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July 5, 1971

A Laboratory Test Is Not a Diagnosis

Author Affiliations

Massachusetts Department of Public Health Boston

JAMA. 1971;217(1):71. doi:10.1001/jama.1971.03190010053014

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It is not surprising that in the sexually permissive society such as exists today, venereal disease should be on the rise. Gonorrhea is epidemic in the United States, with about 2 million people infected annually. Likewise, syphilis has been increasing since 1958; in 1970 there were some 80,000 cases in the primary to secondary stages.

About 20% of patients in the United States are reported in primary or secondary stages, another 20% in the late symptomatic stages. But the bulk—the remaining 60%—are eventually diagnosed because a positive blood test was discovered, usually for a totally unrelated condition. In women, syphilis is a disease of the childbearing period, with the largest number infected between the ages of 15 and 29.

With such an epidemic on our hands, it is well for us to review some of the laboratory tests available for diagnosing venereal disease, with brief mention of the sensitivity and