Molecular Differentiation of Treponema pallidum Subspecies in Skin Ulceration Clinically Suspected as Yaws in Vanuatu Using Real-Time Multiplex PCR and Serological Methods

Kai-Hua Chi Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Damien Danavall Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Fasihah Taleo Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Allan Pillay Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Tun Ye Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Eli Nachamkin Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Jacob L. Kool Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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David Fegan Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Kingsley Asiedu Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Lasse S. Vestergaard Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Ronald C. Ballard Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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Cheng-Yen Chen Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines

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DOI:
https://doi.org/10.4269/ajtmh.14-0459
Volume/Issue:
Volume 92: Issue 1
Page(s):
134–138
Restricted access
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We developed a TaqMan-based real-time quadriplex polymerase chain reaction (PCR) to simultaneously detect Treponema pallidum subspecies pallidum, T. pallidum subsp. pertenue, and T. pallidum subsp. endemicum, the causative agents of venereal syphilis, yaws, and bejel, respectively. The PCR assay was applied to samples from skin ulcerations of clinically presumptive yaws cases among children on Tanna Island, Vanuatu. Another real-time triplex PCR was used to screen for the point mutations in the 23S rRNA genes that have previously been associated with azithromycin resistance in T. pallidum subsp. pallidum strains. Seropositivity by the classical syphilis serological tests was 35.5% among children with skin ulcerations clinically suspected with yaws, whereas the presence of T. pallidum subsp. pertenue DNA was only found in lesions from 15.5% of children. No evidence of T. pallidum subsp. pertenue infection, by either PCR or serology was found in ∼59% of cases indicating alternative causes of yaws-like lesions in this endemic area.

Author Notes

* Address correspondence to Cheng-Yen Chen, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop: A-12, Atlanta, GA 30329. E-mail: cychen@cdc.gov

Authors' addresses: Cheng-Yen Chen, Kai-Hua Chi, Damien Danavall, Allan Pillay, Eli Nachamkin, and Tun Ye, Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, E-mails: cyc1@cdc.gov, krc2@cdc.gov, bpu8@cdc.gov, ajp7@cdc.gov, ecn1@cdc.gov, and gwr5@cdc.gov. Ronald C. Ballard, CDC, Center for Global Health, Atlanta, GA, E-mail: ztp7@cdc.gov. Fasihah Taleo, Ministry of Health, Health Department, NTD Program, Port Vila, Vanuatu, E-mail: ftaleo@vanuatu.gov.vu. Jacob L. Kool, World Health Organization, Office for the South Pacific, Port Vila, Vanuatu, E-mail: KoolJ@wpro.who.int. Lasse S. Vestergaard, WHO, Western Pacific Regional Office, Manila, Philippines, E-mail: vestergaardl@wpro.who.int. Kingsley Asiedu, World Health Organization, Neglected Tropical Diseases, Geneva, Switzerland, E-mail: asieduk@who.int. David Fegan, WHO, Consultant, Brisbane, Australia, E-mail: djfegan@gmail.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2015
Received:
23 Jul 2014
|
Accepted:
01 Oct 2014
|
Published Online:
07 Jan 2015
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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