Yaws is a neglected tropical disease that primarily occurs in poor, rural communities in warm, humid forest areas of West Africa, Southeast Asia, the Pacific Islands, and parts of Latin America. It is caused by the bacterium Treponema pallidum pertenue, which is closely related to syphilis, although yaws is not sexually transmitted.
If untreated, the disease can cause disfiguring and debilitating complications. Between 75 and 80 per cent of those infected are under 15 years of age. It is easily treated with a single dose of antibiotics and prevalence has fallen in recent years.
It is endemic in 15 countries in Africa and Asia and there are about 80,000 cases a year.
Yaws begins with a single wart like bump (papilloma), teeming with infection, usually on the legs, arms or face. This is painless and can go unnoticed, but it is highly infectious and without treatment can ulcerate.
Secondary symptoms develop weeks to months later and may involve multiple skin lesions, bone pain and joint inflammation.
Common signs and symptoms include:
If untreated, tertiary yaws, which occurs about five to 10 years after initial infection, can cause chronic skin thickening, bone deformation and facial disfigurement.
While yaws is rarely fatal, it can lead to severe disfigurement and disability. Chronic lesions may cause permanent scarring and deformities of the skin and bones, particularly in the face and limbs.
Bone problems can lead to restricted movement in affected joints. The social and psychological impact of disfigurement is significant.
Yaws is transmitted through direct skin-to-skin contact with the fluid from an active lesion and it can easily spread between children. Yaws is not spread sexually or via blood transfusion. Poor hygiene, crowded living conditions and limited access to medical care hamper control of the disease.
Yaws is easily treatable with a single dose of the cheap antibiotic azithromycin or an injection of penicillin. It can be treated at any stage but the earlier the treatment the less likely are complications. Early treatment also helps prevent spread of the disease.
There is no vaccine for yaws and prevention focuses on improving hygiene and health education. Mass treatment with antibiotics is also carried out in areas where the disease is rife.
The name yaws is thought to come from the Carib name for the disease, yaya. The disease is thought to have originated in Africa and then spread to other parts of the world, including Europe.
In 1952, the first yaws eradication campaign was launched, and injections of penicillin-based antibiotics were given out across the world, however that effort was not sustained and the disease resurged in the 1970s. Since then cases have come down after another big push from 2012. In 2020 the first cases of azithromycin-resistant yaws were reported in Papua New Guinea but trials of an antibiotic called linezolid have proved promising.
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