P059\u2005Syphilis in Germany – a New All-Time High of Cases

Abstract

Background Since 2001, laboratories are required to notify syphilis diagnoses anonymously in Germany, physicians complement clinical information. Between 2010 and 2017, the number of syphilis cases increased between 5% and 15%, while in 2018 we observed a 2% decline. We analysed syphilis surveillance data from 2019 and January to June 2020 to assess the current dynamics in order to initiate appropriate prevention measures. Methods Potential double notifications are identified. We analyzed syphilis cases by year of diagnosis, age, sex, area of residence, and transmission category. Results 7,889 cases were reported in 2019, corresponding to a 7% rise compared to 2018. Incidence was 9.5/100,000 inhabitants, with highest incidences in metropolitan cities as Cologne (57.8), Berlin (39.7), and Munich (30.2). From January to June 2020, incidence dropped by 3% compared to this period in 2019. Men accounted for 94% of cases in 2019. 86% of cases with information on transmission route were men who have sex with men (MSM), 14% heterosexuals. Median age of MSM ranged between 39–41 years since 2009. HIV-coinfection was reported for 44% MSM. HIV-negative MSM were diagnosed less frequently with reinfection (27%) compared to HIV-positive MSM (66%), and more frequent during primary state of infection (34% vs 23%). Conclusion Data showed a high burden of disease in MSM in metropolitan cities across all age groups. Considering the high proportion of Syphilis reinfections, substantial risk behavior seems to fuel the syphilis epidemic in Germany in MSM, especially in HIV-positive. Targeted approaches to increase early screening and treatment, like internet counselling, home sampling, home testing, and venue-based (rapid) testing should be intensified. The slightly decreasing incidence in the first six months of 2020 may be caused by reduced sexual encounters due to the SARS-CoV-2 pandemic.