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YAWS – EPIDEMIOLOGY,
PREVENTION AND CONTROL
MD DANISH RIZVI
DEPT. COMMUNITY
MD DANISH RIZVI
• Chronic, Contagious, highly infectious, Non-
venereal disease caused by Spirochaete
Treponema pallidum.
• Usually begins in early childhood.
• Primary skin lesion followed by generalised
eruption and a late stage of destructive and
disfiguring and debilitating lesions of skin and
bone.
• Chronic disease showing relapses over several
years.
MD DANISH RIZVI
GEOGRAPHIC DISTRIBUTION
• Exclusively confined to the belt between the
Tropic of Cancer and Capricorn.
• Significant public health problem in Africa,
South-east Asia and Central America in the
past
• Resurgence in certain areas of Africa
• Persistent low level in India till a decade ago.
MD DANISH RIZVI
MD DANISH RIZVI
INDIA
• Reported from tribal communities living in
hilly forests and difficult to reach areas in 49
districts of 10 states.
• States affected – Andhra Pradesh, Assam,
Chhattisgarh, Gujrat, Jharkhand, Madhya
Pradesh, Maharashtra, Orissa, Tamil Nadu,
U.P.
• Number of cases brought down from 3500 in
1996 to zero in 2004.
• Certfication of disease free status in 2011
MD DANISH RIZVI
AGENT
• Treponema pertenue
• Resembles T.pallidum culturally and
morphologically
• Occurs in the epidermis of lesions, lymph glands,
spleen and bone marrow.
Reservoir-
Man is the only known reservoir
Most latent cases found in cluster around an
infectious case
Source of infection-
Skin lesions and exudates from early lesions
MD DANISH RIZVI
HOST FACTORS
AGE-
Primarily a disease of childhood and
adolescence.
GENDER -
M > F
IMMUNITY –
No natural immunity.
MD DANISH RIZVI
ENVIRONMENTAL FACTORS
CLIMATE –
Endemic in warm and humid climate.
SOCIAL FACTORS –
More common in tribal people
Poor personal hygiene, overcrowding, low std. of
living predisposing factors
MD DANISH RIZVI
MODE OF TRANSMISSION
DIRECT CONTACT
FOMITES
VECTORS
INCUBATION PERIOD –
9 – 90 DAYS
MD DANISH RIZVI
CLINICAL FEATURES
• 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 .
-During next five years, mucous membrane, periosteal
snd bone lesions develop, subside and relapse.
- The early lesions are highly infectioous
MD DANISH RIZVI
MD DANISH RIZVI
• 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
MD DANISH RIZVI
MD DANISH RIZVI
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
MD DANISH RIZVI
• 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 MD DANISH RIZVI
3. RESURVEY AND TREATMENT-
Resuveys every6-12 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, follw up of cases
MD DANISH RIZVI
5. ENVIRONMENT IMPROVEMENT
6.ERADICATION EFFORTS- TOTAL
COMMUNITY TREATMENT TOTAL
TARGETTED TREATMENT
MD DANISH RIZVI
• YAWS ERADICATION PROGRAMME • The
programme was started in 1996-97 in Koraput
districts of Orissa then extended to endemic
states as a centrally sponsored health scheme
with the objectives of:
1.Interrupting the transmission of yaws
infection (no case) in the country
2.Eradication of Yaws (i.e. no sero reactivity to
RPR/VDRL in children below 5 years of age)
from the country.
MD DANISH RIZVI

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Yaws

  • 1. YAWS – EPIDEMIOLOGY, PREVENTION AND CONTROL MD DANISH RIZVI DEPT. COMMUNITY MD DANISH RIZVI
  • 2. • Chronic, Contagious, highly infectious, Non- venereal disease caused by Spirochaete Treponema pallidum. • Usually begins in early childhood. • Primary skin lesion followed by generalised eruption and a late stage of destructive and disfiguring and debilitating lesions of skin and bone. • Chronic disease showing relapses over several years. MD DANISH RIZVI
  • 3. GEOGRAPHIC DISTRIBUTION • Exclusively confined to the belt between the Tropic of Cancer and Capricorn. • Significant public health problem in Africa, South-east Asia and Central America in the past • Resurgence in certain areas of Africa • Persistent low level in India till a decade ago. MD DANISH RIZVI
  • 5. INDIA • Reported from tribal communities living in hilly forests and difficult to reach areas in 49 districts of 10 states. • States affected – Andhra Pradesh, Assam, Chhattisgarh, Gujrat, Jharkhand, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, U.P. • Number of cases brought down from 3500 in 1996 to zero in 2004. • Certfication of disease free status in 2011 MD DANISH RIZVI
  • 6. AGENT • Treponema pertenue • Resembles T.pallidum culturally and morphologically • Occurs in the epidermis of lesions, lymph glands, spleen and bone marrow. Reservoir- Man is the only known reservoir Most latent cases found in cluster around an infectious case Source of infection- Skin lesions and exudates from early lesions MD DANISH RIZVI
  • 7. HOST FACTORS AGE- Primarily a disease of childhood and adolescence. GENDER - M > F IMMUNITY – No natural immunity. MD DANISH RIZVI
  • 8. ENVIRONMENTAL FACTORS CLIMATE – Endemic in warm and humid climate. SOCIAL FACTORS – More common in tribal people Poor personal hygiene, overcrowding, low std. of living predisposing factors MD DANISH RIZVI
  • 9. MODE OF TRANSMISSION DIRECT CONTACT FOMITES VECTORS INCUBATION PERIOD – 9 – 90 DAYS MD DANISH RIZVI
  • 10. CLINICAL FEATURES • 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 . -During next five years, mucous membrane, periosteal snd bone lesions develop, subside and relapse. - The early lesions are highly infectioous MD DANISH RIZVI
  • 12. • 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 MD DANISH RIZVI
  • 14. 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 MD DANISH RIZVI
  • 15. • 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 MD DANISH RIZVI
  • 16. 3. RESURVEY AND TREATMENT- Resuveys every6-12 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, follw up of cases MD DANISH RIZVI
  • 17. 5. ENVIRONMENT IMPROVEMENT 6.ERADICATION EFFORTS- TOTAL COMMUNITY TREATMENT TOTAL TARGETTED TREATMENT MD DANISH RIZVI
  • 18. • YAWS ERADICATION PROGRAMME • The programme was started in 1996-97 in Koraput districts of Orissa then extended to endemic states as a centrally sponsored health scheme with the objectives of: 1.Interrupting the transmission of yaws infection (no case) in the country 2.Eradication of Yaws (i.e. no sero reactivity to RPR/VDRL in children below 5 years of age) from the country. MD DANISH RIZVI