Although syphilis cases are rising in most U.S. cities, with the majority of the new infections among gay and bisexual men, health officials in Detroit this week announced that syphilis cases in the city are down nearly 60% this year. Detroit and Wayne County, Mich., topped the list of cities and counties that accounted for at least half of new U.S. syphilis cases in 2001. The numbers went up in 2002, but they are now declining. There were 131 new cases in the first quarter of 2002, but only 81 in the fourth quarter, said state epidemiologist Carla Merritt. The 149 cases reported from January through September of this year represent a 57% decline over the same period in 2002, when there were 343 new cases reported, Merritt said, noting that better case management, training, notification, and community outreach have contributed to the decline.