Yaws.

Yaws is an infectious disease caused by Treponema pallidum pertenue-a bacterium that closely resembles the causative agent of syphilis-and is spread by skin-to-skin contact in humid tropical regions. Yaws causes disfiguring, and sometimes painful lesions of the skin and bones. As with syphilis, clinical manifestations can be divided into three stages; however, unlike syphilis, mother-to-child transmission does not occur. A major campaign to eradicate yaws in the 1950s and 1960s, by mass treatment of affected communities with longacting, injectable penicillin, reduced the number of cases by 95% worldwide, but yaws has reappeared in recent years in Africa, Asia, and the western Pacific. In 2012, one oral dose of azithromycin was shown to be as effective as intramuscular penicillin in the treatment of the disease, and WHO launched a new initiative to eradicate yaws by 2020.

Secondary yaws: an endemic treponemal infection.

Although yaws is rare in developed countries, as worldwide travel has become commonplace, it is essential to recognize this condition when evaluating patients who traveled from endemic regions. Herein, we discuss a case of secondary yaws presenting as extensive expanding annular lesions to raise awareness of this condition.

Occurrence of congenital, cardiovascular, visceral, neurologic, and neuro-ophthalmologic complications in late yaws: a theme for future research.

Late lesions of yaws are thought to be limited to skin, bones and joints, without congenital, visceral, or central nervous system (CNS) involvement. However, the treponemes isolated from patients with yaws, endemic syphilis, and venereal syphilis are genetically identical subspecies of Treponema pallidum. The controversy surrounding distinctions between syphilis and yaws is presented in its historical context, and reports of congenital, visceral, and CNS complications of yaws are reviewed. Isolation of treponemes from aqueous humor, as well as CSF abnormalities in 24.9% of 902 patients with yaws, indicate the existence of CNS involvement. The high prevalence of tropical myeloneuropathies of unknown origin discovered in areas of previous treponemal endemicity, particularly in Jamaica and Colombia, may represent late complications of yaws. Careful analysis of the collected evidence indicates that potential sequelae of yaws include congenital, visceral, and tertiary CNS lesions identical to those of venereal syphilis. The current worldwide resurgence of endemic treponematoses provides an unparalleled opportunity to settle conclusively questions still unanswered regarding the natural history of these infections.

Atlas of framboesia: a nomenclature and clinical study of the skin lesions

A nomenclature, with definitions and photographs, has been attempted for the clinical skin manifestations of framboesia. The old "primary, secondary, and tertiary" terminology has been discarded, as the time relationships of the various stages of the disease are unknown and these stages show much overlapping. (Summary)

The relationship of certain environmental factors to the distribution of yaws in Jamaica

A study of the history of yaws in Jamaica reveals that the disease, while it may have been present before the advent of African negroes, was repeatedly introduced by slaves, and has tended to become localized in certain parts of the island. The present distribution has been determined by inspection trips, by actual survey of 48 widely separated areas, and by questionnaire returns from 611 schools situated in every part of Jamaica. The results of the surveys and questionnaire are tabulated and will be found to agree very closely where a direct comparison is possible. The present distribution, plotted on a map, is seen to be essentially the same as it was 20 and 40 years ago, as estimated from records of the Island Medical Department. The possible relationship between certain environmental factors and this distribution is considered. These factors are rainfall, geological formation, altitude, the sanitary status of the population, urban and rural localities, and the presence of a certain insect, namely, Hippelates pallipes. A discussion considers the possible influencing effects of environment upon distribution. (Summary)