Your Guide to
Neglected Tropical Diseases

Yaws (also known as frambesia) is a bacterial skin infection that mainly affects children in poor tropical communities. The pathogen is closely related to the bacteria that cause syphilis but is not sexually transmitted; it spreads through direct skin-to-skin contact during play and everyday activities. Yaws starts with a raised skin bump that looks like a raspberry. Without treatment, the bump may disappear temporarily on its own after a few months but later progresses to infection, with the bacteria remaining in the body. Subsequently, the infection causes multiple skin sores and painful bone problems. About 10% of untreated people ultimately develop severe disfigurement of the face, hands, and legs. The good news is that yaws can be completely cured with a single pill of antibiotics.

Yaws spreads when the fluid from an infected person’s skin sores touches cuts or scrapes on another person’s skin. This happens most often during children’s play. After infection, it takes about 3-4 weeks for the first bump to appear. Early lesions are highly infectious, and people can be contagious for several months to over a year after infection. The disease does not spread through casual touching like shaking hands. It is not sexually transmitted. Yaws thrives in poor, crowded communities in warm, humid tropical areas where people have limited access to clean water and healthcare.

Geographic scope:

• Yaws remains endemic in tropical regions of Africa, Asia, Latin America, and Pacific islands.
• Over 90 countries had yaws in the 1950s; today, it is endemic in about 16 countries, with some of the highest burdens in Papua New Guinea, Solomon Islands, and Indonesia.

Population affected:

• About 75% of cases occur in children under 15 years old.
• Millions of people live in areas where yaws still exists.
• Without treatment, 1 in 10 infected people develop severe permanent disfigurement after 5-10 years.

Yaws is cured with a single oral dose of azithromycin; benzathine penicillin injections or two weeks of doxycycline pills can also be used, although sometimes mild side effects such as nausea or diarrhea are observed. There is no vaccine currently available for yaws. Because yaws is transmitted from humans to humans, WHO’s eradication strategy involves mass drug administration: giving azithromycin to entire communities in endemic areas, aiming for at least 90% coverage. Some studies show that repeated rounds of treatment every 6 months can further reduce disease prevalence compared with a single round. Mass treatment campaigns reduced global yaws cases by 95% in the 1950s-1960s, but the disease returned when programs stopped, prompting WHO to restart eradication efforts in 2012. Prevention requires improving hygiene, providing clean water and sanitation, and ensuring early access to treatment.

Note: Although categorized under "Children at high risk”, this is a disease that mainly affects children. There is no gender difference in susceptibility.