Bm. Rothschild et Gm. Heathcote, CHARACTERIZATION OF THE SKELETAL MANIFESTATIONS OF THE TREPONEMAL DISEASE YAWS AS A POPULATION PHENOMENON, Clinical infectious diseases, 17(2), 1993, pp. 198-203
Documentation of the antiquity and tracking of the derivation of human
treponemal diseases have been complicated by an inability to distingu
ish among these diseases biochemically, histologically, and immunologi
cally. Skeletal impact, as a population phenomenon, has been suspected
to vary sufficiently among the treponemal disorders to allow their di
fferentiation. As yaws was the only treponemal infection present in pr
e-Spanish Guam, definitive characterization of this disease in terms o
f its skeletal impact has been possible. In the studies described here
in, skeletons from a 500-year-before-present archaeological site at Go
gnga-Gun Beach were examined. Yaws-related periostitis was noted in 19
% of skeletons, achieving full population ''penetrance'' by the second
decade of life. While the cortical-surface striations were often quit
e subtle, general osseous expansion and saber shin deformity were note
d in one-fourth of skeletons. Gummatous destruction was found in 15% o
f individuals and draining cloacae in 10%. Invariably, the presence of
irregular/striated cortical-surface markings (along with saber shin d
eformity) and the absence of epiphyseal separation or dental abnormali
ties distinguished the lesions of yaws from those of syphilis.