Post-Pandemic Syphilis Surge with Latent Cases at 45.6 Percent, Suggests Study
A recent retrospective study published in the Indian Journal of Sexually Transmitted Diseases and AIDS in May 2026 reveals a striking post-pandemic syphilis resurgence, with latent cases comprising 45.6% of the 296 diagnosed patients. This sudden spike warns of a silent, subclinical infection actively circulating in the community.
Although penicillin susceptibility historically drove this sexually transmitted disease (STD) toward near-elimination, this classic mimic is globally re-emerging, with its true seroprevalence obscured by social stigma and asymptomatic presentations. To address this gap, Dr. Bhagyashree Babanrao Supekar and colleagues from the Department of Dermatology, Venereology, and Leprosy (DVL) at Government Medical College (GMC), Nagpur, Maharashtra, India, analyzed a twelve-year retrospective cohort to delineate clinical syphilis trends within central India.
Therefore, the 12-year retrospective study (2013–2024) at a Nagpur sexually transmitted infection (STI) clinic identified 296 confirmed syphilis cases from 11,045 evaluated patients, excluding biologically false-positives. Primary endpoints focused on classifying cases according to Centers for Disease Control and Prevention (CDC) guidelines and tracking Venereal Disease Research Laboratory (VDRL) and Treponema pallidum hemagglutination (TPHA) titers.
Key Clinical Findings of the Study Includes:
- Sharp Post-Pandemic Resurgence: The study documented that 60.81% of cases (180 patients) occurred in the post-Coronavirus Disease 2019 (COVID-19) pandemic years (2022–2024) compared to 25.42% (75 patients) reported pre-pandemic (2013–2019).
- Predominance of Latent Stages: The study revealed that latent syphilis was the most frequent presentation at 45.6% (135 patients), followed by secondary syphilis at 43.92% (130 patients) and primary syphilis at 9.8% (29 patients).
- Stark Male Preponderance: The study identified a male-to-female ratio of 5.51:1, with males comprising 83.8% (248 patients) and females 15.6% (46 patients), primarily affecting the 21–30 age group at 59.12% (175 patients).
- High-Risk Patient Groups: The study highlighted that 32.09% of cases (95 patients) occurred in men who have sex with men (MSM), 14.18% (42 patients) had Human Immunodeficiency Virus (HIV) co-infection, and 15.20% (45 patients) had commercial sex worker (CSW) contacts.
- Specific Dermatological Signs: The study noted that psoriasiform palmoplantar plaques with collarette scales were the most common secondary manifestation, present in 70% (90 patients) of secondary cases.
The results suggest that the alarming resurgence of syphilis, with 60.81% of cases occurring post-pandemic and 45.6% presenting as latent infections, highlights a major public health challenge in central India. These findings emphasize the presence of a substantial subclinical reservoir that facilitates silent transmission in the community.
Thus, the study concludes that clinicians are encouraged to routinely perform comprehensive physical examinations of the palms and soles in sexually transmitted disease clinics and implement early diagnostic screening among high-risk groups, including blood donors and male-only sexual networks, to successfully interrupt subclinical transmission chains.
Although the single-center, retrospective nature of the study represents a geographic limitation that may not fully capture broader national variations, it underscores the vital necessity for multi-center longitudinal research to track subclinical trends across diverse populations.
Reference
Supekar BB, Tomar SS, Chopkar SN, Mukhi JI, Mishra PR, Yede PJ. Trends of syphilis before, during, and after the COVID-19 pandemic in central India: A retrospective study. Indian J Sex Transm Dis 2026;47:16-21
