Chapter 44
Endemic Treponematoses
Yaws, Pinta and Endemic Syphilis
Herman Jan H. Engelkens,
Herman Jan H. Engelkens
Department of Dermatology and Venereology, Ikazia Hospital, Rotterdam, The Netherlands
Search for more papers by this authorHerman Jan H. Engelkens,
Herman Jan H. Engelkens
Department of Dermatology and Venereology, Ikazia Hospital, Rotterdam, The Netherlands
Search for more papers by this authorBook Editor(s):Peter Hoeger,
Veronica Kinsler,
Albert Yan,
John Harper,
Arnold Oranje,
Christine Bodemer,
Margarita Larralde,
David Luk, Vibhu Mendiratta,
Diana Purvis,
Peter Hoeger
Search for more papers by this authorVeronica Kinsler
Search for more papers by this authorAlbert Yan
Search for more papers by this authorJohn Harper
Search for more papers by this authorArnold Oranje
Search for more papers by this authorChristine Bodemer
Search for more papers by this authorMargarita Larralde
Search for more papers by this authorVibhu Mendiratta
Search for more papers by this authorDiana Purvis
Search for more papers by this authorFirst published: 20 November 2019
Summary
The treponemal infections that occur in humans are venereal syphilis and the endemic treponematoses (yaws, endemic syphilis and pinta). The endemic treponematoses, all of which are chronic relapsing tropical diseases, have similar natural histories. Young children are at the highest risk of acquiring these nonvenereal treponematoses. Nearly all of the new cases are found in children less than 15 years of age. As a result of United Nations Children's Emergency Fund (UNICEF) and World Health Organization (WHO) supported mass treatment campaigns in the 1950s and 1960s, the incidence of the endemic treponematoses has been greatly reduced. However, these diseases have not been eradicated. Latent cases are still prevalent and millions of people continue to be at risk of acquiring the endemic treponematoses from individuals with relapsing disease.
In 2012, WHO launched a new initiative for the eradication of yaws by 2020.
References
- Smibert RM. Genus III Treponema Schaudinn 1905, 1728. In: NR Krieg, JG Holt (eds) Bergey's Manual of Systematic Bacteriology. Baltimore, MD: Springer, 1984: 50–2.
- Fohn MJ, Wignall FS, Baker-Zander SA et al. Specificity of antibodies from patients with pinta for antigens of Treponema pallidum subspecies pallidum . J Infect Dis 1988; 157: 32–7.
- Turner TB, Hollander DH. Biology of the Treponematoses. WHO Monograph Series 35. Geneva: World Health Organization, 1957.
- Ovcinnikov NM, Delektorskij VV. Treponema pertenue under the electron microscope. Br J Vener Dis 1970; 46: 349–79.
- Hovind-Hougen K, Birch-Andersen A, Jensen HJS. Ultrastructure of cells of Treponema pertenue obtained from experimentally infected hamsters. Acta Path Microbiol Scand Sect B 1976; 84: 101–8.
- Perine PL, Hopkins DR, Niemel PLA et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis and Pinta. Geneva: World Health Organization, 1984.
- Gonçalves AP, Basset A, Maleville J. Tropical treponematoses. In: O Canizares, RRM Harman (eds) Clinical Tropical Dermatology, 2nd edn. Oxford: Blackwell Scientific Publications, 1992: 129–50.
-
Luger AFH. Endemic treponematoses. In: LC Parish, F Gschnait (eds) Sexually Transmitted Diseases. A Guide for Clinicians. Berlin: Springer-Verlag, 1989: 32–58.
10.1007/978-1-4612-3528-6_4 Google Scholar
- Engelkens HJH, Judanarso J, Oranje AP et al. Endemic treponematoses. I. Yaws. Int J Dermatol 1991; 30: 77–83.
- Engelkens HJH, Niemel PLA, van der Sluis JJ et al. Endemic treponematoses. II. Pinta and endemic syphilis. Int J Dermatol 1991; 30: 231–8.
- Hackett CJ. On the origin of the human treponematoses. Bull WHO 1963; 29: 7–41.
- Rothschild BM. On the antiquity of treponemal infection. Med Hypotheses 1989; 28: 181–4.
