Syphilis

Disease development

Effects of syphilis before penicillin, 1890s.

Destruction of skull bones in tertiary syphilis.

Diagnostics

2025: The incidence of syphilis in Russia reached 25.1 thousand cases.

In 2024, doctors identified 25.1 thousand new cases of syphilis, which is 64% more than four years ago. The most vulnerable group was men over 40 years old: the incidence in this category increased from 4.7 thousand to 9.7 thousand cases over five years. These data Rosstat were published in February 2026.

State Scientific Center of Dermatovenerology and Cosmetology Ministry of Health Russia The statement claims that the negative dynamics has been reversed. According to the center, from 2024 to 2025, the incidence of syphilis decreased by 16%. The press service of the department reported that this result is associated with effective prevention, active detection and timely treatment of infection.

Vadim Pokrovsky, head of the specialized research department for the prevention and control of AIDS at the Research Institute of Epidemiology of Rospotrebnadzor, indicated that statistics depend on the quality of accounting. According to him, in previous years, many commercial medical institutions did not report detected cases, which distorted the picture.

The expert also noted that an increase in the incidence of syphilis is observed in a number of Western countries. One of the likely reasons, according to Pokrovsky, is a decrease in condom use against the background of the spread of antiretroviral therapy for the prevention of HIV.

Vadim Pokrovsky stressed that syphilis is effectively treated. However, he added that self-medication or conversion to unqualified organizations leads to incomplete healing and relapses, which supports the epidemic process.

The decline in condom sales, partly associated with an increase in their cost, raises experts' concerns about the stability of the epidemiological situation. Vadim Pokrovsky also noted a decrease in the information background on the topic of sexually transmitted infections (STIs) in the media space, which led to a weakening of preventive work.^[1]

2024

Global Enzyme Immunosorbent Assay Market Size for Syphilis Diagnosis Reaches $579 Million

In 2024, costs in the global enzyme immunosorbent assay (ELISA) market for the diagnosis of syphilis amounted to $578.93 million. More than half of this amount fell on the North American region. Such data are presented in a study by Precedence Research, the results of which Zdrav.Expert reviewed at the end of November 2025.

The ELISA method is based on the detection of specific antibodies in the patient's blood, which are formed in response to infection with the pale treponema (Treponema pallidum) - the causative agent of syphilis. Such analysis is used for both primary screening (e.g., pregnancy, hospitalization) and confirmation of diagnosis. The advantages of the method are high accuracy, the possibility of early detection of infection, as well as ease of execution. The test allows separate determination of antibodies of class IgM (marker of fresh infection) and IgG (marker of current or past infection). ELISA makes it possible not only to confirm or refute the diagnosis, but also to assess the dynamics of the disease by tracking the amount of antibodies. Based on the results of such tests, the effectiveness of therapy can be monitored: for example, with successful treatment of early syphilis, IgM levels rapidly decrease, while IgG levels can persist for a long time.

One of the drivers of the market, the authors of the study call the increase in the prevalence of syphilis. According to the World Health Organization (WHO), during the COVID-19 pandemic, there was an increase in the incidence of syphilis among adults, including mothers, which led to an increase in the number of cases of congenital syphilis (523 cases per 100 thousand newborns per year). In pregnant women, syphilis in the absence of treatment, as well as in the untimely or incorrect prescription of antibiotics in 50-80% of cases leads to an unfavorable outcome of childbirth. In 2022, according to WHO estimates, the number of new syphilis diagnoses among people aged 15-49 years increased by more than 1 million to 8 million. At the same time, about 230 thousand people died from the disease. Against this background, the demand for accurate diagnostic procedures that allow timely detection of the disease is growing.

Campaigns to inform the public about sexually transmitted infections (STIs) have a positive impact on the industry. Requirements for mandatory testing for syphilis in antenatal clinics, blood banks and high-risk groups provide additional demand for ELISA diagnostics. In addition, technological advances, including the introduction of artificial intelligence, contribute to the market expansion: neural networks speed up the processing of medical data and eliminate the possibility of errors related to the human factor.

From a geographical point of view, North America leads, which in 2024 accounted for 58% of global costs, or $335.8 million. At the same time, the Asia-Pacific region is showing the highest growth rates. Globally, significant industry players are named:

• Abbott Laboratories;
• bioMérieux;
• Siemens Healthineers;
• F. Hoffmann-La Roche AG;
• Bio-Rad Laboratories;
• Thermo Fisher Scientific;
• Zephyr Biomedicals (Trinity);
• Omega Diagnostics;
• Chembio Diagnostics;
• Sekisui Diagnostics.

In 2025, the enzyme-linked immunosorbent assay market size for syphilis diagnosis is expected to reach $611 million. Precedence Research analysts believe that in the future, the CAGR will be 5.54%. Thus, by 2034, costs may increase to $992.65 million.^[2]

Rise in US syphilis newborns up 1.6% to 3,941 cases

In 2024, 3,941 cases of congenital syphilis were reported in the United States. This is 1.6% more than the previous year, when the figure was 3878. Overall, the number of newborns with the disease in the U.S. has increased for 12 consecutive years. Such figures are given in the materials of the American Centers for the Control and Prevention of Infectious Diseases (CDC), published on September 24, 2025.

