when you are.
The most common symptoms of the infection include: Small sores (ulcers) on your penis, vagina, or around your bottom (anus) – these are usually painless and you may only have one of them
Sores in other areas, including in your mouth or on your lips, hands or bottom
White or grey warty growths most commonly on your penis, vagina or around your anus
A rash on the palms of your hands and soles of your feet that can sometimes spread all over your body – this is not usually itchy
White patches in your mouth
Flu-like symptoms, such as a high temperature, headaches and tiredness
Swollen glands
Patchy hair loss on the head, beard and eyebrows
These signs may not appear until three weeks (or more) after you're infected.
Sometimes the symptoms can improve or go away completely, but if you have not been treated the infection is still in your body.
This means you can still pass it on and you're at risk of getting serious problems later on.
Potential complications include: Heart problems like angina, aortic aneurysm and heart failure
Brain problems like fits (seizures), memory problems, personality changes and dementia
Nerve problems like shooting pains, pins and needles, joint pain and gradual damage the joints
Problems with the skin, bones, testicles, liver and any other organ
Syphilis tends to happen in stages. Primary stage - between two to 12 weeks after exposure (patients develops painless sores on the genitals that might heal on their own) Secondary stage - between one to six months after the primary stage (patients may develop itchy rashes on the skin) Latent stage (patients show no signs but remain infectious) Tertiary stage (patients may develop complications)
Some of these problems may not appear for many years after being infected with syphilis.
At any point in the infection, syphilis bacteria - Treponema pallidum - can invade the nervous system and affect the brain, eyes or ears.
This may cause headaches, brain swelling, strokes, and mental changes.
Eyes may become sensitive to light or swollen, or sight may be affected and people may also experience hearing loss, dizziness, or tinnitus if the infection reaches their ears.
Source: NHS, WHO, CDC
"Although numbers remain low, ceftriaxone-resistant gonorrhoea cases are being detected more frequently."
It said 14 cases reported in the first five months of 2025, which is greater than the number of cases reported for the whole of 2024 - 13 cases.
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"Six of the 14 cases in 2025 have been extensively drug-resistant cases, which means that they were resistant to ceftriaxone and to second-line treatment options.
"Most ceftriaxone resistant cases are associated with travel to or from the Asia-Pacific region, where the prevalence of ceftriaxone resistance is high."
UKHSA warned early this year that treatment-resistant STIs run the risk of one day becoming "untreatable".
Despite infections of some STIs dipping, cases still remain high and continue to significantly impact young people, gay and bisexual men, and some minority ethnic groups, UKHSA said.
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It urged people to use condoms with new or casual partners to use a condom and get tested regularly, whatever their age or sexual orientation.
As many STIs don't cause noticeable symptoms, people often pass them on without realising it.
STIs are usually easily treated with antibiotics, but many can cause serious health issues if left untreated.
Chlamydia and gonorrhoea can cause infertility and pelvic inflammatory disease, while syphilis can cause serious, irreversible and potentially life-threatening problems with your brain, heart, or nerves.
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Dr Hamish Mohammed, consultant epidemiologist at UKHSA, said: 'Levels of STIs in this country remain a big threat to sexual wellbeing.
"These infections can have a major impact on your health and that of any sexual partners – particularly if they are antibiotic resistant.
"If you've had condomless sex with new or casual partners – either in the UK or overseas - get tested for STIs and HIV at least yearly, even if you don't have symptoms.
"Regular testing protects both you and those you're having sex with.
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'From August, eligible people will also be offered vaccination to reduce the risk of gonorrhoea and we expect to see the immunisation programme have an impact on diagnoses of this infection in coming years – please take up the vaccine if you are offered it.'
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