Syphilis infections continue to rise – early detection is only in a few patients

The Robert Koch Institute will examine Syphilis notifications since 2017 with an algorithm to avoid Multiple reporting of individual cases. In the current publication of the algorithm unit was applied also on figures of previous years, this can lead to deviations in comparison to older Reports.

The increase in the number of Syphilis infections in Germany is continuing. In the past year, nearly 7500 cases of the sexually transmitted disease have been reported, such as from a recent report by the Robert Koch Institute (RKI) in Berlin. This was an increase of 4.2 percent compared to the year 2016. In particular, in Berlin and Hamburg, ill, according to the report, in relation to the number of inhabitants above average, a lot of people.

Numbers continue to grow internationally

Since 2010, the RKI watch experts pay again a continuous increase of the case, are frequently affected gay men. In particular, in the 80s, the bacterial infection had been pushed back, with the spread of HIV/Aids and Safer Sex. Meanwhile, a HIV-infection as a chronic disease treatable, if not curable. The return of Syphilis may have to do, according to the experts with a higher frequency of condom, abstinence from Sex among men. The come even with changing partners, it said, citing surveys.

The Syphilis Numbers rise internationally. In their report, the experts underline that measures for the prevention, diagnosis and therapy should be further developed. The increase is but in part also to better test offers. HIV-Infected were often diagnosed – probably because you receive a regular Screening is offered.

Early detection is only in a few patients

Often Syphilis usually has no symptoms. In other cases, a few days or weeks, and usually occurs after infection, an ulcer, for example, on the Penis that causes no pain. If left untreated, further symptoms can follow from a fever, fatigue, head, joint, muscle or lymph nodes pain and swollen up to the skin changes.

Years after the infection, some damage to the brain and the blood vessels are possible. Yet Syphilis is detected only in a fraction of the patients at an early stage.

Infection and incubation period

In General, the bacterial species Treponema palladium in unprotected sex will be transmitted, through the smallest of injuries to the skin and mucous membranes. In rare cases, Syphilis can be transmitted during pregnancy to the unborn child through the placenta.

The incubation period, the time from infection until the onset of the disease, depends on the number of ingested pathogens. In General, this period is 14 to 24 days.

First Symptoms: Primary Syphilis

The first stadium of a Syphilis (Lues I), is the primary Syphilis. After the incubation period, a painless dark or red spot or a hard nodule is formed at the location where the pathogens in the body. In men this is usually on the glans or foreskin, in women this Symptom usually occurs on the labia.

Within a few days, the nodules converts to a flat and pain-free ulcer. At the same time the neighboring lymph nodes swell. As these symptoms healed after four to six weeks by itself, is not recognized Syphilis in this stage often.

Secondary Syphilis: The Treponema pallidum spreads

If left untreated, the Treponema pallidum is spreading in the following four weeks by the blood in the body. The Phase of secondary Syphilis (Lues II) identifies various skin and mucosal changes. In addition, flu similar symptoms, such as fever, joint pain, swelling of the Lymph nodes.

After about ten weeks, the Patient gets a skin rash. It can also lead to hair loss. Especially in Places with strong sweat formation and in skin folds weeping pustules, which are called Condylomata lata. These are, if they crumble, very contagious. After about two to three months, all the skin lesions heal completely.

Latency Stage: Symptom Free Period

On the second stage, a symptom-free period usually follows. Up to five years, Syphilis can lie dormant in a standstill with no obvious symptoms. The risk of contagion decreases slowly with time.

In the case of about 30 to 40 percent of Patients symptoms of Syphilis do not show until after three to five years. In some cases, even after ten years. In other cases, it is a life-long-lasting stage of the disease without any external signs of the disease.

Tertiary stage: infestation of the muscles, skin and organs

When you break Through the latency time, the tertiary Syphilis (Lues III) begins. The Treponema palladium affects the organs, and destroyed muscles, and skin.

The pathogen spreads throughout the body and affects internal organs such as the stomach, liver, bones, muscles, and blood trails. It nodes, the harden is often rubber-like form. On the skin can form large ulcers that can also bone break.

Neurosyphilis: In the fourth stage, destruction of the brain

About 20 percent of the Affected ten to 20 years after the beginning of the Syphilis severe neurological symptoms. This final stage (Lues IV) is also called Neurosyphilis, as here, the nervous system, the brain and spinal cord are affected. The Neurosyphilis begins with inflammation of the meninges. It comes to vision problems. If left untreated, identify language problems, amnesia, dementia, and paralysis this Phase. The Neurosyphilis ends with death.

On the basis of the more Mature methods of treatment came for many decades and is increasingly rare in a fourth stage of Syphilis. In the last few years, the final stage, however, appears to be increasing. The reason for this is that a Lues-the disease meets seldom with HIV infection. Because HIV-positive syphilis patients are more likely to Lues IV.

The treatment of Syphilis

As Syphilis is treated primarily with Penicillin. Only in the case of Penicillin intolerance, it is the Dodge necessary, to other antibiotics. The dose and duration of treatment depend on the stage of the disease.

The earlier the treatment begins, the quicker a cure of the Syphilis may occur. Syphilis is among the reportable diseases. As soon as a doctor puts a Syphilis disease, he is obliged to send an anonymous message to the Robert-Koch-Institute. This allows for a good documentation of the disease and its expansion.