The functional cost of tertiary yaws ( Treponema pertenue) in a prehistoric Pacific Island skeletal sample

Abstract

Clinical reports from tropical countries show that the tertiary lesions of yaws ( Treponema pertenue) can cause gross deformities of cutaneous and osseous tissues representing a functional cost to the individual and the community. The palaeopathological literature rarely considers the cost of bone lesions to the individual in terms of limitations in limb function. This paper presents 14 cases with joint and bone lesions in a skeletal sample from prehistoric Taumako Island, southeast Solomon Islands, Southwest Pacific Islands. Clinical reports describing these types of lesions are reviewed in an attempt to assess the functional consequences of joint pathology. A differential diagnosis includes tuberculosis, leprosy and rheumatoid arthritis; however all those affected had co-existent lesions indicative of treponematosis which favours a diagnosis of yaws. The possibility of a concurrent condition contributing to the development of these lesions is not ruled out. The possible pathogenesis of the lesions and related disability is also addressed.