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September 2014

YawsRenewed Hope for Eradication

Author Affiliations
  • 1Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill
JAMA Dermatol. 2014;150(9):933-934. doi:10.1001/jamadermatol.2014.1277

Yaws is the most common and severe of the endemic treponematoses (ie, yaws, begel, and pinta).13 This chronic, neglected tropical disease is caused by a noncultivable, spiral-shaped bacterium that is very closely related (approximately 99.8%) to the agent of venereal syphilis, Treponema pallidum subspecies pallidum (Table). Yaws primarily affects children ages 2 to 15 years who live in poor rural communities in forested tropical areas of Africa, Southeast Asia, and the Pacific Islands. Infection with the yaws agent, T pallidum subsp pertenue, is acquired through contact of broken skin with the fluid of an active yaws lesion. If left untreated, yaws can cause disfigurement and disability. Control of yaws is based on the interruption of transmission through identification and treatment of those who are infected and their contacts. Field diagnosis of yaws is usually based on clinical and epidemiological findings. However, because yaws can be confused with other diseases, field diagnosis should be confirmed with laboratory tests.13 Owing to the antigenic similarity of the yaws and syphilis agents, serological tests for syphilis are also used for the diagnosis of yaws, although these tests cannot differentiate the 2 diseases. Serodiagnosis of active yaws infection requires the detection of antibodies to nontreponemal (eg, cardiolipin) as well as to treponemal antigens.

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