Yaws disease re-emerging

Jan 28 2007

A neglected disease with a nearly forgotten name is making a comeback following a global control programme that almost eradicated it more than forty years ago. Yaws, a disease which eats away at the skin, cartilage and bones of its victims (mostly children), is re- emerging in poor, rural and marginalized populations of Africa, Asia and South America.

Today, more than 500,000 are afflicted by yaws, which is caused by a spiral bacteria that penetrates through a cut in the victim's skin resulting in bumps that burst, ulcerate and spread over the victim's body.

In the 1950s, more than 50 million people worldwide were afflicted by the disease until the World Health Organization (WHO), in partnership with UNICEF, established a massive global control programme to eliminate it. The Global Yaws Control Programme, fully operational between 1952-1964, succeeded in treating 300 million people in 50 countries -- reducing global levels of the disease by more than 95% and virtually eradicating yaws. However, after the enormous success of the programme, sustained surveillance of yaws diminished, which have now given way to its resurgence in the 21st century.

Yaws is transmitted from person to person via skin contact or through breaks in the skin caused by injuries or bites which allow spiral bacteria to penetrate. It is a debilitating disease whose effects in its young victims (mostly children under 15 years of age) can often cause gross deformation. Lesions develop that eat bone, cartilage, skin and soft tissue, leaving victims with gaping holes where their lips or noses should be.

"The persistence of yaws in the 21st century is unacceptable," says Dr Lorenzo Savioli, WHO Director of Neglected Tropical Diseases. "There is a cost-effective approach to treating this disease." Yaws is treated by a single dose of long-acting penicillin that costs as little as US$0.32. Experts believe that yaws can be eliminated and eventually eradicated because humans are the only reservoir of infection.

New cases of yaws appear every year. World experts including officials from the Ministries of Health of selected endemic countries -- Indonesia, Ghana and the Republic of Congo - will be holding an informal consultation to develop a new global strategy for combating this disease, the 2nd attempt of its kind.

The consultation's objectives are three-fold: to detect and treat all yaws cases and their contacts; to interrupt transmission of the disease; and to prevent disability, minimizing suffering and the socio-economic impact the disease has on affected populations. A recent control programme in India provides optimism that elimination can be achieved in other countries with persistent efforts and political commitment. In the south-east Asia region, the aim is to eradicate yaws by 2012.

The consultation this week will examine whether elimination is now possible in other regions of the world, signalling a possible revival of the 1950s global yaws programme as well as the development of a current global strategy to generate much needed support on global, regional and country level to eradicate this disease once and for all.