The number of cases of syphilis among newborns has been rising since 2012, when about 300 episodes were reported. By 2020, the figure reached 2168 cases. A sharp increase was recorded in 2021 and 2022, when the number of babies with syphilis in the United States was 2886 and 3773, respectively. After that, the negative dynamics slowed down, however, over the five-year period as a whole (2020-2024), the value rose by 81.8%.

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Фото: Freepik

The continued rise in congenital syphilis is a worrying sign that we are not taking sufficient action to protect pregnant women and newborns, said Elizabeth Finley, acting executive director of the National Coalition of Directors for Sexually Transmitted Diseases (NCSD).

In the United States, the incidence of congenital syphilis per 100 thousand people is also growing. If in 2020 it was equal to 60 cases, then in 2023 it reached 107.8 cases, and in 2024 - 109.6 cases per 100 thousand people.

Among all age groups in the U.S., 190,242 new cases of syphilis were reported in 2024, the CDC study said. This is 9.1% less than the previous year, when 209,249 episodes were noted. For comparison: in 2020, the value was 133,965 cases.^[3]

2022: During the year, 8 million people were infected with syphilis and gonorrhea in the world, 230 thousand died

The incidence of sexually transmitted infections is growing in the world. Every day syphilis, gonorrhea, chlamydia and trichomoniasis cause more than 1 million cases of infection. This is stated in the report of the World Health Organization, published on May 21, 2024.

In 2022, WHO member states set themselves the task of reducing the annual number of cases of syphilis infection among adults tenfold by 2030, from 7.1 million to 0.71 million. However, in 2022, the number of recorded cases of infection, on the contrary, increased by 1 million, reaching about 8 million (among people aged 15-49 years). The largest growth was recorded in the American and African regions.

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Фото: Unsplash

In 2022, approximately 230 thousand deaths from syphilis were registered. In addition, the authors of the study point to a sharp increase in the incidence of syphilis in pregnant women (1.1 million) and congenital syphilis (523 cases per 100 thousand newborns per year) during the COVID-19 pandemic.

The findings suggest an increase in the incidence of multidrug-resistant gonorrhea. As of 2023, of the 87 countries with enhanced surveillance for antimicrobial resistance to gonococcal infections, nine countries had elevated levels (5% to 40%) of resistance to ceftriaxone, a last-line treatment for gonorrhea.

In 2022, approximately 1.2 million new cases of hepatitis B infection and almost 1 million new cases of hepatitis C infection were identified. According to estimates, the number of deaths from viral hepatitis rose from 1.1 million in 2019 to 1.3 million in 2022 - despite the availability of effective means of prevention, diagnosis and treatment. At the same time, the number of new cases of HIV infection decreased from 1.5 million in 2020 to 1.3 million in 2022.^[4]

2021: World's first combined HIV, hepatitis and syphilis tests launched in Russia

At the end of April 2021, the production of the world's first combined test for four infections began in Russia: HIV, hepatitis B and C and syphilis. Test systems called "Multiskrin" are produced by the company "Biopalitra," which is a resident of the special economic zone "St. Petersburg." Read more here.

Researches

1948: US scientists deliberately infect Guatemalan citizens with syphilis and gonorrhea

USA Barack Obama In 2010, the President deeply apologized over the phone to the President Guatemala for deliberately infecting syphilis gonorrhea and Guatemalan prisoners, mentally ill and military personnel in the 1940s - with the goal of exploring ways to treat sexually transmitted diseases with penicillin. As a result, about one and a half thousand people were injured - including prostitutes used in the experiment (and not knowing about it).

Treatment

1917: Malaria Therapy

At the beginning of the 20th century, patients were infected with malaria to cure syphilis.

Malaria causes a very high temperature that kills syphilis bacteria. But then the patients were treated for malaria. There were no antibiotics at the time and syphilis was a direct threat to life.

Malaria therapy was developed by Julius Wagner-Jauregg, who in 1917 first vaccinated malaria in patients suffering from progressive paralysis. For the development of this therapy, Wagner-Jauregg received the Nobel Prize in Physiology or Medicine in 1927. Wagner-Jauregg also used malaria therapy to treat syphilis, neurosyphilis, multiple sclerosis, and schizophrenia.

16th century: Mercury therapy

Russian Tsar Ivan the Terrible allegedly had syphilis. It was this "French disease," which in the XV-XVI centuries. in Europe caused an epidemic, was treated with mercury, sulema - "liquid silver." The development of medicine at that time was at the level of "one is healing, the other is crippling." "Mercury therapy" inevitably led to chronic poisoning - mercurialism, from which the nervous system suffers, and patients have mental agitation, anxiety, shyness, suspiciousness. These qualities, especially in the last years of his life, were distinguished by John Vasilievich. For more information on the treatment and death of the tsar, see Ivan IV the Terrible.

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