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August 1, 1977

Syphilis Surveillance

Author Affiliations

Emory University Hospital Atlanta

JAMA. 1977;238(5):399. doi:10.1001/jama.1977.03280050039013

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To the Editor.—  In their article, "Syphilis Surveillance: Failure to Screen in a University Hospital" (236:2641-2642, 1976), Tomecki and Plaut rightly criticized such errors as ignoring a positive serology. However, I wish to take issue with one segment of their contention: universal screening, viz, such screening in patients more than 65 years of age. The economics of hospital care have now made the scrutiny of all expenses, no matter how small, necessary.At Emory University Hospital, screening for syphilis has had the sanctity of tradition and official requirements. At the time of this study, an "admissions package" given to each new patient by the admissions office included a requisition for an automated reagin test (ART). To test the efficacy of this, I reviewed 314 consecutive charts selected only by (1) the patient's age (65 years or older) and (2) his discharge (or death) in January through March 1974. The use