By clustering identical and near-identical genomes, we found that we could discriminate clusters of heterosexuals and GBMSM. This suggests we can potentially use WGS to identify/exclude outbreak membership. However, very unlikely that WGS could ever be used to infer patient-2-patient transmission in syphilis.

And when we looked at the sociodemographic characteristics of the patients, those two major sublineages (1 & 14) also have different profiles (sublineage 14 is associated with older GBMSM)

However, there are some regional differences between the common sublineages. The blue sublineage (14) here was absent from northern England