- Hudson EH. Treponematosis in perspective. Bull WHO 1965; 32: 735–48.
- Hollander DH. Treponematosis from pinta to venereal syphilis revisited: hypothesis for temperature determination of disease patterns. Sex Transm Dis 1981; 8: 34–7.
- Castellani A. On the presence of spirochaetes in two cases of ulcerated parangi (yaws). Br Med J 1905; ii: 1280.
- Anonymous. Programme for the Control of the Endemic Treponematoses, VDT/EXBUD/87.1. Geneva: World Health Organization, August 1987.
- Willcox RR. Evolutionary cycle of the treponematoses. Br J Vener Dis 1960; 36: 78–91.
- Editorial. Endemic treponematoses in the 1980s. Lancet 1983; ii: 551–2.
- Mitja O, Marks M, Konan DJP et al. Global epidemiology of yaws: a systematic review. Lancet Glob Health 2015; 3: e324–31.
- Luger A, Meheus A. Drastische Ausbreitung endemischer Treponematosen. [Alarming spread of endemic treponematoses.]. Z Hautkr 1988; 63: 463–4.
- WHO. Eradication of yaws – the Morges strategy. Wkly Epidemiol Rec 2012; 87: 189–200.
- Koff AB, Rosen T. Nonvenereal treponematoses: yaws, endemic syphilis and pinta. J Am Acad Dermatol 1993; 29: 519–35.
- Sehgal VN, Jain S, Bhattacharya SN et al. Yaws control/eradication. Int J Dermatol 1994; 33: 16–20.
- Widy-Wirski R. Surveillance and control of resurgent yaws in the African region. Rev Infect Dis 1985; 7(suppl 2): 227–32.
-
Catterall RD, Hume JC. Summary and recommendations. Rev Infect Dis 1985; 7(suppl 2): 343–50.
10.1093/clinids/7-Supplement_2.S343 Google Scholar
- Maurice J. WHO plans new yaws eradication campaign. Lancet 2012; 379: 1377–8.
- Zahra A. Yaws in Southeast Asia: an overview. Rev Infect Dis 1985; 7(suppl 2): 245–50.
- Sanyakorn CK. Situation of control of yaws in the Southeast Asia region: past, present, and future. Southeast Asian J Trop Med Public Health 1986; 17(suppl): 3–7.
- Sosroamidjojo S, Rai K, Suesen N. Yaws in Indonesia. Southeast Asian J Trop Med Public Health 1986; 17(suppl): 19–34.
-
St John RK. Yaws in the Americas. Rev Infect Dis 1985; 7(suppl 2): 266–72.
10.1093/clinids/7-Supplement_2.S266 Google Scholar
- Hopkins DR, Flórez D. Pinta, yaws, and venereal syphilis in Colombia. Int J Epidemiol 1977; 6: 349–55.
- Falabella R. Nonvenereal treponematoses: yaws, endemic syphilis and pinta. J Am Acad Dermatol 1994; 31: 1075. [letter]
- Castro LGM. Nonvenereal treponematoses: yaws, endemic syphilis and pinta. J Am Acad Dermatol 1994; 31: 1075–6. [letter]
- Fuchs J, Milbradt R, Pecher SA. Tertiary pinta: case reports and overview. Cutis 1993; 51: 425–30.
-
Touré IM. Endemic treponematoses in Togo and other West African states. Rev Infect Dis 1985; 7(suppl 2): 242–4.
10.1093/clinids/7-Supplement_2.S242 Google Scholar
- Pace JL. Treponematoses in Arabia. Saudi Med J 1983; 4: 211–20.
- Basset A, Maleville J. Les tréponématoses endémiques (pian et béjel): des maladies utiles à connaître. Méd Afr Noire 1984; 31: 533–6.
- Pace JL, Csonka GW. Endemic non-venereal syphilis (bejel) in Saudi Arabia. Br J Vener Dis 1984; 60: 293–7.
- Csonka G, Pace J. Endemic nonvenereal treponematosis (bejel) in Saudi Arabia. Rev Infect Dis 1985; 7(suppl 2): 260–5.
- Gazin P, Meynard D. Enquête clinique et sérologique sur le béjel au nord du Burkina Faso. Bull Soc Pathol Exot 1988; 81: 827–31.
