Premarital Syphilis Serologies

To the Editor.— We support the general philosophy of disease control that Dr Felman espoused in his recent article calling for the abolition of mandatory premarital syphilis screening. He advocates screening of high-risk groups and prenatal screening to prevent congenital syphilis. While we agree that screening for syphilis in low-risk groups should not be advocated, we strongly believe that premarital screening should not necessarily be universally abandoned. Arbitrary decisions to maintain or abolish premarital screening make little sense. The decision to screen must rest on local epidemiologic circumstances rather than data from New York City or even national data. Several factors must be considered when deciding whether or not to screen: Local law and practice with respect to premarital syphilis testing. The geographic clustering of syphilis in a community. The distribution of syphilis cases by sexual preference (though almost one half of the infectious syphilis in 1976