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Endemic treponematoses

Beeching, Nicholas ORCID: (2016) 'Endemic treponematoses' in: Infectious Diseases, 4th edition, volume 2, London, Elsevier, pp. 961-965.

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The endemic treponematoses include yaws (Treponema pallidum subsp. pertenue), endemic syphilis (T. pallidum subsp. endemicum) and pinta (T. carateum), which predominantly affect children in poor, rural areas of the tropics and, formerly, south east Europe.

Although control programs have been successful in many countries since the 1940s, yaws remains a significant problem in several countries in Oceania and West Africa.

The endemic treponematoses are transmitted by direct contact or sharing eating utensils, and do not cause venereal or congenital infections.

They have distinct clinical presentations, with primary, secondary and late stages analogous to syphilis, with severe destructive skin, mucosal and bone lesions in late stage disease.

Diagnosis is largely clinical, supported by the different geographical location of each disease.

Conventional reaginic and specific treponemal tests cannot distinguish between the endemic treponematoses or syphilis. Point-of-care tests developed for syphilis are being validated for field diagnoses of the endemic treponematoses.

Recent advances in molecular tests have yielded multiplex polymerase chain reaction (PCR) assays to support diagnosis of individual endemic treponemal infections and to monitor for possible azithromycin resistance.

Treatment and control programs previously relied on parenteral benzathine or oral penicillin, but this has been replaced by single oral doses of azithromycin as the treatment of choice for infected individuals and contacts.

In 2012 the World Health Organization (WHO) endorsed a new program to eliminate the endemic treponematoses by 2020.

Clinicians in non-endemic areas should be aware of the possibility of positive ‘syphilis’ serology caused by endemic treponematoses in migrants from affected countries, and should consider these infections in arrivals with unusual skin or destructive gummatous lesions.

Item Type: Book Section
Subjects: QW Microbiology and Immunology > QW 4 General works. Classify here works on microbiology as a whole.
QW Microbiology and Immunology > QW 50 Bacteria (General). Bacteriology. Archaea
WA Public Health > WA 4 Works on general hygiene
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Stacy Murtagh
Date Deposited: 11 May 2018 10:22
Last Modified: 09 Sep 2019 06:28


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