Currently, there are 140 cases, which is more than triple the number of cases in all of last year.
Health workers are using Wal-Mart gift cards to fight the outbreak.
Officials recently went door-to-door asking people to get tested for syphilis and HIV, in exchange for $10 gift card to Wal-Mart.
The program was so successful that the cards ran out.
Forsyth County is about 100 miles west of Wake County.
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