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Yaws, caused by  Treponema pallidum  ssp.  pertenue , is a neglected tropical disease closely related to venereal syphilis and is targeted for eradication by 2020. Latent yaws represents a diagnostic challenge, and current tools cannot adequately distinguish between individuals with true latent infection and individuals who are serofast following successful treatment. PCR on blood has previously been shown to detect  T .  pallidum  DNA in patients with syphilis, suggesting that this approach may be of value in yaws. We performed real-time PCR for  Treponema pallidum  ssp.  pertenue  on blood samples from 140 children with positive  T .  pallidum  Particle Agglutination (TPPA) and Rapid Plasma Reagin (RPR) tests and 7 controls (negative serology), all collected as part of a prospective study of yaws in the Solomon Islands. All samples were also tested by a nested PCR for  T .  pallidum . 12 patients had clinical evidence of active yaws whilst 128 were considered to have latent yaws. 43 children had high titre rapid plasma reagins (RPRs) of ≥1:32. PCR testing with both assays gave negative results in all cases. It is possible that the failure to detect  T .  pallidum  ssp.  pertenue  in blood reflects lower loads of organism in latent yaws compared to those in latent infection with  T .  pallidum  ssp.  pertenue , and/or a lower propensity for haematogenous dissemination in yaws than in syphilis. As the goal of the yaws control programme is eradication, a tool that can differentiate true latent infection from individuals who are serofast would be of value; however, PCR of blood is not that tool.

Failure of PCR to Detect Treponema pallidum ssp. pertenue DNA in Blood in Latent Yaws