On August 1, Britain's Health Protection Agency warned that syphilis rates have risen to the highest level since the early days of the AIDS epidemic. The HPA's newsletter, Communicable Diseases Review, said diagnoses of infectious syphilis rose 67 percent in men and 33 percent in women between 2001 and 2002.

"Diagnoses of syphilis made in genitourinary medicine clinics are the highest seen since 1984, before the time of widespread awareness to HIV/AIDS in the UK," the report stated.

The biggest concentration of syphilis was in London, where 980 people were diagnosed between April 2001 and May 2003. Manchester reported 495 cases between January 2001 and the end of June 2003. Other places affected include Bristol, Edinburgh, Newcastle-upon-Tyne, Glasgow, Nottingham, Brighton and Northern Ireland.

The report traced the recent growth in syphilis to the popularity of sexual market places such as saunas, Internet chat rooms and cruising grounds, which increase the opportunity to acquire new sexual partners. According to the report, the Bristol outbreak was associated with heterosexual activity, commercial sex work and crack cocaine use, while the outbreaks in Brighton, Manchester, and London occurred among men who have sex with men, some of whom had concurrent HIV infection.

"The characteristics of the outbreaks are very similar to those seen in Western Europe and the United States, infection being associated with high incidence areas, high rates of partner change within risk groups and concurrent HIV infection," the report said.

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