The first time I saw images of the poor unfortunate souls inflicted with late-stage Yaws, I was horrified. It reminded me of syphilis - which can also disfigure in a savage manner. Therefore, it was very interesting to learn that, in fact, yaws is caused by a subspecies of the same bacterium that causes syphilis: Treponema pallidum. Like syphilis, yaws has different stages of disfigurement. However, unfortunately for the kids, yaws is not spread by sexual contact.

Yaws is a tropical illness that was once common in West Africa, Indonesia, New Guinea, the Solomon Islands, Haiti, Dominica, Peru, Colombia, Ecuador and parts of Brazil. In these countries, yaws most often affects children between the ages of 2 and 5, especially children who wear few clothes, have frequent skin injuries and live in areas of poor hygiene.

During the 1950s, yaws was a common tropical illness, infecting 50 million to 100 million people. However, since that time, the World Health Organization (WHO) has battled yaws in many tropical areas of the world and more than 50 million cases of yaws have been treated with penicillin. As a result, the incidence of yaws declined dramatically worldwide.

The major route of infection is through direct person-to-person contact. The ulcerative skin lesions present early in the disease are teeming with spirochetes, which can be transmitted via direct skin-to-skin contact and via breaks in the skin from trauma, bites, or excoriations.

If yaws is contracted and goes untreated, it can progress through three increasingly horrifying stages:

Early Yaws — About three to five weeks after a person is exposed to yaws, a raspberrylike bump appears on the skin, commonly on the legs or buttocks. This bump, sometimes referred to as a frambesioma or mother yaw, gradually will grow larger and form a thin yellow crust. The area can itch, and there can be swollen lymph nodes (swollen glands) nearby. The bump usually heals on its own within six months, and it often leaves a scar.

Secondary Yaws — The next stage of yaws may begin while the mother yaw is still present, or it may not start until several weeks or months after the first stage of yaws heals. In this stage, a crusty rash forms, which can involve the face, arms, legs and buttocks. The bottoms of the feet also can become covered with painful, thick sores. If foot sores develop, walking can become painful and difficult, resulting in a crablike gait called crab yaws. Although the bones and joints also can be affected, second-stage yaws usually does not cause destruction in these areas.

Late-stage Yaws — Late yaws develops in only about 10 percent of people who are infected with yaws. It begins at least five years after the appearance of early yaws, and it has the potential to cause severe damage to the skin, bones and joints, especially in the legs. Late yaws also can cause a form of facial disfiguration called gangosa or rhinopharyngitis mutilans as it attacks and destroys parts of the nose, upper jaw, palate (roof of mouth) and part of the throat called the pharynx. If there is swelling around the nose, a person with late yaws can have headaches, nasal discharge and a distinctive facial appearance called goundou. (or gangosa)

Amazingly enough, all it takes is a single shot of penicillin to treat yaws. Too bad the shot would come a bit too late for these unfortunate souls.

Yaws - a distinctly dreadful disease!