Summary about Disease
Bejel, also known as endemic syphilis, is a chronic infectious disease caused by the bacterium Treponema pallidum pertenue. It primarily affects children and adolescents in arid and semi-arid regions, particularly in the Middle East, North Africa, and the Sahel region of Africa. It's a type of non-venereal treponematosis, meaning it's not primarily spread through sexual contact. It typically spreads through direct skin-to-skin contact or sharing contaminated utensils.
Symptoms
The symptoms of Bejel typically progress through stages:
Early Stage: Mucous patches (painless, moist lesions) in the mouth, nose, and throat are common. Skin lesions may also appear, often on the trunk and limbs.
Late Stage: Gummas (destructive granulomatous lesions) may develop in the skin, bones, and joints. These can cause disfigurement and disability. Bone pain and swelling are also common.
Causes
Bejel is caused by the bacterium Treponema pallidum pertenue. The infection is transmitted through direct contact with infectious lesions or contaminated objects. Poor hygiene, overcrowding, and limited access to healthcare contribute to its spread.
Medicine Used
The primary treatment for Bejel is antibiotics. The most commonly used antibiotics include:
Penicillin: Typically administered as a single intramuscular injection of benzathine penicillin.
Azithromycin: An oral alternative for individuals allergic to penicillin.
Is Communicable
Yes, Bejel is communicable. It spreads through direct contact with infectious lesions, typically through skin-to-skin contact or by sharing contaminated utensils or other fomites.
Precautions
Good Hygiene: Practice frequent handwashing with soap and water.
Avoid Contact: Avoid direct contact with open sores or lesions on others.
Separate Utensils: Do not share eating utensils, drinking glasses, or personal hygiene items.
Early Treatment: Seek prompt medical attention and treatment if symptoms develop.
Public Health Measures: Public health initiatives focused on hygiene education, screening, and mass treatment are crucial in endemic areas.
How long does an outbreak last?
Without treatment, Bejel can persist for years, progressing from early lesions to late-stage complications. An "outbreak" in a community may persist until effective control measures, such as mass treatment with antibiotics and improved hygiene practices, are implemented.
How is it diagnosed?
Bejel is diagnosed based on:
Clinical Examination: Physical examination to identify characteristic lesions.
Serological Tests: Blood tests to detect antibodies against Treponema pallidum. These tests include:
Non-treponemal tests (e.g., VDRL, RPR)
Treponemal tests (e.g., FTA-ABS, TPPA, EIA)
Dark-field Microscopy: Direct examination of lesion fluid under a dark-field microscope to identify Treponema pallidum bacteria (less commonly used).
Timeline of Symptoms
Incubation Period: Approximately 2-8 weeks.
Primary Stage: Mucous patches and skin lesions develop, typically painless and highly infectious. This stage can last for several weeks to months.
Latent Stage: A period without apparent symptoms. This can last for months or years.
Late Stage: Gummas develop in skin, bones, and joints. This stage can occur years after the initial infection and cause significant morbidity.
Important Considerations
Differential Diagnosis: Other conditions with similar skin lesions need to be ruled out.
Mass Treatment: In endemic areas, mass antibiotic treatment campaigns can be effective in reducing the prevalence of Bejel.
Prevention: Focus on improving hygiene and sanitation, particularly in affected communities.
Monitoring: Post-treatment follow-up is important to ensure treatment success and detect any relapse.
Similar Diseases: Bejel is related to other treponemal diseases such as syphilis (venereal), yaws, and pinta.