Munich – Munich breaks a record: the incidence of syphilis infections is at its peak. According to a report by the (RKI) from February 15, 2024, 38.9 people per 100,000 inhabitants were infected in the Bavarian capital in 2022. A Munich doctor says: “We have to take the increase in new infections seriously.”
Bavaria breaks record: increase in syphilis infections by 52 percent
According to data from the RKI, the numbers in Germany have been rising continuously since 2010. Urban areas (over 100,000 inhabitants) are particularly affected; this is particularly evident in cities such as Cologne, Berlin and Frankfurt. But Nuremberg and Munich also had high incidences. As a federal state, Bavaria had another nationwide record: there was the highest increase in incidence compared to the previous year – at 52.5 percent.
According to the Bavarian State Office for Health and Food Safety (LGL), “most reported syphilis cases are in Bavaria […] Transmitted by men who have sex with men (MSM). However, “the number of newly reported cases transmitted through heterosexual sex has also increased approximately twofold from 2003 to 2023.” Syphilis, which is transmitted sexually and through Transmissible through blood contact has been mandatory since the Infection Protection Act came into effect in 2001. According to information from the LGL, in 2023 the number of reported cases in Bavaria will be around 1,400 cases.
Doctor from Munich: “We have to take the situation seriously”
Dr. Stefan Zippel from the Clinic and Polyclinic for Dermatology and Allergology at the LMU Munich tells the AZ that “the increase in new infections should be taken seriously.” However, there is “a case for alarmism […] no reason.” Since it is true in Bavaria and throughout Germany that most infected people belong to the MSM group, there is “a well-defined group that we can also target specifically,” says Zippel. This is in many practices and clinics The case. Counseling centers for gay men are also “important pillars of prevention.”
“Although syphilis is a reportable disease, reliable figures for 2024 are not yet available,” said Zippel in the AZ. However, you can expect late reports to the RKI. However, the LMU outpatient clinic could see an increase in syphilis cases “until 2024,” said the doctor. He adds: “We have to look closely and also identify chains of infection in order to identify possible subgroups in which syphilis is spreading quickly.”
Zippel cites the increased avoidance of condoms during sex as a possible reason for the rapid increase in the number of infections. Many of the men would use “PrEP (pre-exposure prophylaxis) to prevent HIV infection,” which is why many omit the condom. However, this increases the risk of syphilis infection or other STIs (sexually transmitted diseases). However, because of PreP, many men are “also regularly examined for sexually transmitted infections.” With such tests, a “syphilis infection is reliably detected,” says Zippel.
Munich doctor: “We have to assume that syphilis is spreading”
“At the moment we have to assume that syphilis is spreading,” says the doctor. “But there is no reason to worry,” he adds. As a bacterial disease, syphilis can be easily treated with penicilin, an antibiotic. “Syphilis is a highly contagious and sexually transmitted disease,” explains Zippel. The problem is not treatability, but early detection. Because the first stage of the disease is easy to overlook. If left untreated, it can cause serious health problems, such as damage to cranial nerves. “History knows many famous victims of syphilis such as Franz Schubert, Heinrich Heine and Friedrich Nietzsche, all of whom died as a result of syphilis,” said Zippel.
For this reason, the doctor recommends that sexually active people get tested “on a regular basis.” If an infection is detected, it is also important to “always inform sexual partners so that they can also be examined,” says Zippel. He explains: “A trusting advisory situation is an important component here in order to be able to interrupt and close chains of infection.”
Dr. Zippel (LMU): “We can’t just educate people about AIDS”
Nevertheless, the doctor sees a need for action in terms of prevention and education. “We must not only provide information about HIV and AIDS, we must continue to provide information about sexually transmitted diseases and their warning signs.” We have to “clarify about transmission routes, which means we also have to talk about sexual practices,” said Zippel.
He adds: “Open and unbiased advertising not only for testing for HIV, but also for STI testing, is an important contribution to addressing those affected well and thus increasing their willingness to test.” In addition, “an easily accessible and reliable test offer” is an important point. “There should be no access barriers or restrictions here,” says Zippel in the AZ.
LMU doctor: “The increased risk makes me very worried”
In addition to syphilis, according to Zippel, there are other infectious diseases that should be educated and talked about. According to Zippel, the vaccination against human papilloma viruses (HPV), which is currently being discussed again, is being used far too little. There are also “vaccination gaps in the hepatitis B vaccination”. The disease is “transmitted much more easily during sexual intercourse than HIV,” says Zippel.
“I am very concerned about vaccination fatigue and the resulting increased risk. There needs to be more information about these vaccinations as part of the educational process,” says the doctor in the AZ. The Bavarian Health Minister Judith Gerlach called for vaccination against the virus at the beginning of March, on World HPV Day.