YAWS PIAN BUBAS FRAMBOESIA

Yaws and its relatives are caused by spirochete bacteria Treponema

Contagious , non venereal treponemal infection. No cardiovascular or neurological abnormalities

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

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

Caused by Treponema pertenue . Reservoir of infection – Man Age - It affect children < 15 years [peak incidence 6-10 years]. Immunity – no natural immunity. Provides partial immunity to veneral syphilis.

ENVIRONMENTAL FACTORS Climate – endemic in warm and humid conditions Social factors scanty clothing Poor personal cleanliness Overcrowding Bad housing Low standard of living Absence of soap

MODE OF TRANSMISSION Direct contact Fomites Vector INCUBATION PERIOD 3 to 5 weeks

The endemic treponematoses are mainly transmitted by human-to-human contact

CLASSIFICATION Primary stage …..lesion at site of inoculation. Secondary stage ….multiple skin lesion. Latent stage …..no symptom but skin lesion can relapse. Tertiary ….bone , joint & soft tissue deformality

OTHER CASSIFICATION Early----: primary & secondary { contagious skin lesion }. Late -----: tertiary (not contagious).

CLINICAL PRESENTATION Primary lesion called….. mother yaw.[IP 9-90 days]. 1ry papule---enlarge → papilloma {resolve spontaneously after 3-6 months }. 2ry may occur near the 1ry or elsewhere on the body {last for more than 6 months } Macule , papules , nodules ,and hyperkeratotic lesion in palms & soles { CRAB YAWS } ,lesions may ulcerate. Saber shin due to chronic untreated osteoperiostitis. Pt with late yaws → juxtaarticular nodules → gangosa [ rhinopharyngitis mutilans ]

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 Saber shin / tibia Gangosa

INVESTIGATIONS Diagnosis on clinical findings. Non treponema test:VDRL. Positive in all stages except early lesions . Dark-field examination ….. + ve . Biopsy. 

These diseases can be diagnosed in two ways Dark field microscopy Serological Tests

MANAGEMENT Benzathine penicillin ( penicillin G ) 1.2 million units IM once Penicillin V for 7-10 days.[ for 1ry , 2ry &latent]. Tetracyclin 1-2 g\ day for 7-14 days.[tertiary] Erythromycin [tertiary]. Doxycycline 200mg 1 st ,100 mg\day for 7-14 days.[tertiary].

Benzathine penicillin is the main drug of choice for treatment

CONTROL 1. Survey 2. Treatment Total mass treatment ( more than 10% prevalence) Juvenile mass treatment ( 5% to 10 %) selective mass treatment (less than 5 %) 3. Resurvey and treatment ( every 6 to 12 months) 4. Surveillance 5. Environmental improvement 6. Resurgence of yaws 7. Evaluation