Epidemiological trends in adult and congenital syphilis in the EU/EEA: A joinpoint study

Abstract

Background

Syphilis notifications, including congenital syphilis, have increased markedly in recent years across the European Union/European Economic Area (EU/EEA), raising renewed public health concerns. This study aimed to characterise long-term trends in adult syphilis notifications in the EU/EEA from 2000 to 2023 and to examine recent patterns in congenital syphilis using joinpoint regression analysis.

Methods

Annual crude notification rates for adult syphilis (per 100,000 population, 2000–2023) and congenital syphilis (per 100,000 live births, 2010–2023) were obtained from the ECDC Surveillance Atlas. Joinpoint regression was applied to identify significant trend changes, estimate Annual Percent Change (APC) and, where appropriate, Average Annual Percent Change (AAPC).

Results

In the EU/EEA, adult syphilis rates declined from 2000 to 2007 (APC –8.76%), increased from 2007 to 2021 (APC +3.32%), and rose sharply after 2021 (APC +24.65%). Overall AAPC (2000–2023) was +1.12%. Congenital syphilis rates declined between 2010 and 2016 (APC –11.92%), then increased between 2016 and 2023 (APC +9.16%).

Conclusions

Syphilis notifications in the EU/EEA show a sustained resurgence, with recent acceleration and a parallel rising trend in congenital syphilis. Reinforcement of STI screening, timely treatment, and strengthened antenatal care are urgently warranted.