Venereal syphilis, which has been on the decline for the past twenty years in developed countries, has reached low incidence rates of less than 5 per 100,000. Some of these countries, including France, have consequently abolished mandatory reporting, just as syphilis, along with other sexually transmitted infections (STIs), began an unexpected resurgence. In contrast, in developing countries such as those in the Caribbean, syphilis has remained largely endemic with a high and stable incidence. The French departments of Guadeloupe, Martinique, and French Guiana in the Americas, which are socioeconomically well-off, are an exception in the region: STIs (excluding HIV) have followed the same trend there as in Europe, with primary and secondary syphilis having virtually disappeared since 1990 (0 to 5 cases per year in Guadeloupe). Between January and April 2001, 13 cases of primary-secondary syphilis were referred to the University Hospital Center (CHU) in Pointe-à-Pitre, serving an area of 300,000 inhabitants. The situation was reported to health authorities, and investigations were conducted beginning in March 2001 to confirm the outbreak, determine its extent and characteristics, and propose recommendations as appropriate. (R.A.)