Syphilis in Germany - Case numbers stagnate at a high level

Syphilis in Germany - Case numbers stagnate at a high level

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No further increase in syphilis infections for the first time in years

Since 2010, new syphilis infections in Germany have risen further every year. For the first time, this trend now seems to have been broken. According to the latest figures from the Robert Koch Institute (RKI), the increase in syphilis cases did not continue in 2018, but stagnated at a high level. Early diagnosis and treatment of syphilis infections is particularly important in order to interrupt infection chains as early as possible.

The reported syphilis infections are still at a high level, but they have not risen for the first time in years, reports the RKI. "The slight drop in cases compared to 2017 was due in particular to a slightly lower number of cases of heterosexual women and men throughout Germany," the institute said. Much of the infection continues to affect men who have sex with other men (MSM).

Syphilis occurs in three stages

Syphilis is a bacterial infectious disease that only occurs in humans and is usually transmitted during sexual intercourse. The disease typically occurs in three stages, explains the RKI. First, a so-called primary effect (usually painless ulcer at the point of entry) appeared a few days to weeks after the infection. This is followed by a secondary stage with general symptoms and skin symptoms, followed by a tertiary stage (years after the initial infection), in which damage to the brain and blood vessels can occur.

Previous development of syphilis infections

After the introduction of a laboratory reporting requirement for syphilis diagnoses, the number of reported infections initially increased between 2001 and 2004, then stabilized between 2004 and 2008 at a level between 3,000 and 3,500 infections per year, and since 2010 there has been a continuous increase again , which lasted until 2018, according to the RKI.

Persistently high level of new infections

A total of 7,332 syphilis cases were reported to the RKI in 2018, which was 192 (2.6%) fewer cases than in the previous year. Syphilis infections were predominantly diagnosed with MSM, and conurbations were particularly affected, reports the institute. The persistently high level of reported syphilis infections shows the importance of early diagnosis and treatment of syphilis to curb transmission.

Decline in Berlin and Munich

A special feature of the regional distribution of new infections is the decline in reported syphilis diagnoses in Berlin and Munich - metropolitan areas that were previously considered hotspots for new infections. The RKI reports that there is no comparable dynamic in any other major city.

Different reasons or a combination of these reasons are conceivable causes for the decline in the two major cities. For example, increased testing and treatment for syphilis in sexually active individuals may have contributed to the decline, the RKI said. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


  • Robert Koch Institute: Epidemiological Bulletin No. 50 (published 12.12.2019),

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