A deadly Victorian-era STI that was nearly eradicated in the early 2000s is making a comeback, infecting a rising number of women in major Australian cities across the country.
Federal government figures show syphilis among women of childbearing age increased by five per cent in one year and is up 20 per cent over a five-year period.
The bacterial infection, once rampant in the 1800s, is primarily transmitted through oral, vaginal, and anal sex and can also spread during pregnancy.
Often dubbed a silent disease, syphilis may show no symptoms for years, and when symptoms do appear, they typically begin 10 to 90 days after infection. It is treatable with antibiotics.
Untreated cases can eventually lead to serious complications, including blindness, paralysis, organ damage, dementia, and death.
The Royal Australian College of GPs said last year 8,928 cases of syphilis were reported in Australia, compared to 3,881 a decade ago, and 1,962 cases in 2004.
RACGP sexual health expert Sara Whitburn said the geography of syphilis infections is changing, shifting from remote and rural northern Australia to large cities, with NSW and Victoria recording the highest percentage of infections in 2025.
Dr Whitburn said she was seeing more women presenting at GPs with symptoms of an STD but were often shocked when they tested positive for syphilis.
Syphilis is making a comeback in Australia and it often strikes with no symptoms
In the 19th century syphilis sufferers in France were caricatured to warn people of the awful consequences of visiting brothels
A photograph of a patient with tertiary syphilis resulting in gummatous lesions on the dorsal surface of the left hand. Gummatous lesions due to tertiary syphilis occur many years after initial untreated primary syphilis
‘People might be aware of chlamydia, but still are often quite shocked to have chlamydia, even though it’s very, very common,’ she said.
‘And then syphilis, I think people think of this as, you know, oh, isn’t that a Victorian era disease seen in literature and movies.’
Dr Whitburn added that the widespread use of PrEP (Pre-Exposure Prophylaxis) among gay and bisexual men to prevent HIV infection had partly led to an increase in syphilis infections, as it was linked to a decline in condom use in that group.
‘When there is people who cross from those populations to non-Indigenous women, women who might have partners who also identify as gay bisexual men, we start to see syphilis in those populations,’ she said.
‘With COVID and the lockdown, people have perhaps forgotten a little bit around negotiating and communicating around safer sex.’
Dr Whitburn partly attributed the rise in syphilis among women of childbearing age to better screening, given pregnant women are particularly at risk, with the infection known to cause stillbirths and miscarriages, as babies can contract the disease while in the womb.
‘We’re really actively looking to screen for syphilis in that age group because we know that it can actually cause congenital syphilis, which can be life threatening, or can cause quite significant illnesses.’
Curtin University epidemiologist Dr Jennifer Dunne told newsGP new research found congenital syphilis triples the risk of preterm birth.
Close up of Secondary stage syphilis sores (lesions) on the palms of the hand
RACGP sexual health expert Sara Whitburn (pictured) says women are often surprised when they test positive for an STD, especially syphilis
Left untreated, congenital syphilis can cause blindness, deafness, intellectual disabilities, and skeletal deformities in babies – and can be fatal.
Of 100 cases of congenital syphilis reported between 2016 and 2024, there were 33 deaths recorded.
According to the National Syphilis Surveillance quarterly report, rising syphilis cases among women of reproductive age have coincided with a record number of diagnoses of congenital syphilis in 2023, the highest since 1995, and the highest number of related infant deaths ever recorded in a single year.
Worryingly, up to a quarter of women were unaware they had syphilis until they were tested during pregnancy.
Dr Dunne said the findings reinforce the need for changes in STI testing during pregnancy amid the ‘potentially devastating outcomes’ for parents.
‘Current STI screenings happen early in pregnancy, but we need additional checks later in pregnancy, especially in high-risk areas,’ she said.
Syphilis was almost entirely eradicated in Australia by the early 2000s, but cases have exploded following an outbreak in north-west Queensland in 2011.
Since then, the disease has spread nationwide.
In response to rising rates, the Australian Government launched the National Syphilis and Surveillance Monitoring Plan in 2021, with one key goal: reducing syphilis incidence among women of reproductive age.
Suburbs within Sydney’s affluent inner city, such as Newtown, Surry Hills, and Zetland, have seen a spike in syphilis cases, according to the latest quarterly report.
Rising syphilis infections is a trend being seen across the globe, with one in every 1,000 people in parts of England testing positive, as officials warn cases have reached the highest level since 1948.
The World Health Organisation estimates 8 million adults between 15 and 49 years old acquired syphilis in 2022 alone.
It has a global initiative for the elimination of congenital syphilis.
There is no vaccine against syphilis.
