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This study is based on the palaeopathology of leprosy on human skeletal remains and the detection of ancient Mycobacterium leprae DNA. Two cases of childhood leprosy were recognised. The first case was in a Roman necropolis at Martellona (Rome, Central Italy), dated to the 2nd –3rd century CE. The skeleton of a child aged 4–5 years, from tomb 162,...
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Leprosy was rare in Europe during the Roman period, yet its prevalence increased dramatically in medi- 48
eval times. We examined human remains, with paleopathological lesions indicative of leprosy, dated to 49
the 6th–11th century AD, from Central and Eastern Europe and Byzantine Anatolia. Analysis of ancient 50
DNA and bacterial cell wall lipid b...
Leprosy was rare in Europe during the Roman period, yet its prevalence increased dramatically in medieval times. We examined human remains, with paleopathological lesions indicative of leprosy, dated to the 6(th) -11(th) century AD, from Central and Eastern Europe and Byzantine Anatolia. Analysis of ancient DNA and bacterial cell wall lipid biomark...
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... Moreover, children born to mothers with leprosy are at increased risk of developing leprosy. The time it takes to develop varies according to different authors, some stating that leprosy develops by early childhood, around 2 to 5 years old or by puberty [82,85,86]. There is limited evidence of congenital or peri-natal leprosy, with the suggestion that this is often self-healing [82]. ...
... There is limited evidence of congenital or peri-natal leprosy, with the suggestion that this is often self-healing [82]. However one case of an infant aged 3-4 months with intra-cranial leprosy pathology has been described in Byzantine Turkey, suggesting there was active infection [86]. ...
... Leprosy cases also have been found in Uzbekistan, dating to the 1 st -4 th century AD [106], in 1 st century Israel [107] and at the Dakhleh Oasis in Roman Egypt, dated to the early-mid 4 th century AD [108]. Further cases of lepromatous leprosy have been described from mummified remains in early Christian Nubia [109] and the Byzantine period [86,110]. ...
At the Abony-Turjányos dűlő site, located in Central Hungary, a rescue excavation was carried out. More than 400 features were excavated and dated to the Protoboleráz horizon, at the beginning of the Late Copper Age in the Carpathian Basin, between 3780–3650 cal BC. Besides the domestic and economic units, there were two special areas, with nine-nine pits that differed from the other archaeological features of the site. In the northern pit group seven pits contained human remains belonging to 48 individuals. Some of them were buried carefully, while others were thrown into the pits. The aim of this study is to present the results of the paleopathological and molecular analysis of human remains from this Late Copper Age site. The ratio of neonates to adults was high, 33.3%. Examination of the skeletons revealed a large number of pathological cases, enabling reconstruction of the health profile of the buried individuals. Based on the appearance and frequency of healed ante- and peri mortem trauma, inter-personal (intra-group) violence was characteristic in the Abony Late Copper Age population. However other traces of paleopathology were observed on the bones that appear not to have been caused by warfare or inter-group violence. The remains of one individual demonstrated a rare set of bone lesions that indicate the possible presence of leprosy (Hansen’s disease). The most characteristic lesions occurred on the bones of the face, including erosion of the nasal aperture, atrophy of the anterior nasal spine, inflammation of the nasal bone and porosity on both the maxilla and the bones of the lower legs. In a further four cases, leprosy infection is suspected but other infections cannot be excluded. The morphologically diagnosed possible leprosy case significantly modifies our knowledge about the timescale and geographic spread of this specific infectious disease. However, it is not possible to determine the potential connections between the cases of possible leprosy and the special burial circumstances.
