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HEALTH

Syphilis making surprise comeback in Germany

Germany recorded the highest number of syphilis cases last year that the country has seen in the past decade.

Syphilis making surprise comeback in Germany
Photo: DPA.

Germany had 5,722 new cases of syphilis in 2014 – an increase of 14 percent over the year before, according to a new report by the Robert Koch Institute (RKI).

The number of syphilis cases in Germany has been increasing each year since 2010, after spread of the infection started to stagnate and even slightly decline in the mid-2000s. The first half of 2015 also seemed to show a continued increase in cases, the report said.

Syphilis is a sexually transmitted infection (STI) that is contracted through sexual contact, as well as from mother to child at birth. The infection has various stages, the first of which is characterized by sores, the second by a skin rash and sometimes fever.

Untreated cases can lead to death.

The institute said in the report published on Monday that most of the spread of the STI was between men, with 84 percent of new cases believed to be contracted from one man to another.

The vast majority of patients with syphilis were men, with women making up just 6.3 percent of new cases, a slight decrease since the year before.

The influence of party drugs could be a cause for the increase in cases, said Professor Norbert Brockmeyer, president of the German Society for Sexually Transmitted Diseases (DSTIG). Such drugs may reduce the user's awareness of possible risks, he argues.

Berlin is syphilis hotspot

The report also showed a great geographical variance across the country in terms of which regions had the most cases.

Berlin had by far the highest proportion of syphilis cases across the 16 states, with 31 diagnoses for every 100,000 residents. In comparison, the country average was 7.1 cases for every 100,000 residents.

Meanwhile, the state of Brandenburg which surrounds Berlin had one of the lowest rates at about half the national average, along with Thuringia and Schleswig-Holstein.

Hamburg had the second-highest rate at 19.7 cases per 100,000. All other states had rates of 7.2 per 100,000 or less.

Big cities across the country had higher than average rates of syphilis, with Cologne (31.9 cases per 100,000) and Munich (27.2) also recording high incidences. 

But a third of the cases nationwide happened in towns with less than 100,000 citizens.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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