A significant 65% increase in syphilis cases in Greece from 2020 to 2022 was identified in a study conducted by Andreas Syngros Hospital. The study was published in the Journal of the European Academy of Dermatology and Venereology, according to Professor of Dermatology-Venereology at the National and Kapodistrian University of Athens (NKUA), Electra Nikolaidou, who is also Vice President of the Hellenic Society of Dermatology and Venereology (HSDV).

As the professor explained in an interview with the Athens News Agency, data released later by the National Public Health Organization (EODY) and the European Centre for Disease Prevention and Control (ECDC) confirmed that this trend is not unique to Greece—it is observed across Europe and the United States. “There has been a sharp increase in these two diseases. Not in all sexually transmitted infections (STIs). For example, we’re seeing a decrease in genital warts, possibly due to the HPV vaccination program implemented in Greece over the last 20 years.”

Rise in sexual partners and lack of condom use are the main drivers

How can we explain the resurgence of what seem like medieval diseases? Nikolaidou responds, “These are not medieval diseases. Syphilis and gonorrhea were never eradicated; they were simply less prevalent. Unfortunately, in recent years, we’ve seen a major surge. It’s difficult to pinpoint the exact causes during the COVID pandemic, especially since healthcare access and infrastructure haven’t significantly changed.”

“What we have observed is that patients now report having more sexual partners, and condom use has decreased. We believe that is the main reason for the increase in these two STIs.”

A broader awareness campaign is needed – What are the suspicious symptoms?

Asked whether awareness campaigns should be intensified, given that many seem to have forgotten about safe sex, Nikolaidou agrees. “The HSDV runs STI awareness campaigns every year, but I believe there should be a broader campaign—perhaps by EODY—to inform the public that syphilis and gonorrhea still exist. People need to be educated on what symptoms to look for so they can visit a specialist dermatologist-venereologist promptly.”

According to the professor, symptoms that should prompt someone to seek medical advice include:

• A sore or red spot in the genital area
• Wart-like lesions (which could indicate genital warts)
• Increased vaginal discharge in women
• Urethral discharge in men

“Most STI symptoms occur in the genital and anal areas. However, syphilis can also cause a widespread rash, especially noticeable on the palms and soles,” she noted.

What’s included in routine STI screening?

Because some STIs can take time to manifest, Nikolaidou recommends periodic screening. This can include:

• A blood test for HIV, syphilis, and hepatitis B
• Swabs or samples from the urethra, vagina, or cervix
• Urine tests that detect the genetic material of microbes causing STIs—even in people who show no symptoms

Responsible behavior and condom use during summer holidays

Finally, when asked what people should do (and not do) during their summer holidays, Nikolaidou emphasizes, “This is a time to be especially responsible when choosing sexual partners. While it’s a season of relaxation and fun, it’s important to use a condom with new partners. Although not 100% effective against all STIs, condoms offer a high degree of protection.”