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Syphilis and gonorrhoea: What are the symptoms, how do you catch the STIs and how are they treated?

Last year saw the highest rates of gonorrhoea since records began, while syphilis diagnoses were at their highest since just after the end of the Second World War. But what are these STIs and how do they spread?

File photo of doctor and patient. Pic:iStock
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The number of people diagnosed with gonorrhoea last year in England was the highest since records began in 1918.

More than 85,000 people were diagnosed with the STI in 2023, up 7.5% from almost 80,000 the year before.

The figures surpassed the record levels recorded in 2022, which saw gonorrhoea cases increase by more than 50% from 2021.

Meanwhile syphilis - famed as the illness of Victorian sex workers - was diagnosed at rates that haven't been seen since just after the Second World War.

There were more than 9,500 diagnoses in 2023, up 9.4% from about 8,700 in 2022, annual figures from the UK's Health Security Agency (UKHSA) show.

What are the symptoms of these sexually transmitted infections (STIs), how do you know if you've got one and what treatments are available?

What is gonorrhoea and what are the symptoms?

Gonorrhoea is caused by a bacteria. It used to be known as "the clap".

Left untreated it can cause infertility - but half of women and one in 10 men with the STI won't have any symptoms.

Symptoms include unusual green or yellow discharge, burning when urinating and pain or tenderness in the lower abdomen.

Gonorrhoea is caused by bacteria called Neisseria gonorrhoea or gonococcus, which is found in the semen or vaginal fluid of people who have the infection.

It can also be passed from mother to baby during birth but can be treated during pregnancy with antibiotics.

What about super gonorrhoea?

Super gonorrhoea is a strain that is resistant to antibiotics. Cases have been identified in England, prompting warnings that gonorrhoea could become untreatable.

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What is syphilis and what are the symptoms?

Syphilis is another bacterial STI. It develops in three stages and while it can be cured easily if it is caught early, left untreated it may spread to other parts of the body.

The first symptom of syphilis tends to be a small painless sore called a chancre (pronounced "shanker" which means "creeping ulcer").

This sore normally appears around the genitals, anus or mouth - wherever the infection entered the body. Is it highly infectious.

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It might take two to four weeks after infection before the sore appears, and it might go away on its own - but without treatment, the infection is still in your body.

That means it can develop into stage two of the illness. Symptoms may include white patches in your mouth, a non-itchy rash on the hands and feet, flu-like symptoms, weight loss and patchy hair loss.

The third stage is the most dangerous although it is rare for people in the UK to reach this stage, according to sexual health charity Brook.

This stage will begin years or even decades after the first infection and can result in paralysis, blindness, deafness, dementia and stroke.

Without treatment, you can remain infectious for up to two years after infection.

How are syphilis and gonorrhoea spread?

Both STIs can be spread through unprotected sex or sharing sex toys that have not been washed.

Syphilis can also be spread if you inject drugs using a needle that has been used by somebody who has syphilis.

Neither STI can be spread through hugging and kissing or casual contact with objects such as towels, sheets, toilet seats or cups and cutlery.

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How are they treated?

Both are bacterial infections and so can be treated with antibiotics.

Syphilis is usually treated with a single antibiotic injection or a course of injections.

Treatment for gonorrhoea involves having an antibiotic injection and a single dose of antibiotic tablets.