The Canary Islands have become the community with the highest number of syphilis cases in Spain

In 2023, the Canary Islands became the region with the highest number of syphilis cases in Spain. In total, 1,183 cases of syphilis were detected in the archipelago last year, which puts it first in the country – by a wide margin – in the incidence of this sexually transmitted infection (STI), which affects 53 out of every 100,000 inhabitants.

This is evidenced by the report Epidemiological surveillance of sexually transmitted infections in Spain in 2023, which states that the Canary Islands are followed by the Balearic Islands (33.97), Madrid (32.52) and Catalonia (30.5). In 2023, 10,879 cases of syphilis were reported throughout Spain, representing a rate of 22.62 cases per 100,000 inhabitants. In other words, the Canary Islands duplicate government data, but the report itself concludes that the differences across autonomous communities may be due to the surveillance systems that each region has.

Syphilis is a sexually transmitted infection caused by bacteria. treponema pallidum, which affects the genital area, lips, mouth or anus and affects both men and women. Syphilis develops in three stages, each with characteristic symptoms separated by periods of apparent good health, making diagnosis difficult.

In the early stage, there is usually one small, painless ulcer. Sometimes this causes swelling of nearby lymph nodes. If left untreated, it usually results in a non-pruritic skin rash, often on the arms and legs. Many people do not notice symptoms for many years. Symptoms may disappear and reappear.

More common in men

It is the most common STI among men in the Canary Islands. Of the more than 1,000 cases identified in 2023, 947 were male (81.2%) and 219 were female (18.8%). Moreover, the increase in incidence has not stopped in recent years. In 2023, the incidence rate increased by 58% compared to 2022. However, compared to 2020 values, it has doubled.

This exponential growth has particularly affected men over 35 on average. “It’s mostly older people,” says Alvaro Torres, head of the Canary Islands government’s epidemiology department, who makes it clear that the rise in STI rates is not just among young people.

Regarding territorial distribution, Lanzarote is the island with the highest incidence of syphilis: 132.3 cases per 100,000 inhabitants. twice the average for the Autonomous Community. A total of 210 cases of the disease were detected on this island, which is much more than on other non-capital islands. For comparison, Fuerteventura has 50 cases, La Palma – 16, La Gomera – 5 and El Hierro – 1. In turn, Gran Canaria stands out among the capital islands, where 490 cases have been detected compared to 364 in Tenerife.

This increase in the number of cases has taken even the Canary Islands by surprise, which, however, has carried out an analysis of the situation in recent months to try to find the reason for this increase. As Torres explains, the rise in syphilis rates may have two aspects: improving access and simplifying diagnostic tests; and loss of fear of infection.

Improved diagnostics

And over the past year, several improvements have been implemented to STI detection processes in the Canary Islands, which have led to a noticeable increase in incidence rates. “In Tenerife we ​​launched check pointsThese are places where you can go without an appointment for diagnostic tests if you suspect an STI,” says Torres, who assures that they have been very well received by patients and that they have been able to diagnose many more cases than in the past. .

At the same time we improved Infectious disease surveillance reporting systems and more sensitive and less invasive diagnostic methods began to be used, although the latter had a greater impact on the chlamydia and gonococcus data.

The epidemiologist also warns that many of the cases identified last year may have been infected many years ago. “Unlike gonococcus or chlamydia, which have acute symptoms, meaning they can be detected urgently, syphilis can remain in the body for a long time without a person knowing about it,” he points out. Actually, He boom syphilis began to lose steam just a year later. “At this point in 2024, we are seeing a decrease in the number of cases compared to the same period in the previous year,” Torres emphasizes.

But improved diagnostics are not the only thing that has had an impact. The Public Health Authority is aware that the Canary Islands, like the rest of Spainis experiencing a crisis of sexually transmitted diseases, an upward trend that has been observed for several years. Syphilis is not the only one. In the archipelago last year, 1,347 cases of chlamydia were recorded (60 cases per 100 thousand inhabitants) and another 1026 cases of gonorrhea (46 cases per 100 thousand inhabitants). The Canary Islands do not stand out above the national average in either of the two regions, but their increasing upward trend worries professionals.

Risky behavior

The focus is on the loss of fear of infection. “More and more patients are coming in for consultation with one of these infections and admitting to engaging in risky sexual behavior,” Torres says. For experts, the improvement in HIV prognosis and the availability of drugs to treat both this and other STIs are among the reasons for this social behavior.

In addition, experts in the Canary Islands are also beginning to see a connection between new diagnoses and dangerous sexual practices, the use of escape drugs during sexual intercourse with multiple partners at the same time, e.g. He chemsex or clapping.

The professional claims that, in addition, they have not seen any correlation between the increase in the number of cases and the celebration of various holidays, such as the celebration of LGBTI Pride Week in Gran Canaria. “These infections are not happening in this festive environment.”offer.

The Canary Islands are preparing a new awareness campaign to try to give condoms back the importance they deserve. “We want it to be longer and not just focused on certain days like Carnival,” Torres says.