Elimination of yaws in India

Overview

Yaws is a nonvenereal endemic treponematosis caused by the bacterium Treponema pallidum, subspecies pertenue, a Gram-negative spirochete. Infection is transmitted by skin-to-skin contact among people with poor hygiene practices living in certain warm and humid tropical areas of Africa, the Americas and Asia. Children aged 2–5 years are the most vulnerable to infection, which targets the skin, bones and cartilage, causing destruction of tissue and deformities in the late stages.

Yaws remains one of the most neglected tropical diseases, affecting primarily the poorest and most vulnerable populations: tribal and indigenous people living in remote, rural areas. Although highly amenable to eradication epidemiologically (humans are the only reservoir of infection, and the disease is localized to a few endemic areas), technologically (curable by a single injection of penicillin) and in terms of cost effectiveness, the disease has not attracted global attention.

Reports suggest that yaws was non-existent in India until 1887, when cases were first noticed among tea plantation labourers in Assam. It later spread to a geographically contiguous and predominantly tribal area in central India involving the states of Bihar (including Jharkhand), Madhya Pradesh (including the present state of Chattisgarh), Maharashtra, Orissa and Uttar Pradesh, where it remained endemic.