Yaws

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Yaws is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pertenue. Other treponematosis diseases are bejel (Treponema endemicum), pinta (Treponema carateum), syphilis (Treponema pallidum), and Lyme Disease (Borrelia burgdorferi).

Yaws is an infection caused by the spiral-shaped bacteria, Treponema pallidum, subspecies pertenue. It is closely related to the bacterium that causes syphilis, but this disease is not sexually transmitted.

A sample from a skin sore is examined under a special type of microscope called darkfield examination. There is no blood test for yaws. However, the blood test for syphilis is usually positive in people with yaws because the bacteria that cause these two conditions are closely related.

Treatment involves a single dose of one type of penicillin, or 3 weekly doses for later stage disease. It is rare for the disease to return. Anyone who lives in the same house with someone who is infected should be examined for yaws and treated if they are infected.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Yaws is an infection caused by the spiral-shaped bacteria, Treponema pallidum, subspecies pertenue. It is closely related to the bacterium that causes syphilis, but this disease is not sexually transmitted.

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Different rash-like conditions may be misdiagnosed with Yaws, including:^[1]

• Syphilis – commonly presents with generalized systemic symptoms such as malaise, fatigue, headache and fever. Skin eruptions may be subtle and asymptomatic. It is classically described as 1) non-pruritic bilateral symmetrical mucocutaneous rash; 2) non-tender regional lymphadenopathy; 3) condylomata lata; and 4) patchy alopecia.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Yaws mainly affects children in rural, warm, tropical areas, such as the Caribbean Islands, Latin America, West Africa, India, and Southeast Asia.

The disease is transmitted by skin contact with infected individuals or eye gnats, the spirochete entering through an existing cut or similar damage. Within ninety days (but usually less than a month) of infection a painless but distinctive ‘mother yaw’ ulcer appears. These tracts heal with keloid formation which can cause deformities, disabilities and limb contractures. The bone lesions caused are periostitis, osteitis, and osteomyelitis, damage to the tibia can lead to a condition known as sabre shins. In a very few cases a condition known as goundou is caused where growths on the nasal maxillae can result in extensive and severe damage to the nose and palate.

The largest group afflicted by yaws are children aged 6 to 10 years in tropical areas of the Americas, Africa, Asia or Oceania. There were World Health Organization funded campaigns against yaws from 1954 to 1963 which greatly reduced the incidence of the disease, although more recently numbers have risen again.

The disease is identified from blood tests or by a lesion sample through a darkfield examination under a microscope. Treatment is by a single dose of penicillin, erythromycin or tetracycline, recurrence or relapse is uncommon.

Examination of ancient remains has led to the suggestion that yaws has affected hominids for the last 1.5 million years. The current name is believed to be of Carib origin, “yaya” meaning sore; frambesia is a Modern Latin word inspired by the French word Pétasse (“raspberry”).

Yaws was nearly eradicated by a worldwide treatment program in the 1950s, which reduced the number of sufferers of yaws from an estimated 50 million to nearly zero. However, the World Health Organization reported in January 2007 that yaws is on the rise again, with roughly a half a million sufferers, mostly in poor, rural areas.^[1]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Yaws may damage the skin and bones, affecting the appearance and ability to move. It can also cause deformities of the legs, nose, palate, and maxilla.

If treated in its early stages, yaws can be cured. Skin lesions may take several months to heal. By its late stage, yaws may have already caused damage to the skin and bones. It may not be fully reversible, even with treatment.

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