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Yaws and Other Endemic
Jack McCarrick
Yaws and its relatives
are caused by spirochete bacteria
Treponema pallidum
The endemic treponematoses are
mainly transmitted by human-tohuman contact
Yaws is typically found in tropical areas of
Africa, South America, and Asia
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
Sabre Tibia
Endemic syphilis (bejel) is usually found in
dry, hot climates (mainly in West Africa)
Endemic syphilis starts with primary
white ulcers in the mouth and can end
up like late yaws
Pinta is primarily found in arid climates
in Central and South America
Pinta starts out similar to yaws but can
eventually lead to hyperpigmentation or
What do we understand about the
pathogenesis of these diseases?
Not much
These diseases can be diagnosed in
two ways
Dark field
Benzathine penicillin is the main
drug of choice for treatment
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
• Antel, George M., et al. “The Endemic Treponematoses.” Microbes
and Infection 4.1 (January 2002): 83-94.
• Desrosiers, Daniel C. and Radolf, Justin D. “Treponema pallidum,
the stealth pathogen, changes, but how?” Molecular Microbiology
72.5 (May 2009): 1081-1086.
• Perine, Peter L. Handbook of Endemic Treponematoses : Yaws,
Endemic Syphilis, and Pinta. Geneva: World Health Organization ;,
1984. Print.
• Schell, Ronald F., and Daniel M. Musher. Pathogenesis and
Immunology of Treponemal Infection. New York: M. Dekker, c1983.
• Yaws: A forgotten disease. World Health Organization., January