Epidemiology

Syphilis is a common STI. There were an estimated 6 million new cases of syphilis worldwide in 2016.[8] 

Syphilis in the US:

In 2017, the incidence rate of primary and secondary syphilis was 9.5 cases in 100,000 population (30,644 new cases).[9]  This represents a 10.5% increase from 2016 (8.6 cases in 100,000 population), and a 72.2% increase from 2013 (5.5 cases in 100,000 population). Over half (57.9%) of all reported cases of primary and secondary syphilis occurred in men who have sex with men (MSM). The incidence rate of primary and secondary syphilis was 16.9 cases in 100,000 men in 2017, and 2.3 cases in 100,000 women.[9] In men, the incidence rate was highest in the age group 25-29 years, followed by age groups 20-24 years and 30-34 years (incidence was similar in these two age groups). In women, the highest rate was in the age group 20-24 years, followed by age group 25-29 years.

In 2017, the incidence rate of primary and secondary syphilis was highest in black people (24.2 cases in 100,000 population).[9]  The incidence rate in black people was 4.5 times higher than in white people (5.4 cases in 100,000 population). From 2013-2017, rates have increased among all race/ethnicity groups. Between 2016-2017, the greatest increase was observed among American Indians/Alaska Natives (38.8%), and those identified as multi-racial (31.7%), followed by Asians (15.7%), white people (10.2%), Native Hawaiians/other Pacific Islanders (9.4%), Hispanics (9.3%), and black people (5.7%).[9]

The incidence of congenital syphilis in 2017 was 23.3 cases in 100,000 live births (628 cases); a 43.8% increase from 2016 (16.2 cases in 100,000 live births) and a 153.3% increase from 2013 (9.2 cases in 100,000 live births).[9]

Syphilis in other countries:

Syphilis has been increasing in Europe since 2011, particularly among MSM.[10]  In 2016, there were 29,365 new cases reported across the 28 countries in the European Union (EU) (6.1 cases in 100,000 population). The highest rates were in the UK (9.9 cases in 100 000 population), Malta (9.2), Iceland (9.0), and Germany (8.7). The lowest rates (<2 cases in 100,000 population) were in Croatia, Cyprus, Estonia, Portugal, and Slovenia. The incidence rate was 8 times higher in men (10.8 cases in 100,000 population) than in women (1.3 cases in 100,000 population). The highest age and sex-specific rate was in men aged 25-34 years (25 cases in 100,000 population).[10]

In London, UK, the number of syphilis diagnoses reported in 2017 (3,397) was double the number reported in 2013.[11]

Thirty-seven congenital syphilis cases were reported in 23 EU/Europen Economic Area Member States in 2016.[12] This represents a crude rate of 1.1 cases in 100,000 live births. 

In China, where syphilis was virtually eradicated in the 1950s, both the incidence and prevalence of the disease have more than quadrupled from the 1990s to the 2010s.[13] The increases have been attributed to migration from rural communities to urban environments, limited screening for the presence of the disease, lack of adequate partner notification, and a reluctance by the general population to access STI healthcare services.[14]

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