Syphilis diagnoses reach a new record level in Germany
Germany is witnessing a continuous rise in syphilis cases, with a new record set in 2024 according to data from the Robert Koch Institute (RKI), which reported 9,519 cases compared to 9,159 cases in 2023, an increase of 3.9% in just one year.
When comparing the figures since the mandatory reporting of the disease began in 2001, it shows that the number of cases has doubled significantly. At that time, fewer than 2,000 cases were documented annually in Germany. By 2015, the number exceeded 5,000 cases, then temporarily decreased during the Corona pandemic, before sharply rising again.
The vast majority of infections were recorded among men who have sex with men, with the percentage of infected women not exceeding 7.6%. Nevertheless, a slight increase in the number of infections was observed among individuals acquiring the infection through heterosexual relationships. Additionally, the proportion of cases related to sexual relationships among men has decreased compared to previous years. The average age of the infected individuals was around 41 years. The disease is caused by the bacterium Treponema pallidum, which is a spiral-shaped bacterium often transmitted through sexual contact, but can also be transmitted from mother to fetus or through blood. Antibiotic treatment such as penicillin is considered effective, although diagnosis is often delayed.
The highest infection rates are seen in major urban areas. Berlin recorded the highest infection rate at 35.7 cases per 100,000 people, followed by Hamburg with 30.3 cases. The lowest infection rates were in Brandenburg and Thüringen. In terms of cities, Trier, Köln, Frankfurt am Main, and München recorded relatively high infection rates. Syphilis symptoms often begin with a small sore ranging from 0.5 to 1 centimeter that appears days or weeks after infection in the mouth, genital, or anal areas, and often goes unnoticed by the infected person as it does not cause pain, even though it is highly contagious.
Even without treatment, this ulcer can heal spontaneously, but the bacteria remain in the body. In the second stage, a rash may appear weeks after infection, especially on the palms of the hands and soles of the feet, and it often does not cause itching. Other symptoms may accompany the disease at this stage, such as fever, fatigue, headache, joint and muscle pain, and hair loss. If the infection is left untreated, the disease may progress to its third stage after several years, where it can lead to damage to blood vessels and the central nervous system. There are currently no vaccines available against syphilis according to RKI. The use of condoms is considered the most effective means of preventing infection.