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Nonvenereal endemic treponematoses: yaws, endemic syphilis (bejel), and pinta 

Nonvenereal endemic treponematoses: yaws, endemic syphilis (bejel), and pinta

Nonvenereal endemic treponematoses: yaws, endemic syphilis (bejel), and pinta

David A. Warrell



Differences between T. p. pallidum and T. p. pertenue strains—explored by comparing their whole genomes.

Updated on 31 May 2012. The previous version of this content can be found here.
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date: 28 April 2017

The endemic treponematoses are chronic, granulomatous diseases caused by morphologically and serologically identical spirochaetes of the genus Treponema. They are spread by intimate but nonsexual contact and sometimes by fomites, mainly among children. Treponema pallidum subsp. pertenue causing yaws (framboesia), T. pallidum subsp. endemicum causing endemic syphilis (bejel) and T. carateum causing pinta (carate) are distinguishable from T. pallidum subsp. pallidum, causing venereal syphilis, by their epidemiology and pathological effects and genomic structure (e.g. the arp gene).

Despite the successful WHO/UNICEF mass penicillin treatment campaign (1952–64), there has been a resurgence of yaws, mainly in West Africa. Children living in rural areas in warm, humid climates in tropical countries are most affected by yaws. About 10% of untreated cases develop late, disfiguring, or crippling lesions of skin, bone, and cartilage.

Endemic syphilis occurs in arid areas of the Sahel and Arabian peninsula. It presents with buccal mucocutaneous lesions from contaminated cups. Late systemic effects are much less common than in venereal syphilis. Pinta persists in small foci in southern Mexico and South America, causing hypo- or hyper-pigmented skin lesions. Single-dose benzathine penicillin is effective treatment.

Prevention is by improving hygiene and eliminating the reservoir of infection by mass treatment.

Acknowledgement: The author gratefully acknowledges inclusion of material from previous editions by his late friend and colleague Dr Peter L Perine.

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