“Yaws, a chronic infectious disease, has been eliminated from India”, said Mr. Anbumani Ramadoss, Union Health Minister of India, in New Delhi on September19, 2006. “However, it will be two years before the disease is eradicated,” he added.

The Background:

Elimination means no case has been reported for the past three years, whereas elimination means no incidence for two more years or for the last five years. It is learnt that the disease was originally noticed earlier in remote areas of 49 tribal districts, particularly in the states of Andhra Pradesh, Orissa and Chattisgarh in East Central region of India.

There are other diseases like leprosy which are eliminated from India. There are other diseases like Polio and Kala Azar (Black Fever) which are on the verge elimination. India took up the Yaws eradication Programme (YEP) in sensitive areas in the year 1996-97 covering even states like Assam, Jharkhand, GUJARAT, Madhya Pradesh, Maharashtra, Tamil Nadu and Uttar Pradesh.

YAWS - Introduction:

The word ‘yaws’ might owe its origin to Caribbean word ‘yaya,’ means ‘a sore.’ Also, because the lesions of yaws look like berries, the disease is also called frambesia or frambesia tropica (from French ‘framboise,’ meaning ‘raspberry’). Yaws is also called as granuloma tropicum, polypapilloma tropicum, and thymiosis.

frambesia is a Modern Latin word inspired by the French word framboise ("raspberry").

This infectious disease is caused by the infection with spirochete bacteria entering body through an existing cut or damage. Yaws papilla occur on skin of the face, hands, feet, and genital area It is transmitted by direct contact with infected individuals or eye gnats. In a few weeks after infection, a painless, distinct, 10-50 mm sized raspberry like ulcerous papule, called 'mother yaw' appears on the skin at the point of infection (inoculation).

This ancient disease, thought to have plagued humans for some 1.5 million years, usually affects children aged below 15 years in the warm, humid tropics of Caribbean, Latin America, West Africa, Southeast Asia, India and Oceania among poor rural populations living in overcrowded environment with poor sanitation. This disease do not have sex predilection and do not cause fatalities and progresses in stages:

Primary stage: Initial yaws lesion develops at inoculation site and may persist for up to nine months.

Secondary stage: As the ‘mother yaw’ heals, widespread secondary growths results in multiple 'raspberry' like skin lesions similar to primary yaws lesion. But these are smaller and ulcerous, exuding a thin, highly infective fluid which attracts flies. If untreated, lesions may merge together into thick fissured plaques. When they form on the feet gait is affected. These secondary growths are irreversible but there can be relapsing lesions and asymptomatic periods.

Latent stage: Usually, no symptoms are present, but skin lesions can relapse.

Tertiary stage: Bone, joint, and soft tissue deformities may occur. In this stage, the lesions are not contagious. In some cases, it may take a decade or more to reach this stage!

Diagnosis and Treatment:

The diagnosis involves blood tests or visual examination of lesion sample under a microscope. It can be treated by a single dose of broad spectrum antibiotics like penicillin, erythromycin or tetracycline. The relentless campaigns by WHO between 1954 and 1963 greatly helped to reduce the incidence of the disease world wide but it still raises its head now and then.