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State drops blood tests

Syphilis finding rare in premarital screen

For more than 60 years it has been a prewedding ritual, as much a part of getting married as compiling the guest list or choosing a caterer. Last week, with little fanfare, it simply ceased to exist: Couples intending to marry in Massachusetts are no longer required to get a blood test.

The Bay State required the blood test to prevent the spread of syphilis, which was incurable and widely feared when the push for premarital testing began in the 1930s. During World War II, public health posters warned young soldiers that venereal diseases such as syphilis were a greater threat to the nation's security than Hitler or Hirohito.

But from its inception in 1943, the Bay State's premarital test detected far fewer untreated syphilis cases than public health officials had expected, identifying it in about 1 percent of those tested, instead of the predicted 10 percent, according to Dr. Alfred DeMaria, director of communicable disease control at the Massachusetts Department of Public Health.

In recent years, the detection rate has been a fraction of a percent, DeMaria said, and most states preceded Massachusetts in abandoning the blood test requirement. Fewer than a dozen still require it.

"It was just expensive and inconvenient, and there was no yield," DeMaria said of the blood tests. "It wasn't doing us any good. Why were we putting people through this for so many years?" The premarriage test for syphilis was rooted in the presumption that most people didn't have sex until they were married, a notion that seems quaint today, he said.

"It doesn't make sense to screen people just because they happen to get married -- for anything," DeMaria said.

Governor Mitt Romney signed the bill into law that repealed the testing requirement to obtain a marriage license in Massachusetts late last year. It went into effect Friday.

Nicole St. Peter, a DPH spokeswoman, said the blood test requirement cost the general public about $2 million a year in medical and lab fees.

After a decade of steady decline, the number of syphilis cases rose nationwide in 2002 for the second straight year, according to the most recent figures from the US Centers for Disease Control and Prevention. In that year, Boston had the 15th highest rate of syphilis among US cities, with eight cases per 100,000 people, a figure double that of Los Angeles and substantially higher than New York.

There were about 100 cases of syphilis reported in Massachusetts last year, largely among gay couples.

Massachusetts also had a voluntary rubella test, but that disease has become increasingly rare since babies began to be vaccinated against it in 1969. Although rubella is typically a minor condition in adults, it is a serious disease for a developing fetus.

Tom Weisand, a 43-year-old advertising executive who is getting married at the end of the month, didn't realize the state had scrapped the law until his doctor called him yesterday to cancel the appointment he had made to be tested. Weisand wasn't disappointed.

"One of the last little details we had to deal with was getting a blood test so we could get our marriage license," he said. "It's very nice that I'm not going to get a blood test tomorrow and have somebody stick a needle in my arm."

Scott Greenberger can be reached at greenberger@globe.com.

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