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US Sees Decline in Syphilis and Gonorrhoea Cases as New Prevention Efforts Show Results

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Newly released data indicates that cases of syphilis and gonorrhoea in the United States have seen a notable decline, marking a positive shift after years of increasing sexually transmitted infections (STIs). Health experts attribute the reduction to enhanced prevention strategies, including increased access to antibiotics as preventive treatment and more proactive public health efforts.

According to the Centers for Disease Control and Prevention (CDC), the most infectious stages of syphilis dropped by 10% in 2022, representing the first significant decline in over two decades. Gonorrhoea cases also fell by 7%, marking a second consecutive year of decreases and returning case numbers to pre-pandemic levels in 2019. Dr. Jonathan Mermin of the CDC expressed cautious optimism about the trend, stating, “I’m encouraged, and it’s been a long time since I felt that way” regarding the nation’s ongoing battle with STIs.

The CDC reports that over 2.4 million cases of chlamydia, gonorrhoea, and syphilis were diagnosed in the US last year. This includes 1.6 million cases of chlamydia, 600,000 of gonorrhoea, and more than 209,000 cases of syphilis. While the recent downturn in syphilis and gonorrhoea is promising, experts note syphilis remains a particular concern, especially as it continues to disproportionately affect gay and bisexual men.

Syphilis cases had been in steady decline for decades, particularly after the introduction of antibiotics in the 1940s, but began rising again around 2002. The latest report shows a 13% drop in early-stage syphilis among gay and bisexual men, a first since data tracking for this group began in the mid-2000s. However, the CDC found a 12% increase in cases of syphilis at unknown or later stages, often from infections contracted years prior. Alarmingly, congenital syphilis cases—passed from infected mothers to newborns—also rose, with nearly 4,000 reported cases and 279 associated stillbirths and infant deaths.

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Experts suggest the decline in some STIs is partly due to the increased use of the antibiotic doxycycline as a preventative measure. Studies have shown that taking doxycycline within 72 hours of unprotected sex can reduce the risk of contracting syphilis, gonorrhoea, and chlamydia. In June, the CDC formally recommended doxycycline as a post-exposure prophylactic for individuals at high risk, including gay and bisexual men and transgender women. Some health departments had already been providing doxycycline in select areas, and experts believe these efforts, along with a recent increase in STI testing and contact tracing, contributed to the decline.

The report comes amid contrasting developments in Europe, where health authorities recently warned of a surge in STI cases. The European Centre for Disease Prevention and Control (ECDC) reported sharp increases in gonorrhoea, syphilis, and chlamydia in 2022, with gonorrhoea cases reaching a decade-high of over 70,800. ECDC officials urged governments to enhance testing, treatment, and prevention efforts to curb the rising infections across Europe.

Despite positive trends in the US, experts warn that ongoing support for STI prevention, testing, and education remains essential to sustain progress and address emerging public health challenges in both the US and globally.

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More Europeans Take Up Sport, but Major Gaps Remain Across Countries

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More Europeans are exercising regularly than they were four years ago, but participation continues to vary sharply depending on where people live, their age, education and financial circumstances, according to a new European Commission survey.

The latest Eurobarometer survey on sport and physical activity found that 39% of respondents said they never exercise or play sport, down from 45% in 2022. Nearly half of the 26,508 people surveyed said they exercise or play sport every day or several times a week.

The results also showed wide differences between countries. Finland recorded the highest share of people exercising daily, at 21%, followed by Denmark at 20%. In both countries, another 59% of respondents said they exercise several times a week.

At the other end of the scale, 68% of respondents in Portugal said they never exercise or play sport. Greece and Romania followed, with 66% in each country reporting that they never take part in sport or exercise.

Time was the most commonly cited barrier among people who wanted to exercise more, with 37% identifying it as an obstacle. A lack of motivation or interest was mentioned by 26%, while 15% pointed to health problems or injury. Cost was cited by 12%.

Education and household finances were also closely linked to participation. Some 59% of people who continued their education until at least the age of 20 said they exercise or play sport several times a week. That compared with 23% among those who left education at 15 or younger.

Financial circumstances showed a similar divide. People who said they had the greatest difficulty paying their bills were twice as likely to report never exercising as those who rarely or never faced financial difficulties, at 54% compared with 26%.

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“More Europeans are getting active, but the opportunity to take part still depends too much on income, age and education,” said Roxana Mînzatu, Executive Vice-President for Social Rights and Skills, Quality Jobs and Preparedness.

The survey also highlighted a significant age gap. Nearly three-quarters of people aged 15 to 24 exercise or play sport at least several times a week, compared with 25% of those aged 75 and over. Health problems or injury were the main barrier for older respondents, while younger and middle-aged people were more likely to cite a lack of time.

Physical activity linked to everyday life also increased. Active commuting rose from 24% in 2022 to 37%, while 72% of respondents said they now walk for at least 10 minutes at a time.

