Infectious diseases Syphilis in Germany is spreading rapidly

Syphilis on the rise
The venereal disease syphilis was hardly common in Germany for a long time. For several years, however, the number of illnesses has risen again, affecting men in the first place. In light of this development, experts repeatedly emphasize the importance of screening tests. Because syphilis usually causes no symptoms at the beginning, the dangerous disease is often diagnosed very late in many cases.
Illness causes no discomfort in the early stages
Syphilis (also called "lues") is a worldwide sexually transmitted disease caused by bacteria. The disease is often referred to as the "chameleon of medicine", because as those affected usually notice no symptoms at the beginning, it is discovered in many cases relatively late. A dangerous matter, because the syphilis is not treated, it takes a chronic course and can cause severe late damage. The disease is very contagious and can be transmitted through blood as well as with all sexual contacts.

Increase in new diagnoses by up to 155 percent
For a long time, the disease was almost gone. But now, according to recent statistics, there has been a reverse trend for some years now. Because, as the current issue of the "Epidemiological Bulletin" of the Robert Koch Institute (RKI) shows, there has been a continuous increase in new cases since 2010, which continued in the first half of 2015. In 2014, a new high of 5,722 new diagnoses was recorded. While the number of infections likely to be acquired on a heterosexual path remained at the level of 2013 and even decreased by almost 3 percent in women, 20.2 percent showed a significant increase in men who have sex with men (MSM), so the RKI.

An increase was observed in this group in a total of 12 federal states, in six federal states such as Germany. Mecklenburg-Vorpommern (increase by 155%) or Bavaria (plus 70.6%), he was particularly high. Overall, the proportion of cases presumably transmitted via sexual contact between men was 84% ​​in 2014, while the proportion of heterosexual transfers was only 15.8%..

Berlin has by far the most contagion
The big city also seems to be a risk factor. For in 93.7% of all reports with information on the infection route from cities with more than one million inhabitants was given as the infection route sex between men. Berlin occupies by far the first place, because the capital has a more than 4-fold increased incidence compared to the national average, the report said. In addition, according to the significantly more populous North Rhine-Westphalia with 31 cases per 100,000 inhabitants, even in absolute numbers, most cases of syphilis occurred nationwide. According to the RKI, referring to the European MSM Internet Survey (EMIS), it can be assumed that the comparatively high proportion of the population of MSM and the "very diverse possibilities for establishing sexual contacts" such as clubs, saunas and porn cinemas have a significant impact on the high incidence of syphilis there.

Internet makes getting to know other men easier
According to Prof. Norbert Brockmeyer, another risk factor is party weekends, in which stimulating drugs such as Crystal Meth are consumed. Because by the drugs take away the risk awareness, in addition, these party goers are difficult to reach anyway about drug counseling, said the President of the German Society for Sexually Transmitted Diseases (DSTIG) to the news agency "dpa".

But the infectious disease is spreading not only in the big city. Instead, just under a third (32.5%) of the reports would come from places with less than 100,000 inhabitants, according to the RKI. "We suspect that it has become easier for men to get to know other men through the Internet, for example, or perhaps through dating apps," said the RKI expert for sexually transmitted infections, Viviane Bremer, to the news agency "dpa". "You know each other really well, that makes the use of condoms more difficult," adds Prof. Brockmeyer. Because with the new form of "dating" messages would normally be exchanged before the first meeting, which quickly creates a "deceptive trust".

Infections with HIV could have an important impact
As the RKI further reports, it should also be assumed that infections with HIV have an important influence on the syphilis epidemic in Germany. "We repeatedly see in studies that HIV-positive sometimes have unprotected sex with other HIV-positive," explains Viviane Bremer. Although this relationship can not be precisely quantified at present, it is suspected that many of the cases of syphilis occur in HIV-positive, as the venereal disease is taken here as a "lesser evil" in purchasing. Other experts also assume that AIDS and HIV have been frightened by the new treatment options in many sufferers and are therefore often not considered sufficient protection during sex.

Once a year to the addiction test
In view of the increased number of new cases, according to Armin Schafberger, a medical consultant at the German AIDS Aid, it is important to diagnose earlier than before. Because only in about one third of cases, the infection is discovered in the early stages. Therefore, people with high risk on the advice of Aids help should have a preventive screening test at the doctor once a year. However, the health insurance company only covers the costs here if symptoms are discernible, which at first primarily include lymph node swelling and painless ulcers on the penis, in the vagina, on and in the mouth or on and in the buttocks. In addition, fever, recurrent rash, and rubbery nodules usually occur throughout the body

But this is precisely where the problem lies, because since syphilis usually does not cause any symptoms at the beginning, the patient may already be in an advanced stage at the time of the test. In addition, according to the RKI report, many men who have sex with men are not informed about appropriate offers, as well as "the breadth of the diagnostic services [.] To be desired". In contrast, in other structurally comparable European countries (such as the Netherlands or the United Kingdom), "there is a very broad network of MSM-focused, low-threshold counseling, testing and treatment centers", says the RKI. (No)