Background:
The number of primary and secondary (P&S) syphilis cases reported in the United States decreased during the 1990s; in 2000, the number was the lowest since reporting began in 1941. Unfortunately, the number has since increased 33.5%, from 5,979 in 2000 to 7,980 in 2004.

Objective:
To characterize the epidemiology of P & S syphilis in Las Vegas, NV.

Method:
We analyzed P & S syphilis surveillance data for 2000-September 30, 2005 using STD*MIS and Epi Info Version 6.03.

Result:
The number of P & S syphilis cases reported in Las Vegas, NV has increased 1,925% from 2000 to 2005 (4 to 81 cases, respectively). This increase occurred among both males and females. The number of P & S syphilis cases reported from 2002 – 2005 increased among Whites, Blacks, and Hispanics but the percentage of total cases decreased among Whites, increased among Blacks, and remained stable among Hispanics. In 2005, the male:female ratio of P & S syphilis cases among Whites was 8.4, while among Blacks it was 1.1. From 2002-2005, the number of P & S cases among men who have sex with men (MSM) increased 2,700%, from 1 to 28 cases. For all years, the most number of cases were reported among 20-49 years olds and the percentage of total infectious syphilis cases reported among these three age categories was relatively stable over time.

Conclusion:
Like other major metropolitan areas in the U.S., Las Vegas, NV has experienced a resurgence in P & S syphilis cases. Unlike these cities, though, Las Vegas appears to be experiencing this epidemic concurrently among two distinct sub-populations – Black heterosexuals and White MSM.

Implications:
In order for syphilis control efforts to be successful, they must target the appropriate affected communities.