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Background   Haemophilus ducreyi  and  Treponema pallidum  subsp.  pertenue  are major causes of leg ulcers in children in Africa and the Pacific Region. We investigated the presence of DNA (PCR positivity) from these bacteria on asymptomatic people, flies, and household linens in an endemic setting.    Methodology/Principal findings  We performed a cross-sectional study in rural villages of Lihir Island, Papua New Guinea during a yaws elimination campaign. Participants were asymptomatic subjects recruited from households with cases of leg ulcers, and from households without cases of leg ulcers. We rubbed swabs on the intact skin of the leg of asymptomatic individuals, and collected flies and swabs of environmental surfaces. All specimens were tested by PCR for  H .  ducreyi  and  T .  p .  pertenue  DNA. Of 78 asymptomatic participants that had an adequate specimen for DNA detection,  H .  ducreyi- PCR positivity was identified in 16 (21%) and  T .  p .  pertenue -PCR positivity in 1 (1%). In subgroup analyses,  H .  ducreyi- PCR positivity did not differ in participants exposed or not exposed to a case of  H .  ducreyi  ulcer in the household (24% vs 18%; p = 0.76). Of 17 cultures obtained from asymptomatic participants, 2 (12%) yielded a definitive diagnosis of  H .  ducreyi , proving skin colonization. Of 10 flies tested, 9 (90%) had  H .  ducreyi  DNA and 5 (50%) had  T .  p .  pertenue  DNA. Of 6 bed sheets sampled, 2 (33%) had  H .  ducreyi  DNA and 1 (17%) had  T .  p .  pertenue  DNA.    Conclusions/Significance  This is the first time that  H .  ducreyi  DNA and colonization has been demonstrated on the skin of asymptomatic children and that  H .  ducreyi  DNA and  T .  p .  pertenue  DNA has been identified in flies and on fomites. The ubiquity of  H .  ducreyi  in the environment is a contributing factor to the spread of the organism.

Haemophilus ducreyi DNA is detectable on the skin of asymptomatic children, flies and fomites in villages of Papua New Guinea