Yaws

Yaws and other (non-Syphilis) endemic treponematosesJordan Oakes

1Treponema pallidum is a species of Gram negative spirochete that cause treponemal diseases.

2Yaws, also known as Frambesia tropica, is a chronic infection of the skin, bones and joints

-Chronic infection that mainly affects the skin, bones and joints-Caused by Treponema pallidum pertenue~Closely related to the bacteria that causes syphilis (Treponema pallidum pallidum)~Yaws from Carib word yaya

3

Yaws is an ancient and tropical disease that has been affecting hominids for 1.5 million years

-Believed to have originated in tropical areas in Africa and spread via immigration and slave trade-Also believed to have originated in SE Asia-Found in rural areas of Caribbean Islands, Latin America, W Africa, India, SE Asia

1950s: common tropical illness ~50million-1million ppl infected

4WHO estimates 75% of all people affected by Yaws are under the age of 15

-Most commonly affects ages 2-5-direct skin contact .: children w/ few clothes, frequent skin abrasions/injury and poor hygiene put them at elevated risk5The disease begins with the appearance of the Mother Yaw and can lead to tissue destruction and bone and joint disfigurement.

-Mother Yaw: 2-4 weeks post infection, painless sore develops; can last for months-Daughter yaws can appear nearby at the same time or after the mother yaw

6There are three stages of infection; primary, secondary and tertiary

Primary:Resolves within 6 monthsSecondary (highly infectious):Months to years laterWidespread skin lesions Tertiary:5-10 years after infectionBone, joint and soft tissue destruction

7Infection is transmitted through direct contact with pus from an open lesion

Transmitted through direct contact with pus from open lesionEnter through abrasions and travel through tight junctionsHas very few antigen epitopes on bacterial cell surface

8All treponemal diseases can be cured with penicillin, tetracycline or erythromycin

Usually, single does of intramuscular penicillinSingle oral dose of azithromycin shown to be just as effectiveCan also be treated with pillsPenicillinErythromycinTetracycline

9Yaws is on its was to being eradicated from many countries

Control program launched in 1957 reduced incidence by 93%-supported by UNICEF and WHO-screening for it conducted in 4 states

>160million examined in 46 countries and more than 50million cases treated with penicillin & brought 50million down to 2million

India:

1950s 50-100million infected

1970s resurgence

Now: