The question of the first sexually transmitted disease (STD) is complicated because the modern definition relies on identifying a specific pathogen transmitted through sexual contact. An STD is caused by an organism, such as a bacterium, virus, or parasite, that passes from one person to another during sexual activity. The ability to identify a microscopic organism and link it specifically to sexual transmission is a relatively recent scientific achievement. The search for the “first” STD must navigate between the earliest surviving written descriptions of symptoms and the much older biological evidence locked within ancient DNA and human remains.
Why Pinpointing the “First” is Complex
The complexity in identifying the first STD lies in the difference between historical documentation and biological antiquity. Written history can only record what people recognized and chose to document, usually the sudden appearance of severe symptoms. Many ancient infections existed for millennia before they were accurately categorized or recognized as sexually transmissible.
Most STDs do not leave lasting marks on the skeleton or internal organs, complicating the search through archaeological records. Infections like yaws and bejel, related to syphilis, are spread through non-sexual skin-to-skin contact, making it difficult to distinguish their ancient symptoms from sexually transmitted forms. The oldest biological evidence often predates clear written records, forcing historians to rely on paleopathology and genetic analysis.
Syphilis The Historical Record Holder
Syphilis, caused by the bacterium Treponema pallidum, often holds the historical record for being the first clearly defined STD due to its explosive and well-documented European outbreak. The disease appeared suddenly in Europe around 1495 during the French invasion of Naples, quickly earning the names “The Great Pox” and “French disease”. The virulence of this initial epidemic was extreme, causing widespread death and disfigurement that was more severe than the syphilis seen today.
The sudden social impact and horrific symptoms forced physicians and chroniclers to document it distinctly from other known illnesses like leprosy. This widespread documentation established it as a new entity in the European consciousness. The debate over its origin—whether it was brought back by Christopher Columbus’s crew (Columbian hypothesis) or was a pre-existing, milder disease that mutated (pre-Columbian hypothesis)—further cemented its historical prominence. The Italian physician and poet Girolamo Fracastoro officially gave the disease its current name in 1530 in an epic poem titled Syphilis sive morbus gallicus.
Vague Descriptions of Ancient Genital Infections
While syphilis has the clearest historical debut, older texts contain vague descriptions of genital ailments likely corresponding to other STDs. Ancient Mesopotamian clay tablets and Egyptian papyri, dating back to 1550 BC, mention symptoms like urethral and vaginal discharge. These non-specific flows were likely caused by pathogens such as Neisseria gonorrhoeae (gonorrhea) or Chlamydia trachomatis (chlamydia).
In the Greco-Roman world, physicians described various genital lesions and discharges, but they could not identify the specific cause without microbiology. The Greek physician Galen coined the term “gonorrhea” in 130 AD, mistaking the pus-filled discharge for an involuntary “flow of semen.” Ancient texts also describe genital warts, known as condyloma, which are now known to be caused by the Human Papillomavirus (HPV). These records describe visible symptoms but lack the scientific clarity to confirm the pathogen or its specific transmission route.
Tracing Origins Through DNA and Paleopathology
Modern science uses genetic sequencing (phylogenetics) and the study of ancient remains (paleopathology) to trace the origins of pathogens far beyond written history. Genetic analysis shows that the family of bacteria causing syphilis, Treponema pallidum, has a long history in the Americas, suggesting its origin is much older than the 15th-century European outbreak. Phylogenetics reveals that venereal syphilis is a relatively recent offshoot from a common ancestor shared with yaws and bejel, which are ancient, non-sexually transmitted diseases.
The genetic record of the Human Papillomavirus (HPV) suggests it may be the oldest sexually transmitted agent, potentially predating modern humans. Molecular clock models estimate that the virus has been evolving in hominins for over 500,000 years; its DNA has even been found in an ancient Egyptian mummy. While the pathogen itself is ancient, the transition to its modern sexually transmitted forms likely occurred as human social and sexual behaviors evolved.