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Tokyo Syphilis Outbreak Sets 21st Century Highs

Neil Campbell
Neil lives in Canada and writes about society and politics.
Published: June 11, 2023
A file photo of a woman performing as an Edo-era “Oiran” courtesan during a parade in Tokyo in 2014. Tokyo’s outbreak of the sexually transmitted disease syphilis is rapidly spreading, setting 21st century highs. Officials attribute the problem to a rise in casual sexual encounters. (Image: KAZUHIRO NOGI/AFP via Getty Images)

Japan and its 125 million person population has a syphilis problem, and it’s only getting worse, reports Japanese media.

The Mainichi reported on June 1 that the sexually transmitted disease is “spreading at a record pace in Japan,” specifically in capital city Tokyo, which is on pace for at least a 20 percent increase in cases compared to 2022.

The significance is that 2022 was the worst year for syphilis in Tokyo the country has registered in the 21st century: 3,677.

Tokyo’s 3,677 cases amounted to almost 30 percent of the national calculation of 13,228 in 2022, The Mainichi states. And while this number may sound small by comparison to Coronavirus Disease 2019 (COVID-19) positive PCR count, the figure itself is a staggering 5,245 more infections than Japan reported in 2021.

As of May 21, Tokyo already had 1,422 syphilis cases, the outlet reported, noting that 921 men and 501 women have been infected, with the majority of male cases being aged between 20 and 50 and two-thirds of female cases being in their 20s

In May of this year, The Mainichi reported that nationally, 4,370 syphilis cases had been uncovered by April 23, a drastic increase compared to 3,072 over the same period in 2022.

The article quoted a representative of the Tokyo Metropolitan Infectious Disease Surveillance Center as directly stating, “One of the major causes is thought to be an increase in opportunities for sexual encounters.”

In February, Japanese website NHK directly stated on the trend, “Many syphilis cases are linked to the sex industry, where some establishments and workers offer services without condoms.”

NHK interviewed a sex worker in her 20s who said she tested positive in May of 2022 and believed she contracted the disease from a client.

“I understood the risk, but a part of me thought, ‘I’ll probably be fine.’ When it actually happened, though, it was devastating,” she said.

The woman told the outlet that the economics of selling sex changed during COVID lockdown measures, and now that society is open, Johns are putting something of a pinch on workers if they want to get paid.

She explained, “The number of customers began to change depending on what we were willing to do for a reasonable price. I’m afraid of catching an STD, but I have to put up with that because we’re supposed to sell pleasure.”

The outlet said the woman “was told not to tell her clients” she was infected, and quoted her as explaining, “I think that to protect their profits, they didn’t want me to tell people and make a big deal out of it. I feel really sorry for the customers I infected.”

It’s not the only STD to be in booming circulation in Japan. At the end of March, The Japan Times reported that monkeypox, a disease that has primarily transmitted in the homosexual community and sometimes with devastating consequences, had “crept up this month, in contrast with many other countries where the number of cases has recently declined.”

The outlet stated that 100 percent of the cases were found in men in their 20s and 60s, but most cases were concentrated in the 30s and 40s age bracket.

And yet STD-related trends haven’t been isolated to Japan.

In May of 2022, federally-funded messenger outlet Canadian Broadcasting Corporation reported that the Province of Manitoba, which shares its Eastern border with Ontario, had 47 cases of congenital syphilis in 2021.

Congenital syphilis is when the disease is passed on to newborn children.

Although the number on its own is small, Manitoba holds only 1.37 million of Canada’s 38.25 million people. Despite the disparity, the whole of the rest of the country reported only 50 cases combined.

The 47 cases also represented a significant jump from 2020, where 36 cases were reported.

Congenital syphilis on the rise in Manitoba was attributed by the CBC to the fact that “Manitoba has also been coping with a spike in adult syphilis cases over the years.”

“The province reported a 537 per cent increase in cases [of adult syphilis] from 2016 to 2020, the Public Health Agency of Canada said,” the article reported.

CTV News reported in April that the congenital syphilis trend is beginning to snowball nationally, “According to Health Canada, the country has seen a 13-fold increase in the number of babies born with syphilis over a five-year span. In 2021, the rate of babies born with syphilis reached 26 per 100,000 live births, which is up from two per 100,000 in 2017.”

Manitoba’s numbers are an outlier to the average at 371 cases per 100,000 live births, CTV stated.

Sexually transmitted diseases may be a tribulation for sex workers and their clients, but for others, it brings an opportunity.

A June 5 article published on a website promoting data analysis services stated that the market for rapid test kits for syphilis was not only already valued at $622 million in 2022, but is expected to increase 4 percent a year to $741 million as soon as 2028.

A second article by another service believes the market will expand to $1.6 billion by 2033, growing at a 7.2 percent pace.

America has not been untouched by STD news. In January, CBS reported that a “a new strain of gonorrhea that appears to have developed resistance to a broad swath of antibiotic treatments” was found in Massachusetts.

On June 9, NBC Bay Area published an article after a billboard stating “Gonorrhea Alert!” accompanied by a picture of the Titanic crashing had sprung up in the San Diego area.

The outlet states the billboard is part of a 16-state campaign by the AIDS Healthcare Foundation, quoting a Regional Director of the group as explaining, “It’s a call to action for the individual to think about gonorrhea, to have conversations about gonorrhea with their partners.”

NBC stated, “In 2021, there were 710,151 reported gonorrhea cases in the U.S. compared to 677,769 in 2020 and 616,392 in 2019, according to the CDC.”