Quarterly report on diagnoses of syphilis, gonorrhoea and ceftriaxone-resistant gonorrhoea in England: provisional data, March 2026
Updated 26 March 2026
Applies to England
© Crown copyright 2026
This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.
Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.
This publication is available at https://www.gov.uk/government/publications/sti-quarterly-surveillance-reports-provisional-data/quarterly-report-on-diagnoses-of-syphilis-gonorrhoea-and-ceftriaxone-resistant-gonorrhoea-in-england-provisional-data-march-2026
Interpretation notes are available for the provisional data on diagnoses of syphilis and gonorrhoea data in England.
Diagnoses of syphilis and gonorrhoea by gender identity and sexual orientation from January 2019 to September 2025
Main points
Diagnoses of infectious syphilis (primary, secondary and early latent stages) at sexual health services (SHSs) in England decreased in quarter 3 (July to September) 2025 to an estimated 1,860 (1,170 in gay, bisexual and other men who have sex with men [GBMSM] and 690 in other groups), down from 2,090 (1,290 in GBMSM and 800 in other groups) in the previous quarter. This follows a levelling of the trajectory during 2024.
There were an estimated 15,910 diagnoses of gonorrhoea (9,060 in GBMSM and 6,850 in other groups) at SHSs in England in quarter 3 (July to September) 2025, lower than 16,290 (9,450 in GBMSM and 6,840 in other groups) in the previous quarter. This is a continuation of the preceding downward trajectory since quarter 2 (April to June) 2023.
Background information
There has been an overall increasing trend in infectious syphilis and gonorrhoea diagnoses since the early 2000s. A marked but temporary decline in diagnoses of both infections was seen during 2020 and 2021, largely explained by a fall in testing during disruption to SHSs caused by the COVID-19 pandemic.
The figures have been stratified into GBMSM and other groups to follow trends that may be related to targeted preventative interventions (such as 4CMenB vaccine [4-component serogroup B meningococcal vaccine, against gonorrhoea] and doxyPEP [doxycycline post-exposure prophylaxis, against syphilis], both of which were introduced in summer 2025) more easily and allow interpretation of overall long-term trends in light of these changes.
These provisional quarterly figures will likely be an undercount but can be used to monitor indicative trends in the data and are more timely than the annual sexually transmitted infection (STI) official statistics and the indicators on the Sexual and Reproductive Health Profiles. The annual data will be published around 6 months after the end of the data collection year with more complete figures and additional breakdowns.
Please also see the Sexual and reproductive health in England: local and national data guide for other presentations of STI data.
Figures 1a and 1b show data on diagnoses of infectious syphilis and gonorrhoea by gender identity and sexual orientation in England by quarter.
Figure 1a. Diagnoses of infectious syphilis [note 1] by gender identity and sexual orientation [note 2] in England by quarter, January 2019 to September 2025
Figure 1b. Diagnoses of gonorrhoea by gender identity and sexual orientation [note 2] in England by quarter, January 2019 to September 2025
Source: Data from routine returns to the GUMCAD STI Surveillance System.
Note 1: infectious syphilis refers to primary, secondary and early latent stages.
Note 2: the category ‘Other groups’ is comprised of heterosexual men and women, lesbians, and people where information for their gender identity or sexual orientation was not reported.
Note 3: data for the most recent available quarter, shown in the shaded part of the graph, are likely to increase as delayed data submissions are received.
To account for uncertainty in this provisional data, the data points have been rounded to the nearest 10.
Quarterly GUMCAD data releases for 2025 are presented as provisional only. Provisional data may be incomplete due to outstanding GUMCAD submissions therefore, numbers may change between quarterly releases as more submissions are received. Further details on GUMCAD submission completeness are available in Table 1.
Table 1. GUMCAD submission completeness in England, 2025
| GUMCAD submissions | Quarter 1 (January to March) |
Quarter 2 (April to June ) |
Quarter 3 (July to September) |
Quarter 4 (October to December) |
|---|---|---|---|---|
| Required [note 4] | 231 | 230 | 227 | Not available |
| Received | 226 | 227 | 207 | Not available |
| Completeness | 98% | 99% | 91% | Not available |
Note 4: the number of required GUMCAD submissions may change between quarters where SHSs open or close mid-year.
All diagnoses of ceftriaxone-resistant Neisseria gonorrhoeae to 28 February 2026
Main points
Ceftriaxone-resistant Neisseria gonorrhoeae (the bacterium that causes gonorrhoea) was first detected in England in 2015. By 28 February 2026, a total of 70 cases had been reported in England, an increase of 8 cases since the publication of the previous quarterly report. Of these 70 cases, 25 were extensively drug-resistant (XDR, resistant to first- and second-line antibiotics) (Figure 2).
The frequency of detecting ceftriaxone-resistant Neisseria gonorrhoeae has increased since 2021. There were 29 cases reported in 2025 which is more than double the number of cases reported in 2024.
Background information
Neisseria gonorrhoeae has developed resistance to every class of antibiotics used to treat it, and cephalosporins are the last remaining class of antibiotics available for use as empirical monotherapy. The currently recommended first-line therapy is 1g ceftriaxone (a cephalosporin) and, while the vast majority of gonorrhoea cases in England are susceptible to ceftriaxone, cases of ceftriaxone-resistant Neisseria gonorrhoeae detected in England are increasing. Most ceftriaxone resistant cases are associated with travel to or from the Asia-Pacific region, where the prevalence of ceftriaxone resistance is high.
Guidance is available on the management of ceftriaxone-resistant gonorrhoea. Suspected ceftriaxone treatment failures should be reported to UK Health Security Agency (UKHSA) via the ‘Gonorrhoea treatment failure report form’ on the HIV and STI Data Exchange. For any queries, please contact grasp.enquiries@ukhsa.gov.uk
Ceftriaxone-resistant isolates should be referred to the UKHSA sexually transmitted infections reference laboratory (STIRL). Annual data on trends in antimicrobial resistance and decreased susceptibility in gonococcal infection in England and Wales are published in the Gonococcal resistance to antimicrobials surveillance programme (GRASP) report.
Figure 2 . Number of cases of infection with ceftriaxone-resistant Neisseria gonorrhoeae in England, January 2015 to 28 February 2026
Source: Referrals to the STIRL at UKHSA from sexual health services in England.
Note 5: extensively drug-resistant (XDR) infections are defined as resistant to both first- and second-line treatment options and to other antibiotics.
Note 6: 2026 shows data from January to 28 February 2026.