Yaws: Treatment, Procedure, Cost and Side Effects

Pian, FrambessiaTtropica, Parangi, Paru thymiosis, polypapilloma tropicum, granuloma tropicum

A chronic debilitating and disfiguring infectious condition or disease caused by a bacterium, the spirochete (a spiral shaped bacteria), Treponema pallidum (treponema pertenue bacteria) is known as Yaws. This disease affects skin, bone, cartilage, foot, hand and forms skin lesion or bumps throughout the victim’s body. The skin gets round hard swelling with a diameter of 2 to 5 cm. The disease generally occurs in warm and humid climatic conditions, in poor communities. The bacterium causes venereal syphilis which includes skin rashes and sore, but in case of yaws, the infection is non-venereal. About 75% of the children under the age of 15 years generally get affected in this disease; especially children within 6-12 years of age are more likely to get affected by this disease. It can happen to both male and female child.

Yaws generally begins when the bacteria treponema pallidum enters a patient’s body through a cut wound or scrapped area and is transmitted by direct physical contact with the infected person. At first a single skin lesion or bumps occurs during the entry of the bacterium, and then after two to three weeks it spreads throughout the body with several other lesions or bumps. The initial lesion is known as mother yaw and when it gets spread throughout the body then it is known as daughter yaws. The developmental stages of yaws continue of four stages; primary, secondary, latent and at the end tertiary. The primary stage involves with the appearance of the mother yaw. The secondary stage involves the spreading of the lesion and the sore, the latent period stars with the symptoms of weakness and loss of appetite and the tertiary stage involves with the destruction of skin, bone, joints and enormous pain. The palms and soles of hand and feet gets thickened.

Yaws can be treated very easily. Penicillin G benzathine is injected intramuscularly in primary, secondary and even in latent period. Penicillin V can also be given orally for 10 days, but injection dosage is more reliable than oral dosage of medicine. Patients who are allergic to penicillin can be given erythromycin, doxycycline, and tetracycline as well for treatment of yaws. According to the recommendation of WHO a single dose of azithromycine i.e. 30 mg/kg of body weight can be given to a patient to ease the administration of yaws. In case of the tertiary stage of yaws the patient is treated for the symptoms of chronic conditions i.e. the destructed areas of bones, joints, soft tissues and cartilages. No vaccines for yaws is still found.

In the tertiary phase, some patient develops ulceration of the nasopharynx area of nose, which is termed as gangosa. And some patient also gets painful skeletal deformities and destruction in soft tissues of the body. Genital area of the patient also gets affected by the bacterium of yaws, pain full skin lesions and swollen bumps are found.

However, there are some epidemiologic treatment for yaws, which includes, if more than 50% of the children are seropositive (hyper endemic) then the total population must be treated and if less than 50% of the children are seropositive then treat the active cases and all children under 15 years of age.

Yaws generally infect children within 15 years of age, mainly in those areas where the disease is common. This disease is mainly found in the tropical area under hot and humid climatic conditions. Therefore, peoples belonging to tropical areas must go through the series of medical test to identify the appearance of yaws, especially children under 15 years of age.

People not living in tropical part of the world or not living in hot and humid climatic conditions does not require to be treated for yaws bacterium i.e. T.pallidum. If a person is suffering from any skin lesion which shows symptoms other than the symptoms of yaws should go for diagnosis for their respective problems and not for yaws. According to world health organisation (WHO) the ministry of health and family welfare declared India as an yaws free country.

The side effects of yaws are very vast. Untreated children who grow up with deformities which is debilitating and this can cause severe sore and ulceration on the skin. Yaws is a non venereal infectious disease and can be easily transferred with normal skin to skin contact with the infected person.

People living in places other than the tropical areas of the world are free of yaws, but they can also suffer the same side effects for various other reasons. Skin ulceration or painful sore on skin is very common side effects of yaws and the treatment takes much longer time for recovery.

Yaws can be treated very quickly and easily in the primary and secondary stages by taking penicillin or azithromycin dosage. Though there are no such strict guidelines to be followed, but a person once suffered from yaws must follow healthy diet and maintain a hygiene condition for living. Medications can improve the disease but only neat and clean healthy condition can prevent further problems regarding the disease. Therefore, it is always needed for all the patient suffering from such skin problems.

One must always take medicines at time so that the disease doesn’t spread. The patient suffering from yaws must be kept in a hygiene conditions throughout the treatment and one must always maintain skin contact with the patient while he/she is suffering from yaws to reduce the chance of spreading of the disease.

Yaws generally take two to four weeks to get recovery results. The diagnosis and medications together takes about 4-6weeks in total in case of curing primary and secondary yaws. In case of latent and tertiary yaws the recovery time depends on the amount of damage caused by the disease.

Although India is a yaws free country as mentioned by the world health organisation, still for a brief knowledge about the condition; it might be helpful to know the fact of price range for the treatment. The treatment of yaws in India costs about Rs. 250 – Rs. 500 for the consultation of doctor and a minimum cost up to Rs. 1200 for medication.