- Autier P, Delcambe JF, Sangaré D et al. Etudes sérologiques et cliniques sur la tréponématose endémique en République du Mali. Ann Soc Belge Méd Trop 1989; 69: 319–30.
- Abbas SMA, Satwekar SR. Positive treponematosis in Saudi antenatals and their perinatal outcome over a 7-year period. Saudi Med J 1989; 10: 301–4.
- Basset A, Maleville J, Basset M. Aspects de la syphilis endémique des Touareg du Niger. Bull Soc Pathol Exot 1969; 62: 80–92.
- Pace JL, Csonka GW. Late endemic syphilis: case report of bejel with gummatous laryngitis. Genitourin Med 1988: 64: 202–4.
- Hackett CJ. The transmission of yaws in nature. J Trop Med Hyg 1957; 60: 159–68.
- Fribourg-Blanc A, Niel G, Mollaret HH. Confirmation sérologique et microscopique de la tréponémose du cynocéphale de Guinée. Bull Soc Pathol Exot 1966; 59: 54–9.
- Engelkens HJH, Vuzevski VD, Judanarso J et al. Early yaws: a light microscopic study. Genitourin Med 1990; 66: 264–6.
- Engelkens HJH, ten Kate FJW, Vuzevski VD et al. Primary and secondary syphilis: a histopathological study. Int J STD AIDS 1991; 2: 280–4.
- Williams HU. Pathology of yaws especially the relation of yaws to syphilis. Arch Pathol 1935; 20: 596–630.
- Hasselmann CM. Comparative studies on the histopathology of syphilis, yaws, and pinta. Br J Vener Dis 1957; 33: 5–12.
- Lever WF, Schaumburg-Lever G. Treponemal diseases. In: WF Lever, G Schaumburg-Lever (eds) Histopathology of the Skin, 7th edn. Philadelphia: J.B. Lippincott, 1992: 352–9.
- Engelkens HJH, ten Kate FJW, Judanarso J et al. The localisation of treponemes and characterisation of the inflammatory infiltrate in skin biopsies from patients with primary or secondary syphilis, or early infectious yaws. Genitourin Med 1993; 69: 327.
- Pecher SA, Azevedo EB. Aspectos histopatológicos da pinta terciária. Med Cutan Ibero Lat Am 1987; 15: 239–42.
- Engelkens HJH, Ginai AZ, Judanarso J et al. Case report 724. Skeletal Radiol 1992; 21: 194–7.
- Román GC, Román LN. Occurrence of congenital, cardiovascular, visceral, neurologic, and neuro-ophthalmologic complications in late yaws: a theme for future research. Rev Infect Dis 1986; 8: 760–70.
- Lawton Smith J, David NJ, Indgin S et al. Neuro-ophthalmological study of late yaws and pinta. II. The Caracas project. Br J Vener Dis 1971; 47: 226–51.
- Basset A. Pian et béjel ou syphilis endémique. Tempo Méd Afr 1982; 32: 13–20.
- Tabbara KF, Al Kaff AS, Fadel T. Ocular manifestations of endemic syphilis (bejel). Ophthalmology 1989; 96: 1087–91.
-
Perine PL, Nelson JW, Lewis JO et al. New technologies for use in the surveillance and control of yaws. Rev Infect Dis 1985; 7(suppl 2): 295–9.
10.1093/clinids/7-Supplement_2.S295 Google Scholar
- Stamm LV, Bassford PJ Jr. Cellular and extracellular protein antigens of Treponema pallidum synthesized during in vitro incubation of freshly extracted organisms. Infect Immunol 1985; 47: 799–807.
- Hardy PH. Prospects for improved laboratory diagnoses of treponemal infections and species differentiation. Rev Infect Dis 1985; 7(suppl 2): 300–4.
- Ijsselmuiden OE. Development and evaluation of modern enzyme immunoassays for comprehensive syphilis serology. Thesis. Rotterdam, The Netherlands, 1989.
- Report of a WHO Scientific Group. Treponemal Infections. WHO Tech Rep Series, 1982: 674.
-
Brown ST. Therapy for nonvenereal treponematoses: review of the efficacy of penicillin and consideration of alternatives. Rev Infect Dis 1985; 7(suppl 2): 318–26.
