Syphilis returns
Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.
More posts by Christiane Fux All content is checked by medical journalists.In Germany, more people are infected with syphilis. While there were around 3,000 reported cases in 2009, the Robert Koch Institute recorded almost 8,000 cases in 2019 - the highest level since the count began in 2001. A particular problem is that many infections are only discovered at a later stage.
Because syphilis is an insidious disease. In the early stages of the disease, it is quite harmless. A small, mostly pain-free ulcer forms at the entry point of the bacterium - i.e. on the genital organs, in the anal area or, in the case of oral sex, in the mouth, which heals on its own (primary stage).
In the second phase of the disease (secondary stage) the symptoms are non-specific: some fever, a rash, and headache and joint pain. That too will pass by itself.
Long-term damage: skin ulcers, organ damage, blindness and dementia
If the immune system fails to get the infection under control, considerable damage can occur years later. Ulcers then appear all over the body, and the bacterium attacks the blood vessels and nerves. The possible consequences are blindness, deafness, and dementia.
The pathogen that was so feared in the past centuries can now be treated well with antibiotics. So if you notice typical signs, you should have them checked by the doctor quickly and avoid sex in the meantime.
Only a quarter of the cases are discovered early
However, a large proportion of the infections are only diagnosed as the disease progresses. Only a good quarter (26.5 percent) of infections are discovered in the primary stage, 15.5 percent in the secondary stage and 24.5 percent in the early latency phase. It covers the first year after infection. The infected then no longer have symptoms, but can infect others.
This distribution shows that the number of unreported cases is likely to be high. Anyone who discovers such symptoms should take them seriously and see a doctor they trust as quickly as possible.
Condoms only protect to a limited extent
Sex should be avoided until clarification or until the end of the treatment. Because even a condom does not provide 100% protection against transmission. With medication, the bacterium is quickly defeated and the danger for others and for one's own long-term effects is permanently averted.
The fact that, thanks to so-called pre-exposure prophylaxis, unprotected sex has been possible again for some years now without fear of infection with HIV could contribute to the increase in the numbers. This medical achievement is used especially in the gay community.
But it does not protect against other sexually transmitted diseases. In fact, it is predominantly men who have sex with men (MSM) who become infected with syphilis. Their share among the infected makes up around 86 percent.
Syphilis strongholds: Cologne, Berlin, Munich and Hamburg
It is not surprising that syphilis is particularly common in large cities. The front runner here is Cologne with 57.8 cases per 100,000 inhabitants, followed by Berlin, Munich and Hamburg.
But even more rural regions are not free from syphilis, the RKI statistics show. Also in Mecklenburg-Western Pomerania, Brandenburg or Schleswig-Holstein - the federal states with the lowest prevalence of syphilis - sexually active people should take the corresponding symptoms seriously.
