The number of Americans with common sexually transmitted diseases (STD) has jumped to record levels, according to new research.
Nearly 2.3m cases of chlamydia, gonorrhoea and syphilis were diagnosed in the US in 2017, scientists found.
It is the highest figure ever recorded – outstripping the record set in 2016 by more than 200,000.
In the last year, cases of primary and secondary syphilis grew more than 10%.
Gonorrhoea infections also surged by 18%, while chlamydia case were up 6% within the last 12 months.
All can be cured with antibiotics but if left untreated can lead to infertility and serious complications.
The numbers were described as "very concerning" by Dr Gail Bolan, director of the Division of STD Prevention at the Centres for Disease Control and Prevention (CDC), a federal agency which released the stats.
"We have seen steep and sustained increases over the last five years," Dr Bolan said
"Usually there are ebbs and flows, but this sustained increase is very concerning. We haven't seen anything like this for two decades."
David Harvey, another CDC executive, said there was a "direct correlation" between the increase in numbers and no new funding by the federal government since 2016.
The spike has also been blamed on lower condom usage and antibiotic-resistant strains of diseases.
More women are also getting syphilis and unknowingly passing it on to their babies, a 2017 CDC report found.
Charlotte Gaydos, a professor of medicine at the Johns Hopkins University School of Medicine, blamed the rise of dating and hook-up apps, too.
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"It's easier to find partners with the dating apps," she told NBC News.
"People can find partners and they don't even need to know their names."
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