Quarterly report on diagnoses of syphilis, gonorrhoea and ceftriaxone-resistant gonorrhoea in England: provisional data, September 2025
Updated 12 September 2025
Applies to England
© Crown copyright 2025
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-september-2025
Interpretation notes are available for the provisional data on diagnoses of syphilis and gonorrhoea data in England.
Diagnoses of syphilis and gonorrhoea from January 2019 to March 2025
Main points
Diagnoses of infectious syphilis (primary, secondary and early latent stages) at sexual health services in England decreased in quarter 1 (January to March) 2025 to an estimated 2,030, down from 2,320 in the previous quarter. This follows a levelling of the trajectory during 2024.
There were an estimated 15,920 diagnoses of gonorrhoea at sexual health services in England in quarter 1 (January to March) 2025, lower than 18,250 in the previous quarter. This shows a decrease from the previous quarter, and 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 sexual health services caused by the COVID-19 pandemic.
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 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 in England by quarter.
Figure 1a. Diagnoses of infectious syphilis [note 1] in England by quarter, January 2019 to March 2025
Figure 1b. Diagnoses of gonorrhoea in England by quarter, January 2019 to March 2025
Source: GUMCAD STI Surveillance System.
Note 1: infectious syphilis refers to primary, secondary and early latent stages.
Note 2: data for the most recent quarter in 2025, 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.
All diagnoses of ceftriaxone-resistant Neisseria gonorrhoeae to 1 September 2025
Main points
Ceftriaxone-resistant Neisseria gonorrhoeae (the bacterium that causes gonorrhoea) was first detected in England in 2015. By 1 September 2025, a total of 53 cases had been reported in England, an increase of one case since the publication of the previous quarterly report. Of these cases, 19 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 the end of the Covid-19 pandemic with 44 cases, including 18 XDR cases, being detected since the start of 2022. Furthermore, there have now been 15 cases reported in 2025 so far which is greater than the number of cases reported for the entirety of 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 1 September 2025
Source: Referrals to the STIRL at UKHSA from sexual health services in England.
Note 3: extensively drug-resistant (XDR) infections are defined as resistant to both first- and second-line treatment options and to other antibiotics.
Note 4: 2025 is showing data from January to 1 September 2025.