Eight grim symptoms of medieval killer disease which has made an unprecedented comeback in the UK

Woman's arms examining skin
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Record levels of a deadly disease that ravaged Europe in the Middle Ages, causing millions of deaths, have been reported. Characterised by symptoms such as sores, warts, and rashes, if untreated, it can lead to fatal complications affecting the heart and brain.

Syphilis first exploded across Europe in the 1490s as an "exceptionally virulent" affliction, leading to severe ulceration and an estimated five million fatalities, and cases have been reported as surging by 9.4% from 8,693 diagnoses in 2022 to 9,513 diagnoses in 2023.

However, syphilis isn't the only STI making a comeback, as gonorrhoea cases also surged by 7.5% within a year, from 79,268 diagnoses in 2022 to 85,223 in 2023- the most diagnoses recorded in a single year since data collection began in 1918. Gonorrhoea can also result in significant health issues if left unchecked. For the latest health and Covid news, sign up to our newsletter here

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The UK government acknowledges that increased testing may partly explain the rise in figures but emphasises that the magnitude of the increase indicates a higher rate of STI transmission within the population. Additionally, there's growing concern over the increasing antibiotic resistance of gonorrhoea, which could render it untreatable in the future.

What are the symptoms of syphilis?

The NHS has warned that untreated syphilis can lead to severe and potentially fatal complications. The symptoms of this sexually transmitted infection (STI) can take three weeks or more to appear after infection, and include:

  • small sores/ulcers on your penis, vagina or around your anus

  • sores in other areas, including in your mouth or on your lips or hands

  • white or grey warty growths, most commonly on your penis, vagina or around your anus

  • a rash on the palms of your hands and soles of your feet that can sometimes spread all over your body – this is not usually itchy

  • white patches in your mouth

  • flu-like symptoms, such as a high temperature, headaches and tiredness

  • swollen glands

  • patchy hair loss on the head, beard and eyebrows.

Even if the symptoms improve or disappear entirely, without treatment, the infection remains in the body, posing a risk of serious problems later on.

Syphilis is treated with antibiotics, and it's crucial to abstain from sex until you've completed your treatment and received the all-clear. If left untreated, syphilis can cause severe and potentially life-threatening issues, some of which may not manifest for many years post-infection.

As for gonorrhoea, the NHS states that symptoms typically develop within two weeks of infection, but they can sometimes take several months to appear. Approximately one in 10 infected men and half of infected women will not experience any noticeable symptoms, leading to the condition going untreated for extended periods.

Symptoms differ between men and women, and gonorrhoea can be passed from a mother to her baby during childbirth. If left undiagnosed and untreated, gonorrhoea can continue to spread, leading to potentially serious complications, including infertility.

What are the symptoms of gonorrhoea?

Symptoms in women include:

  • an unusual vaginal discharge, which may be thin or watery and green or yellow in colour

  • pain or a burning sensation when passing urine

  • pain or tenderness in the lower abdominal area (this is less common)

  • bleeding between periods, heavier periods and bleeding after sex (this is less common).

In men, symptoms of gonorrhoea can include:

  • an unusual discharge from the tip of the penis, which may be white, yellow or green

  • pain or a burning sensation when urinating

  • inflammation (swelling) of the foreskin

  • pain or tenderness in the testicles (this is rare).

Gonorrhoea is normally treated with antibiotics, with symptoms typically improving within a few days. It's crucial to abstain from sex until treatment is completed and you've been confirmed clear to reduce the risk of re-infection or spreading the infection.

The UK Health Security Agency has advised that anyone having sex with new or casual partners should use a condom and undergo regular testing.

Dr Hamish Mohammed, consultant epidemiologist at UKHSA, said: "We saw more gonorrhoea diagnoses in 2022 than ever before, with large rises particularly in young people. STIs aren’t just an inconvenience – they can have a major impact on your health and that of any sexual partners. Condoms are the best defence, but if you didn’t use one the last time you had sex with a new or casual partner, get tested to detect any potential infections early and prevent passing them on to others. Testing is important because you may not have any symptoms of an STI."