10.1093/clinids/7-Supplement_2.S318 Google Scholar
- Stapleton JT, Stamm LV, Bassford PJ Jr. Potential for development of antibiotic resistance in pathogenic treponemes. Rev Infect Dis 1985; 7(suppl 2): 314–17.
- WHO. Programme for the Control of the Endemic Treponematoses, VDT/EXBUD/87.1. Geneva: World Health Organization, August 1987.
- Engelkens HJH, Oranje AP, Stolz E. Early yaws, imported in The Netherlands. Genitourin Med 1989; 65: 316–18.
- Vorst FA. Attenuating endemic treponematosis. Thesis. Amsterdam, The Netherlands, 1974.
-
Vorst FA. Clinical diagnosis and changing manifestations of treponemal infections. Rev Infect Dis 1985; 7(suppl 2): 327–31.
10.1093/clinids/7-Supplement_2.S327 Google Scholar
- Niemel PLA, Brunings EA, Menke HE. Attenuated yaws in Surinam. Br J Vener Dis 1979; 55: 99–101.
-
Niemel PLA, Sadal S, van der Sluis JJ. Yaws in Suriname. Rev Infect Dis 1985; 7(suppl 2): 273–5.
10.1093/clinids/7-Supplement_2.S273 Google Scholar
- Fegan D, Glennon M, Macbride-Stewart G et al. Yaws in the Solomon Islands. J Trop Med Hyg 1990; 93: 52–7.
- Csonka GW. Clinical aspects of bejel. Br J Vener Dis 1953; 29: 95–103.
- Engelkens HJH, van der Sluis JJ, Stolz E. Syphilis in the AIDS era. Int J Dermatol 1991; 30: 254–6.
- Engelkens HJH, Stolz E. Framboesia tropica en andere endemische treponematosen. In: WR Faber, B Naafs (eds) Import Dermatologie. Nieuwegein: Glaxo, 1991: 107–12.
- Engelkens HJH, Niemel PLA, Stolz E. De endemische treponematosen in de jaren negentig. Memisa Med 1993; 59: 31–7.
- Schell RF, Le Frock JL, Babu JP et al. Use of CB hamsters in the study of Treponema pertenue . Br J Vener Dis 1979; 55: 316–19.
- Miao RM, Fieldsteel AH. Genetic relationship between Treponema pallidum and Treponema pertenue, two noncultivable human pathogens. J Bacteriol 1980; 141: 427–9.
- Noordhoek GT. Syphilis and yaws: a molecular study to detect and differentiate pathogenic treponemes. Thesis. Utrecht, The Netherlands, 1991.
- Antal GM, Causse G. The control of endemic treponematoses. Rev Infect Dis 1985; 7(suppl 2): 220–6.
-
Meheus A. Integration of yaws control and primary health care. Rev Infect Dis 1985; 7(suppl 2): 284–8.
10.1093/clinids/7-Supplement_2.S284 Google Scholar
-
Hopkins DR. Control of yaws and other endemic treponematoses: implementation of vertical and/or integrated programs. Rev Infect Dis 1985; 7(suppl 2): 338–42.
10.1093/clinids/7-Supplement_2.S338 Google Scholar
- Capuano C, Ozaki M. Yaws in the Western Pacific Region. A review of the literature. J Trop Med 2011;2011: 642832.
- Anselmi M, Araujo E, Narváez A et al. Yaws in Ecuador: impact of control measures on the disease in the Province of Esmeraldas. Genitourin Med 1995; 71: 343–6.
- Meheus A, Antal GM. The endemic treponematoses: not yet eradicated. Rapp Trimest Statist Sanit Mond 1992; 45: 228–37.
- Farnsworth N, Rosen T. Endemic treponematosis: review and update. Clin Dermatol 2006; 24: 181–190.
- Mitja O, Hays R, Rinaldi AC et al. New treatment schemes for yaws: the path toward eradication. Clin Infect Dis 2012; 55: 406–12.
- Mitja O, Hays R, Ipai A et al. Single-dose azithromycin versus benzathine benzylpenicillin for treatment of yaws in children in Papua New Guinea: an open-label, non-inferiority, randomised trial. Lancet 2012; 379: 342–7.
