Maccabi data: Sharp rise in syphilis, a sexually transmitted infection that can affect the brain and heart

More than one million new sexually transmitted infections occur every day around the world, and according to World Health Organization estimates, hundreds of millions of people live with various STIs. New data from Maccabi Health Services show that since the beginning of 2026, the number of positive tests for four common STIs, chlamydia, gonorrhea, Mycoplasma genitalium and trichomoniasis, has fallen by nearly 20% among both women and men, compared with the corresponding months in the previous four years. Alongside the encouraging trend, the data reveal a worrying figure, the rate of syphilis diagnoses has jumped by 120% in four years.

"We are seeing many forms of syphilis that we used to read about in books and are suddenly encountering," says Dr. Shirly Shapira Ben David, head of infectious diseases at Maccabi Health Services, in a conversation with ynet. "Sometimes there is a delay in diagnosis because it is not always suspected, and it is not always linked to this disease, but syphilis is a common disease in both sexes, and it is important that both patients and doctors are aware of it."

A decline in common STIs

According to Maccabi data, over the past four years there has been a decline of nearly 20% in positive tests for chlamydia, gonorrhea, Mycoplasma genitalium and trichomoniasis among both sexes. Between January and May 2022, 3,100 positive results were recorded, while in the corresponding period in 2026 there were only about 2,500.

"The data surprised us too," says Dr. Shapira Ben David. In her view, no single factor can explain the decline, and it is likely the result of a combination of a certain drop in the volume of testing, the effects of the ongoing war on sexual behavior patterns, and increased awareness of the importance of using protection.

"It is possible that the war and the complex security reality led to a reduction in risky sexual behaviors," she says.

Dr. Shapira Ben David adds that over the past year there has been broader use among high-risk patients of preventive treatment with the antibiotic doxycycline, known as Doxy-PEP, which is given after casual sexual contact and may reduce the risk of contracting some STIs, mainly gonorrhea and chlamydia. "This is not 100% prevention, but according to studies the treatment significantly reduces the risk of infection with these bacteria."

These figures are encouraging in light of Health Ministry data from last September, according to which between January and September 2025, 1,755 cases of gonorrhea were reported, compared with 634 in 2024 and 460 in 2023. The number of chlamydia cases in that period reached nearly 2,000, double the number reported in the corresponding period in 2024, which stood at about 600.

Dr. Shirly Shapira Ben David Photo: Ofer Hajajov

As noted, Maccabi's breakdown of the data shows a different picture when it comes to syphilis. Tests for detecting it recorded a sharp 120% increase in the number of positive results between January and May, comparing 2022 with the current year. Among women, the increase stands at 160%, and among men at about 90%.

Syphilis is an infectious disease caused by the bacterium Treponema pallidum and is usually transmitted through unprotected sexual contact. The disease begins as a painless ulcer on the genitals, mouth or another part of the body. Without treatment, it can cause severe damage to the heart and brain, and can even lead to death. When diagnosed early, it can be treated effectively with antibiotics.

Dr. Shirly Shapira Ben David: "Sometimes there is a delay in diagnosis because it is not always suspected, and it is not always linked to this disease, but syphilis is a common disease in both sexes, and it is important that both patients and doctors are aware of it"

"This is a steady and sharp increase over the years, not a moderate trend, and it has been seen in both sexes," says Dr. Shapira Ben David. "Unfortunately, the level of suspicion for syphilis is not high enough among all doctors. Sometimes there is a delay in diagnosis because the disease is not always suspected. Syphilis is a common disease in both sexes, and it is important that it remains in the awareness of both doctors and the general public."

The danger to pregnant women

Against the backdrop of the sharper rise among women, Dr. Shapira Ben David highlights one of the main dangers, syphilis during pregnancy. During pregnancy, the disease can pass from an infected mother to the fetus, a condition known as congenital syphilis. Newborns born with the disease may suffer from a rash, fever, enlarged liver and spleen, and even severe complications such as deformities, deafness, developmental delays and death.

"Infection of a fetus in the womb can cause a very severe infection. We do not see many cases of congenital syphilis, but it certainly exists," says Dr. Shapira Ben David. She adds that all pregnant women undergo screening tests for the disease.

The bacterium Treponema pallidum that causes syphilis Photo: shutterstock

The troubling trend is not unique to Israel. According to CDC data, between 2018 and 2022 there was an increase of about 80% in syphilis cases in the United States, with more than 200,000 cases in 2022. An even sharper increase was recorded in congenital syphilis cases, from 1,325 cases in 2018 to 3,755 in 2022, an increase of about 180%. It should be noted that part of the period overlapped with the coronavirus pandemic, which affected behavioral patterns, access to medical services and the scope of testing, so the data may have been influenced by this.

Also in the gay community, and not only around Pride Month

Dr. Shapira Ben David emphasizes that STIs are not common only among the gay community, as is sometimes assumed. "We see such cases in both sexes, and not necessarily among people who belong to the gay community."

However, she notes that reduced fear of HIV infection, thanks to the effective preventive treatment PrEP, can sometimes lead to less use of protection. "The preventive treatment provides a sense of security, and some people give up condoms, which increases the risk of contracting other STIs."

A blood test for syphilis is recommended for anyone who has sex with different partners, and not just for LGBTQ people Photo: shutterstock

Dr. Shapira Ben David recommends routine testing for all STIs. "It is part of healthy sexuality, just ask your family doctor or family physician." She adds that anyone diagnosed with an STI should inform their partners so they can be tested and treated.

"Even if there are no symptoms, but there is known exposure or unprotected sexual contact, it is important to get screening tests every few months. We make a point of encouraging such testing and raising awareness of the issue, in order to enable early diagnosis and treatment as soon as possible."