title: The great pretender returns to Dublin, Ireland.
abstract: BACKGROUND
  An outbreak of syphilis has been identified primarily in Dublin, Ireland. On a background of a stable low incidence of syphilis, a significant increase in the number of cases of syphilis has been observed over the past 18 months.
  
  
  RESULTS
  181 cases of syphilis were seen in this period. 121 were defined as early syphilis. These cases were mainly among men who have sex with men (92%). A high rate of HIV co-infection was present; 16 patients who regularly attended HIV clinics were diagnosed with early syphilis. Nine patients were co-diagnosed with HIV and early syphilis. High risk behaviour and concurrent diagnoses with other sexually transmitted infections were prevalent in this cohort. Sexual networks were also investigated.
  
  
  CONCLUSIONS
  An education campaign, widespread advertisements, and on-site testing in commercial venues have revealed further cases. Safer sex messages need to be emphasised particularly among the HIV population. Further innovative strategies continue to be explored.
authors.affiliation: Department of Genitourinary Medicine, St James's Hospital, James's Street, Dublin 8, Ireland. fmulcahy@stjames.ie
authors.forename: S
authors.initials: S
authors.lastname: Hopkins
authors.forename: F
authors.initials: F
authors.lastname: Lyons
authors.forename: F
authors.initials: F
authors.lastname: Mulcahy
authors.forename: C
authors.initials: C
authors.lastname: Bergin
mesh_terms: D000328:Adult; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology*