Yaws and Other Endemic Treponematoses

Jack McCarrick

Yaws and its relativesare caused by spirochete bacteria

Treponema pallidum

The endemic treponematoses are mainly transmitted by human-to-

human contact

Yaws is typically found in tropical areas of Africa, South America, and Asia

The first sign of yaws is a primary lesion known as a “mother yaw”

Without treatment, secondary widespread lesions form

After years without treatment, larger problems may develop

Gangosa Sabre Tibia

Endemic syphilis (bejel) is usually found in dry, hot climates (mainly in West Africa)

Endemic syphilis starts with primary white ulcers in the mouth and can end

up like late yaws

Pinta is primarily found in arid climates in Central and South America

Pinta starts out similar to yaws but can eventually lead to hyperpigmentation or

depigmentation

What do we understand about the pathogenesis of these diseases?

Not much

These diseases can be diagnosed in two ways

Dark field microscopy

Serological Tests

Benzathine penicillin is the main drug of choice for treatment

Between 1950 and 1970, WHO and UNICEF led a campaign to treat people in 46 countries

It worked, but these diseases now receive little attention

References• Antel, George M., et al. “The Endemic Treponematoses.” Microbes

and Infection 4.1 (January 2002): 83-94.• Desrosiers, Daniel C. and Radolf, Justin D. “Treponema pallidum,

the stealth pathogen, changes, but how?” Molecular Microbiology 72.5 (May 2009): 1081-1086.

• Perine, Peter L. Handbook of Endemic Treponematoses : Yaws, Endemic Syphilis, and Pinta. Geneva: World Health Organization ;, 1984. Print.

• Schell, Ronald F., and Daniel M. Musher. Pathogenesis and Immunology of Treponemal Infection. New York: M. Dekker, c1983. Print.

• Yaws: A forgotten disease. World Health Organization., January 2007. http://www.who.int/mediacentre/factsheets/fs316/en/index.html.