BACKGROUND Yaws is a chronic, highly contagious skin and bone infection affecting children living in impoverished, remote communities and caused by Treponema pallidum subspecies pertenue. The Philippines was thought to be free of yaws following the 1950s eradication campaign but it has been reported in the Liguasan Marsh area, Central Mindanao. This is the first documentation of yaws cases in the Philippines since the 1970s. We describe active and latent yaws recently detected in the Southern Philippines. CASE PRESENTATION Cross-sectional surveys and screening of skin diseases were conducted in one randomly selected public elementary school per selected municipality in Liguasan Marsh, covering three municipalities per province. Yaws suspects underwent screening and confirmatory serologic tests for Treponema pallidum using Dual Path Platform Syphilis Screen and Confirm Assay (DPP) and Treponema pallidum Particle Agglutination (TPPA). Children with yaws skin lesions and reactive confirmatory tests for T. pallidum and non-treponemal antibodies were considered confirmed yaws cases. Four children aged 5-10 years old had confirmed secondary yaws in Tulunan Municipality, Cotabato Province and in Lambayong Municipality, Sultan Kudarat Province. All had secondary yaws lesions such as moist, cauliflower-like papillomas, thick yellow crusts on pink papules and nodules, whitish, papulosquamous papules and plaques, or hypopigmented patches with small papules on the periphery. Yaws papillomas and erosions were also found on the soles of the feet of one child. The index case had a skin punch biopsy of a partially treated papilloma on his axilla. Histopathological findings showed lichenoid psoriasiform dermatitis with plasma cells, consistent with yaws. CONCLUSIONS The clinical, serological, and histopathological confirmation of four yaws cases among children has made the Philippines the 14th country endemic for yaws. This report can help health personnel recognize hidden cases of yaws based on skin signs and serological tests. Yaws remained unrecognized and unreported in the Philippines and in countries previously endemic for yaws probably due to the unsustained integration of the yaws program in the general health services and complacency after the 1950s eradication campaign. Our findings have provided the necessary evidence and stimulus to develop a yaws control and eradication program as one of the country's neglected tropical diseases.

中文翻译：

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菲律宾的雅司：自1970年代以来首次报告病例。

背景技术偏航是一种慢性，高度传染性的皮肤和骨骼感染，影响生活在贫困偏远社区的儿童，并由梅毒螺旋体亚种引起。在1950年代的铲除运动之后，菲律宾被认为没有偏航，但据报道棉兰老岛中部的利瓜桑沼泽地区曾出现过这种偏航。这是自1970年代以来菲律宾首次出现偏航事件。我们描述了最近在菲律宾南部发现的活跃和潜在偏航。病例介绍在利瓜桑沼泽的每个选定城市中，在随机选择的一所公立小学中进行横断面调查和皮肤病筛查，覆盖每个省的三个城市。使用双路径平台梅毒筛查和确诊分析（DPP）和梅毒螺旋体颗粒凝集（TPPA）对雅虎疑犯进行了梅毒螺旋体的筛查和确诊血清学测试。患有偏航角皮损的儿童以及对梅毒螺旋体和非螺旋体抗体进行反应性确认试验的儿童被视为确诊偏航角病例。在哥打巴托省图卢南市和苏丹库达拉特省兰巴雍市，有四名年龄在5至10岁的儿童证实患有偏航。所有患者都有继发性偏航性病变，例如湿润，花椰菜样乳头状瘤，粉红色丘疹和结节上的黄色硬皮，发白，丘疹性丘疹丘疹和斑块，或色素沉着斑块，周围有小丘疹。在一个孩子的脚底也发现了偏航性的乳头状瘤和糜烂。索引病例的腋窝部分经乳头状瘤乳头活检。组织病理学结果显示类脂性牛皮癣样皮炎伴浆细胞，与偏航性一致。结论临床上，血清学和组织病理学证实了四例偏航儿童，使菲律宾成为偏远地区的第14个国家。该报告可以帮助卫生人员根据皮肤症状和血清学检查识别出隐匿的偏航病例。在菲律宾以及以前流行于偏航的国家中，偏航仍未得到认可和报道，这可能是由于1950年代根除运动后偏航计划未持久地纳入一般卫生服务和自满状态所致。