The survey found, however, that some Europeans do not consider their neighbourhoods suitable for walking or cycling, potentially restricting opportunities for active travel.

Mînzatu said affordable sport and safe places to exercise should be available close to where people live, including for children from families unable to afford club fees, older people and those with disabilities.

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Congenital Infections Linked to Higher Risks of Autism and Intellectual Disability

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Children born with certain infections acquired during pregnancy face substantially higher risks of autism and intellectual disability later in life, according to a study of more than 3.7 million people in Sweden.

Researchers found that children with congenital infections were about three times more likely to be diagnosed with autism and more than seven times more likely to receive a diagnosis of intellectual disability than those without such infections.

The findings suggest that infections transmitted from a pregnant woman to her foetus may have lasting effects on brain development, although the study identifies an association rather than proving that the infections directly cause autism or intellectual disability.

The research focused on TORCH infections, a group that includes syphilis, rubella, toxoplasmosis, cytomegalovirus and herpesvirus. These infections can cross the placenta and affect the developing foetus, potentially increasing the risk of miscarriage, stillbirth and other pregnancy complications.

“Although these congenital infections are rare, some of them can be prevented, which makes them important from a public health perspective,” said Reneé Gardner of the Department of Global Public Health at Karolinska Institutet, who contributed to the study.

The researchers examined people born in Sweden between 1987 and 2021 and followed them for up to 30 years. Among the 3.7 million participants, 975 had been diagnosed with a congenital TORCH infection.

Although congenital infections accounted for only a small proportion of autism cases across the population, the risk among affected children was considerably higher. The researchers estimated that about one in five children born with a TORCH infection could later develop autism.

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The study also found elevated risks of intellectual disability across different levels of severity. The risk of severe to profound intellectual disability was as much as 30 times higher among children with a congenital infection than among those without one.

The researchers found evidence of an impact on educational outcomes even among people who were not diagnosed with autism or intellectual disability. A total of 420 participants with a TORCH infection showed poor school performance without receiving either diagnosis.

Congenital cytomegalovirus, or CMV, is the most common of these infections globally and affects roughly one in 150 newborns. Its burden is substantially greater in low- and middle-income countries.

The researchers said the findings highlight the importance of prevention, particularly in regions where these infections are more common. They pointed to vaccination programmes and other preventive measures as important tools for reducing congenital infections.

They also called for improved identification of affected newborns. Current screening systems, including those used in Sweden, may miss asymptomatic infections because universal screening for TORCH infections is not routinely carried out.

The authors said stronger screening and prevention strategies could help identify children at risk earlier and improve long-term support and care.

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AI Chatbots Make Faster, Less Nuanced Kidney Transplant Decisions Than Doctors

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Artificial intelligence chatbots may make faster and more confident decisions than human doctors when determining which patient should receive a life-saving kidney transplant, but a new study found that the systems often rely on fewer factors and show less sensitivity to the ethical complexity of such choices.

Researchers from Penn State University in the United States compared decisions made by large language models (LLMs) with choices made by people in earlier studies on kidney allocation. The researchers presented AI models with hypothetical cases based on existing datasets in which human participants had previously chosen between two patients competing for a single available kidney.

The patients were described using characteristics including age, health and drinking habits. Both were considered eligible for the transplant, requiring the decision maker to determine which patient should receive the available organ.

The researchers tested the AI systems in several ways. Some scenarios focused on individual characteristics, while others combined several traits to examine how the models handled competing considerations. In some tests, participants and AI systems were also given the option of flipping a coin, allowing researchers to assess indecision as part of moral decision-making.

Human participants generally placed greater importance on age, often favouring younger patients over older patients. Many of the AI models, however, placed greater weight on lower alcohol consumption.

Hadi Hosseini, the study’s lead researcher at Penn State University, said the findings showed that AI chatbots can diverge from human values when weighing characteristics of patients.

The researchers found that human decisions tended to consider several factors together and were more sensitive to context. LLMs, by contrast, frequently focused on a single characteristic when making their choices.

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Another difference involved uncertainty. Human participants were more likely to recognise that organ allocation can involve competing ethical considerations and that there may not be one objectively correct answer. AI models generally showed little hesitation and committed to one choice.

John Dickerson, chief executive officer of Mozilla.ai and a collaborator on the study, said humans recognise ambiguity when allocating scarce resources and use debate to shape how such decisions are made.

The findings come as AI systems are increasingly being used in healthcare for clinical workflows, diagnosis, treatment planning and decisions involving limited medical resources.

The researchers said kidney allocation presents a particularly important test because decisions over deceased-donor and living-donor organs involve medical, ethical and moral considerations.

Hosseini said the ethical stakes are high because decisions involving organ allocation can directly affect patients’ lives. He stressed that the study was not intended to encourage replacing professional medical judgment with AI.

Instead, the researchers said understanding how AI systems behave in high-stakes situations is becoming increasingly important as individuals, organisations and businesses use AI to make decisions or provide recommendations.

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