Syphilis cases have surged worldwide, leaving public health officials scrounging for ways to stop the spread. Now, a large, collaborative study of syphilis genetics from four continents has found hints of a possible target for a vaccine. The work is published in The Lancet Microbe journal.

Syphilis is a sexually transmitted illness that first appeared in Europe about 500 years ago. Its initial symptoms can vary, but the spiral shaped bacterium that causes it can persist in the body for years, often in the central nervous system, and cause birth defects when it infects infants in utero. Syphilis cases decreased in the middle 20th century as easy, effective treatment with injectable penicillin became available, and became uncommon in the 1990s due to changes in sexual behavior in the wake of the HIV epidemic.

But recently, syphilis has made an unwelcome comeback. There were 207,255 cases in the U.S.

in 2022, according to the Centers for Disease Control (CDC), more than any time since the 1950s. Babies, some of them stillborn, made up 3,755 of those cases. Other countries worldwide are seeing the same disturbing upward trend.

Stopping syphilis's spread has become a pressing public health goal. Now, an international collaboration of researchers and doctors has collected one of the most extensive genomic surveys of the syphilis bacterium to date and correlated the genetic data with clinical information about the patients who provided the samples. They are using the data to search .