Yaws | Research & Encyclopedia Articles

Yaws

Yaws is a chronic illness that first affects the skin, and later the bones.

Yaws tends to strike children, particularly between the ages of two and five. It is common in areas where poverty and overcrowding interfere with good hygiene. It is most prevalent in rural areas throughout Africa, Southeast Asia, and in locations bordering the equator in the Americas.

Yaws is caused by a spiral-shaped bacterium (spirochete) called Treponema pertenue. This bacterium belongs to the same family as the bacterium that causes syphilis.

Yaws is passed among people by direct skin contact. The bacterium requires a scratch or insect bite to actually settle in and cause infection. An injury on the leg is the most common part of the body through which the bacteria enter. Young children, who are constantly bumping themselves in play, who wear little clothing, who do not wash their hands often, and who frequently put their hands in their mouths, are particularly susceptible to yaws.

The first symptom of this disease occurs three to four weeks after bacterial infection. The area where the bacteria originally entered the skin becomes a noticeable bump (papule). The papule grows larger and develops a punched-out center (ulcer), covered with a yellow crust. Adjacent lymph nodes may become swollen and tender. The first papule may take as long as six months to heal. Secondary soft, gummy growths then appear on the face, arms and legs, and buttocks. These soft, tumor-like masses may also grow on the soles of the feet, causing the patient to walk in an odd and characteristic fashion on the sides of his or her feet (nicknamed "crab yaws"). More destructive tumors may then disrupt the bones of the face, the jaw, and the lower leg. Ulcers around the nose and on the face may be very mutilating.

Samples taken from the first papules may be examined using a technique called dark-field microscopy. This often allows the spirochetes to be identified. They may also be identified in fluid withdrawn from swollen lymph nodes. Various tests can also be run on blood samples to determine if an individual is producing antibodies (special immune cells) in response to the presence of these spirochetes.

A single penicillin injection in a muscle is sufficient to completely end the disease.

Without treatment, yaws is a terribly disfiguring chronic illness. With appropriate treatment, progression of the disease can be completely halted.

The World Health Organization (WHO) has been working to totally eradicate yaws, just as smallpox was successfully eradicated. This has not occurred, however. WHO continues to work to identify and respond to outbreaks quickly, in an effort to at least slow the spread of yaws.