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Annual diagnoses of infectious syphilis in England triple over 10 years

Annual diagnoses of infectious syphilis in England have tripled within 10 years, increasing from 2648 diagnoses in 2010 to 7982 in 2019, according to the latest data from Public Health England (PHE).

The increase was steepest between 2013 and 2017 (110% increase), with a 10 per cent increase between 2018 and 2019.

People of Black ethnic backgrounds experienced the highest rate of syphilis diagnosis, whereas gay, bisexual and other men who have sex with men (MSM) accounted for 78.4 per cent of new diagnoses in 2019. Diagnoses among MSM increased by 247 per cent between 2010 and 2017, and by 3.4 per cent between 2018 and 2019.

Syphilis diagnoses among heterosexuals also rose rapidly during the period, most particularly between 2018 and 2019 - by 21 per cent for men and 33 per cent for women - the data show.

The rate of confirmed syphilis test results among blood donors has risen among both men and women, suggesting increasing prevalence in the general population, noted PHE.

Clinically, in 2019, infectious syphilis accounted for 75.7 per cent (7982/10,540) of all syphilis diagnoses; this proportion has remained constant in recent years.

Early latent-stage diagnoses increased from 17.5 per cent (771/4394) in 2010 to 26.3 per cent (2770/10,540) in 2019. Late latent syphilis accounted for 22.1 per cent (2325/10,540) of all diagnoses in 2019.

Complications of syphilis represented 2.2 per cent of the total (n=233), of which 192 were neurosyphilis and 41 were cardiovascular syphilis.

Complications of syphilis may be underreported as cases with cardiovascular syphilis and neurosyphilis are likely to present in clinical settings other than sexual health services and therefore not be recorded in sexually transmitted infections surveillance systems. New codes for otosyphilis and ocular syphilis have been introduced and reported for the first time in 2019, and analysis of these data will be presented in future reports, said PHE.

The 2019 PHE Syphilis Action Plan brings together the existing recommendations for PHE and partner organisations to address the continued increase in syphilis diagnoses.


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