The Robert Koch Institute tested the syphilis message from 2017 with an algorithm that avoids multiple reports from individual cases. In the current publication, the algorithm is consistently applied to the values of the previous years, which can lead to deviations from the older reports.
This is an increase of 4.2 percent compared to 2016. Especially in Berlin and Hamburg, according to the report, they fell in relation to the population above the average number of people.
Numbers are also increasing internationally
Since 2010, RKI experts have been observing a continuous increase in the number of cases, often affecting gay men. Especially in the 1980s, the bacterial infection was suppressed by the spread of HIV / AIDS and safe sex.
In the meantime, HIV infection, such as chronic illness, can be treated if it can not be cured. In the opinion of experts, the return of syphilis may have to do with the more frequent retention of condoms from sex among men. This also happens with changing partners, cited by quoting interviews.
The syphilis numbers are also growing internationally. In their report, experts stress that further preventive, diagnostic and therapeutic measures are being developed. The increase is partly for better testing. People who are infected with HIV, for example, are often diagnosed – probably because they are regularly given an overview.
Early detection only in a few patients
Often syphilis runs without symptoms. In other cases, usually several days or weeks after infection, an ulcer occurs, for example, on the penis, which does not cause pain. Left untreated, other symptoms may follow – from fever, fatigue, headache, joint or muscle pain, and swollen lymph nodes to changes in the skin.
For years after infection, it is possible to damage the brain and blood vessels. To date, syphilis has been detected earlier in only a small number of patients.
Period of infection and incubation
The bacterium Treponema palladium is usually transmitted during unprotected sexual intercourse, through minutes of skin injuries 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 the disease, depends on the number of affected pathogens. As a rule, this time is 14 to 24 days.
First symptoms: Primary syphilis
The first stage of syphilis disease (Lues I) is the primary syphilis. It is only after the incubation period that a painless dark red spot develops or a hard knot develops at a place where the pathogen enters the body. In males, this is usually on the glans or in the skin of the skin, in women this symptom usually occurs on the labia.
Within a few days, the node turns into a flat and painless ulcer. At the same time, adjacent lymph nodes are growing. Since these symptoms are treated 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 next four weeks. The secondary syphilis phase (Lues II) indicates various changes in the skin and mucous membranes. In addition, there are symptoms such as flu, such as fever, joint pain, lymph node island.
After about ten weeks, the patient gets a rash. It can also lead to hair loss. Wet dots, so-called. Condilomata lata, develop in areas with severe sweating and scarring of the skin. This is very addictive when it breaks down. After about two to three months, all the skin lesions are completely frozen.
Latency: a period without symptoms
The second phase usually follows a period without symptoms. Up to five years, syphilis can sleep here at rest without apparent symptoms. The risk of infection decreases over time.
In the case of about 30 to 40 per cent of patients, symptoms of syphilis again after three to five years. In some cases, even after ten years. In other cases, it is a phase of lifelong disease without external signs of the disease.
Tertiary phase: involvement of muscles, skin and organs
When latency breaks, tertiary syphilis begins (Lues III). Treponema palladium infects the organs and destroys muscles and skin.
The pathogen spreads throughout the body, affecting internal organs such as stomach, liver, bone, muscle and blood. Nodes are formed, often solid rubber. Sometimes large sores can appear on the skin, which can also break through the bones.
Neurosyphilis: In the fourth phase of brain destruction
About 20% of those affected develop severe neurological symptoms ten to 20 years after the onset of syphilis. This final phase (Lues IV) is also called neurosyphilis because it also affects the nervous system, brain, and spinal cord. Neurosyphilis begins with the inflammation of the meninge. There is a blurred vision. Left untreated, speech problems, amnesia, dementia and paralysis characterize this phase. Neurosyphilis ends with death.
Due to more mature treatment methods, in the decades it has become increasingly rare in the fourth phase of syphilis. In recent years, however, the final phase is being repeated more and more. The reason for this is that syphilis disease often coincides with HIV infection. Given that patients with HIV-positive syphilis often achieve IV particles.
Treatment of syphilis
Syphilis is still treated with penicillin. Only in the case of penicillin intolerance is it necessary to switch to other antibiotics. The dose and duration of therapy depend on the stage of the disease.
The sooner the treatment begins, the faster the syphilis can be healed. Syphilis is one of the diseases that can be reported. As soon as the doctor identifies the syphilis disease, he is obliged to send an anonymous report to the Robert Koch Institute. This provides good documentation of the disease and its prolongation.
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