For Nursing Students

1. YAWS

2. YAWS
• Yaws is also known as framboesia, buba,
pian and Pain
• Yaws is a chronical contagious,
nonvenereal, treponemal infection in
humans
• It is caused by T. pertenue
• It is characterized by a primary skin
lesion followed by generalized eruption
and a late stage of destructive lesions of
the skin.

3. • The has been reported in India from the tribal
communities living in hilly forests and difficult
to reach areas in 49 districts of 10 states
namely Andra Pradesh, Assam, Chattisharh,
Gujatrat, Jharkhand, Madhya Pradesh,
Maharashtra, Orissa Tamilnadu and Uttar
Pradesh.

4. Epidemiological Determinants
Agent Factors
1. Agent:
• Yaws is caused by
T.pertenue.
• It measures 20 µ in length
with 8 to 12 rigid spirals.
• Treponema pertenue is
morphologically identical to
Treponema pallidum.

5. Reservoir of infection
• Man is the only one reservoir of yaws.
• Clinical lesions may relapse 2 to 3 times or
more during the first five years of infection,
and serve as a source for new infection.
• The source of infection is usually skin lesions
and exudates from early lesions.

6. Host Factors
• Age: yaws is primarily a disease of childhood
and adolescents. Over 75 % cases occurs
within the age of 15 years.
• Sex: Generally the prevalence among males
is greater than females.
• Immunity: Man has no natural immunity.
Acquired immunity develops slowly and may
take months or years to develop fully unless
suppressed by treatment.

7. Environmental Factors
• Climate: Yaws is endemic in warm and humid
regions
• Social Factors: Yaws is mostly endemic
among the tribal people in India, whose way of
living favour its transmission.

8. Mode of transmission
• Direct Contact: By contact with secretions from
infectious lesions.
• Fomites: The organism may remain alive on
fomites or on the floor in hot and humid conditions
• Vector: There are some evidence that small flies
and other insects feeding on the lesion may possibly
convey the infection mechanically.
• INCUBATION PERIOD: 3 To 5 Weeks

9. Clinical manifestations
EARLY YAWS-
- Primary lesion (Mother Yaws) appears at the
site of inoculation after 3-5 weeks.
- Seen on exposed parts of body
- Lymph glands are enlarged.
- With in next 3-6 weeks generalised eruption
appears consists of large yellow, crusted,
granulomatous
eruptions .

10. During next five years, mucous membrane,
periosteal and bone lesions develop, subside and
relapse.
- The early lesions are highly infectioous

11. • LATE YAWS
- Destructive and deforming lesions of
skin, bone and periosteum develop.
CRAB Yaws – lesions of palm and soles
Gangosa – lesions of soft palate, hard
palate and nose

12. CONTROL OF YAWS
1. SURVEY:
• Clinical survey of all families in endemic area.
Should not cover less than 95% of total
population.
2. TREATMENT
• Single dose of Azithromycin or single long
acting Penicillin will cure infection
• Simultaneous treatment of cases and their
likely contacts in the community will interrupt
transmission

13. WHO has recommended 3 treatment policies-
TOTAL MASS TREATMENT- In hyperendemic areas(>
10% prevalence of clinically active Yaws). Entire
population treated with Pen G.
JUVENILE MASS TREATMENT – In mesoendemic
areas(5-10% prevalence). Treatment given to cases,
contacts and all children below 15 years
SELECTIVE MASS TREATMENT – In hypoendemic
areas(<5% prevalence) Treatment to cases, household
and other obvious contacts

14. 3. RESURVEY AND TREATMENT
• Resuveys every 6-12 months to assess
problem magnitude.
4. SURVEILLANCE
• Surveillance and Containment measures for
affected villages, households and contacts of
known Yaws cases.
• Epidemiological investigations to trace
possible sources of infection, prophylactic
treatment of contacts, follow up of cases

15. 5. ENVIRONMENT IMPROVEMENT
• Recurrence of the disease is possible to
occur unless environmental improvement is
promoted.
• Eg: Improvement of personal and domestic
hygiene, adequate water supply, liberal use of
soap , better housing conditions etc.

16. THANK YOU