Endemic Treponematoses and Their Relations

Abstract

Ali endemic treponematoses (yaws, pinta, endemic syphilis and related conditions) are commonly non-venereal infections and show close similarity in their epidemiological pattern. They are prevalent in under developed areas among rural population where the family offers the best opportunities for the treponemal infection to assume an endemic non-venereal spread.

The most characteristic epidemiological feature of all endemic treponematoses is the onset of the disease. The infection occurs predominantly in children regardless of the prevalence of the disease. When, the infections decline or cease in children, the endemicity of the disease becomes steadily regressive and the respective endemic treponematosis disappears in the end completely.

Clinical differences which appear to exist among endemic treponematoses are mainly based on different ecological influences and host factors.

In endemic non-venereal treponematoses primary lesions are rarely observed what appear to depend on a massive exposure to infection. This relatively rare occasion is governed by living habits and specific epidemiological conditions in endemic areas what may also cause differences in regard to extent and location of the primal lesion.

The most interesting phenomenon which is throwing more light on the relationship of the treponemal infections is the correlation in similarity or identity of clinical manifestations in various treponematoses with the development of the immunological state of the disease.

Condylomata lata are already basically identical in all treponemal syndromes and even more by the full developed allergic stage of the disease when destructive gummatous lesion are appearing.

This variation caused by different degrees of immunological development are in fact the reflection of biological variations of very closely related treponemes with intrinsic biological characteristics common to all treponemes.

The frequency of late lesions in expansive foci of endemic treponematoses where a great reservoir of infection is existing is considered to be mainly caused by super infection of a previously infected host being in allergic state.

The treponemes responsible for various treponemal infections are morphologically identical with basically identical antibody response of the host, close relationship in cross — immunity and identical response to antibiotics.

The endemic treponematoses do not represent whether identical nor separate clinical entities but a very close related group of infections with variations of clinical symptoms which display more essential similarities than differences.