Australians are dying from a disease that was almost eliminated years ago

Australians are dying from syphilis, a disease that was almost eliminated more than a decade ago Mon 15 Jun 2026 at 7:52am This is the damage late-stage syphilis can do to bones. The Victorian-era sexually transmitted infection is preventable and curable, so why are infection rates rising in Australia? Turning over old bones, Emeritus Professor Maciej Henneberg is trying to get to the bottom of an old disease that has resurfaced in Australia. Like a cold case detective, he's excavated remains upturned by development and construction all over the world. The bioarchaeologist is scouring remains for signs of syphilis in past populations. "[Advanced syphilis] causes body changes, growth of additional bone, especially the leg bones, and some destruction of other bones," Professor Henneberg explains. Inside South Australia's Vernon-Roberts Museum, where tightly controlled bone samples are held for teaching, Professor Henneberg has special permission to show the remains of an unknown Adelaide patient from the late 19th century. "The skull we have here in our museum is of a person who suffered syphilis for a number of years because it got into its final stages," he explains. "You can see pits in the bone of the skull and these were caused by gummatous lesions, the slow-acting ulcers of syphilis." Professor Henneberg is working with the University of Adelaide to uncover how untreated syphilis impacted colonial settlements, before the advent of penicillin as a treatment in the 1940s. A resurgence of untreated cases in Australia has the professor concerned the worst of syphilis may not stay contained history. "It worries us a lot," he says. "It's 100 per cent important not to allow it to spread and to become endemic." The return of syphilis The origins of syphilis are hotly contested. Caused by a corkscrew-shaped bacterium, Treponema pallidum, syphilis can slip between the skin barrier during sexual contact. It can also be transferred from mother to baby in the womb or at birth, causing neonatal death, stillbirth or life-long health implications. The dangers posed by Australia's current outbreak are so concerning, Australia's Chief Medical Officer Michael Kidd last year declared it "a communicable disease incident of national significance". Annual syphilis notifications across the country almost doubled in the last 10 years, from 4,773 cases in 2015 to 8,993 in 2025. The Australian Centre for Disease Control (CDC) says there were 130 cases of congenital syphilis in that decade, with 42 babies dying from it. The CDC says 60 per cent of those deaths were First Nations children. Australia is currently failing to meet World Health Organisation targets to eliminate congenital syphilis. The director of sexual health and blood borne viruses strategy and policy for NT Health, Professor Kelly Hosking, described congenital syphilis as a "health disaster and a tragedy". "It is entirely preventable, so even if a pregnant person got syphilis, we can totally treat that pregnant person, and then the baby will not be at risk any longer," she says. Professor Hosking has taken the reins as incident controller for syphilis in the Northern Territory, where infection rates are 7.5 times higher than the national figures. The NT's notification rates of syphilis in 2025 were 169 per 100,000 people — the national rate was 23. Sourcing grants from the Ian Potter Foundation, and in-kind support from every health organisation in the NT, Professor Hosking has helped set up an Incident Management Team (IMT) for syphilis with Indigenous health experts to improve services for the communities hit hardest. "The Aboriginal health workforce is really pivotal to being able to make change and to get on top of this outbreak,"she said. On the frontline Rolling a 21-gauge needle back and forth between the palms of her hands, Patricia Nundhirribala demonstrates how to deliver the potentially lifesaving treatment. "I'm warming it up first so that the medication goes through the needle, deep in the muscle," the Aboriginal health worker explains. A past participant of the IMT syphilis workshops, Ms Nundhirribala is now a facilitator. She demonstrates on a rubber buttock how to administer the penicillin injection. From Numbulwar in south-east Arnhem Land, Ms Nundhirribala has travelled about 800 kilometres to access this training in Darwin to keep her community safe. "No one knows they have it, and you don't know you got the sickness until you get the test," she explains. Symptoms of early syphilis include a painless chancre sore, rash, fever and headaches. But syphilis can be easy to miss — about half of those infected are asymptomatic. Left untreated, it can be deadly. "That can happen, like, five to 30 years later," Professor Hosking says. "So you could just have [the bacteria] there, just running amok, and that can affect all organs, so it can affect the brain and cause strokes, it can affect the heart and [trigger] heart attacks." The answer to the outbreak is literally in Ms Nundhirribala's hands, and she is fighting the uphill battle to deliver it. "I sometimes get very emotional giving them two injections … because it's painful for them," she says. "But I always do give them the right story and tell them, 'It's a treatment that will help you get rid of the syphilis and it's safe for you'." NT's Chief Health Officer Dr Paul Burgess says this culturally-led approach can work to turn the syphilis outbreak around. "It's very easily treated, if we find it," Dr Burgess says. "Our tactics … are to train a lot of our Aboriginal colleagues to help us and help their communities in terms of decreasing stigma but also, importantly, accelerating our testing." Most sexual health clinics in Australia offer free or low-cost testing, and all general STI checks include syphilis and HIV screening. Pathway to end the outbreak Modelling shows syphilis cases can be controlled if testing rates reach between 70 and 80 per cent. "We need to do this over repeated cycles, annually for five years," Dr Burgess says. "So a conservative estimate for what we would like to see from the Commonwealth is about $25 to $30 million of investment over a five-year period and we will drive down the case numbers, and we will have success, because we have the buy-in of communities, and we have the buy-in all of our service providers." The CDC says the federal government had committed $132.5 million over four years for a range of programs, including initiatives to reduce sexually transmissible infections (STI). Dalaba and Jawoyn woman Sarah Betts — the senior project officer driving testing, treatment and community engagement with the NT's syphilis IMT — says Aboriginal health workers are critical to bringing infection rates down. "The education needs to be in an environment where it's culturally safe," Ms Betts says. Her dual focus is destigmatising disease and decolonising the system, so primary healthcare is accessible to the people who need it most during the outbreak. It's a call bioarchaeologist Professor Henneberg supports as he continues his work digging up the past. At 77, he is still researching the impacts of the old-world disease from a time when it infected 10 per cent of Australia's colonial settlements. He says people can avoid that suffering today. "It was difficult to treat until the 20th century," he says. "Public programs are necessary, informing the public that the cure for syphilis is penicillin." Credits Reporter: Laetitia Lemke Camera operators: Che Chorley and Dane Hirst Digital producer: Gemma Ferguson Graphics: Jessica Henderson Editing: Kylie Stevenson Additional editorial guidance: Miriam Corowa Mon 15 Jun 2026 at 7:52am - Share options - Copy link - X (formerly Twitter) Related topics Adelaide Alice Springs Archaeology Darwin Disease Outbreak Epidemiology Health Policy Indigenous Australians Infectious Diseases Katherine Libraries, Museums and Galleries Medical History Medical Research NT Numbulwar Pregnancy and Childbirth Public Health Regional Communities Rural and Remote Communities Sexual Health Sexually Transmitted Diseases Tennant Creek Vaccines and Immunity