The Robert Koch Institute has tested syphilis messages since 2017 with an algorithm to avoid multiple reports from individual cases. In the current publication, the algorithm has been consistently applied to previous years, which may lead to deviations from earlier reports.
This is an increase of 4.2 percent compared to 2016. Especially in Berlin and Hamburg, the report relative to the population fell above average number of people.
Numbers also rise internationally
Since 2010, RKI experts have observed a continuous increase in caseload numbers, which often affect gay men. Especially in the 1980s, the bacterial infection had been suppressed with the spread of HIV / AIDS and safe sex.
Meanwhile, HIV infection is treated as a chronic disease, if not curable. According to experts, the return of syphilis can result in a more frequent condom withdrawal from having six men. This also happens to change partners, say it and quote interviews.
Syphilis also increases internationally. In its report, experts stress that prevention, diagnostic and therapeutic measures should be further developed. The increase is partly reversed to better test deals. For example, people infected with HIV have been diagnosed – probably because they are offered regular screening.
Early detection only in some patients
Often, syphilis runs without symptoms. In other cases, usually a few days or weeks after infection, a wound occurs, for example on the penis, which causes no pain. Left untreated, other signs may follow – from fever, fatigue, headache, joint or muscle pain and swollen lymph nodes to skin changes.
Years after infection, damage to the brain and blood vessels is possible. So far syphilis has been detected early in only a fraction of patients.
Infection and incubation period
As a rule, the bacterium Treponema palladium is transferred under unprotected intercourse through minor damage to the skin and mucous membranes. In rare cases, syphilis can be transmitted to the fetus via the placenta during pregnancy.
The incubation period, the time from infection to the onset of disease, depends on the number of pathogens taken. This rule is usually 14 to 24 days.
First symptoms: Primary syphilis
The first stage of syphilis disease (Lues I) is the primary syphilis. Only after the incubation period develops a painless dark red spot or a hard nodule at the point where the pathogen enters the body. In the cock it is usually on shine or foreskin, in the woman this symptom usually occurs on the labia.
Within a few days, the nodule becomes a flat and painless wound. At the same time, the adjacent lymph nodes swell. Since these symptoms heal themselves after four to six weeks, syphilis is often not recognized at this stage.
Secondary syphilis: Treponema pallidum spreads
Left untreated, Treponema pallidum spreads through the body for the following four weeks. Phase of secondary syphilis (Lues II) marks various changes in skin and mucous membranes. Additionally, flu-like symptoms, such as fever, joint pain, swelling of the lymphatic gland, occur.
After about ten weeks, the patient gets rash. It can also lead to hair loss. Wet stains, called condylomata lata, develop in areas with severe sweating and skin folds. These are very contagious when they decay. After about two to three months, all skin damage completely heals.
Latency Stage: Symptomatic period
The second step is usually followed by a symptom-free period. For up to five years, syphilis can sleep here in silence without obvious symptoms. The risk of infection decreases slowly over time.
In the case of about 30 to 40 percent of patients, symptoms of syphilis again after three to five years. In some cases, even after ten years. In other cases, it is a lifelong stage of disease without any external signs of disease.
Tertiary stage: Muscle, skin and organ involvement
When the latency breaks through, tertiary syphilis begins (Lues III). Treponema palladium infects organs and destroys muscles and skin.
The pathogens spread throughout the body, affecting internal organs such as stomach, liver, bone, muscles and bloodstream. Nodes are formed, which often cure as rubber. On the skin can sometimes form large wounds, which can also break through the legs.
Neurosyphilis: In the fourth row, the brain is destroyed
About 20 percent of the victims develop severe neurological symptoms ten to twenty years after the onset of disease. This final stage (Lues IV) is also called neurosyphilis, as it also affects the nervous system, the brain and spinal cord. Neurosyphilis begins with an inflammation of the meninges. It comes to blurred vision. Untreated left, speech problems, amnesia, dementia and paralysis characterize this phase. Neurosyphilis ends with death.
Due to the more mature treatment methods, it has become increasingly rare for many decades to a fourth stage of syphilis. In recent years, the last step is increasingly evident. The reason for this is that a syphilis disease often coincides with an HIV infection. Since HIV-positive syphilists achieve lice IV more often.
The treatment of syphilis
Syphilis is still treated mainly with penicillin. Only in case of penicillin intolerance is it necessary to switch to other antibiotics. Dosage and treatment time depend on the stage of the disease.
The earlier treatment begins, the faster healing of syphilis can occur. Syphilis is one of the communicable diseases. As soon as a physician identifies a syphilis disease, he is required to send an anonymous report to the Robert Koch Institute. This enables a good documentation of the disease and its extension.
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