While pathways may vary, the response to infections appears to be trans-phylogenetic, at least from the appearance of its macroscopic effect on the bone. Chronic recurrent multifocal osteomyelitis is an unusual disease of suspected infectious origin. Actinomycosis-induced polycystic bone surface alterations are highly diagnostic and well represented in the zoologic record, at least in mammals. Brucellosis produces an apparently unique curvilinear resorption of the anterior surfaces of vertebral endplates. Antiquity of brucellosis is suggested by its presence in Neandertal. Tuberculosis, caused by Mycobacterium tuberculosis, presents as space-occupied masses, zones of resorption, and gibbus formation and by hypertrophic osteoarthropathy. Only 5% of individuals with tuberculosis actually manifest clinical symptoms. Tuberculosis has been documented in the Pleistocene and tuberculosis-like alterations, recognizable as far back as the Triassic. Bovine tuberculosis, caused by Mycobacterium bovis, apparently had its origin in the Pleistocene Siberian-Alaskan refugium. Examination of contemporary humans with leprosy revealed patterns of disease quite different from those found in individuals previously diagnosed because they were found in the cemeteries of leprosaria and misdiagnosed because of failure to recognize that leprosy was a generic/nonspecific term for conditions affecting the skin. Leprosy has trans-phylogenetic representation in mammals. Fungal disease presents as spheroids, the expansion of which independent of tissue density is highly characteristic. Criteria have been vetted for distinguishing among the treponematoses. Previously considered criteria for syphilis (e.g., congenital hypoplastic dental and cranial alterations) are not necessarily diagnostic (Hillson et al. 1998) with the former preserved too rarely for epidemiologic study. Yaws was identified in 1.5 million ybp Homo erectus, having been identified in North America going back 11,000 years. Syphilis apparently represents a mutation from yaws that occurred 1800–2000 ybp. Bejel also apparently represents a mutation from yaws that occurred at least 15,000 ybp and reached the western coast of North America ~5000 ybp. Treponemal disease is not limited to humans, with yaws specifically identified in other primates and immunologically identified in an 11,000 ybp Arctodus simus. Avian leucosis retroviruses produce a highly recognized bone overgrowth, in comparison to other viruses that cause congenital defects and, rarely, osteomyelitis. Trichomonas does not cause bone alterations and is not responsible for holes in tyrannosaur mandibles. Echinococcus produces expansile cysts, often with calcification of their borders. Echinococcus is trans-phylogenetic in mammals. It has been noted in a Pleistocene camel. Coprolites are the major substrate for parasite recognition and DNA analysis, for recognition of malaria.
The association between the science of palaeopathology and archaeology is longstanding since a great proportion of the human and faunal remains studied are derived from archaeological excavations. It is no surprise that palaeopathology relies upon accurate and/or reasonable diagnosis in order to address questions regarding health and disease in the past. Clinical medicine provides a means to evaluate independently the presence of bone changes in archaeological or mummified remains. The integration of parasitology with palaeopathology has a long history, stemming in part from the identification of parasites in mummified remains from Egypt. Biomolecular approaches to the study of disease in the past have traditionally focused on the recovery and identification of DNA in archaeologically recovered human materials and the assessment of stable isotopes in human and faunal remains. The fact that fauna serves as hosts for pathogens is only one facet towards understanding disease in the past.
In 2009 and 2010, a rescue excavation at Nitra-Selenec II (Slovakia) was carried out by the Institute of Archaeology of the Slovak Academy of Sciences. A medieval cemetery dated to the end of 11th century was discovered, yielding 72 individuals, including the skeleton of a young female manifesting skeletal changes consistent with leprosy. The lesions of rhino-maxillary syndrome (facies leprosa) were observed together with atrophied/tapered metatarsal bones of ‘licked candy’ appearance. In addition, cribra orbitalia, cribra cranii, bilateral periostitis of distal ends of the tibiae and fibulae, and vertebral hypervascularisation were recorded. The results of light-microscopic investigation agreed with the macroscopic diagnosis of leprosy. Reported cases of leprosy from eastern Central Europe are few, coming mostly from the region of present-day Hungary. Until recently, only three probable cases of leprosy (all dated to pre-Crusade Middle Ages) were discovered in the area of former Czechoslovakia, all of them discovered in the modern Czech Republic. The case from the late 11th century, presented in this paper, can be considered the first evidence of the disease in the region of Slovakia.
The conquest of Britain by the Roman Emperor Claudius from AD 43, saw the introduction of urban settlements, associated infrastructure (e.g., roads, water supply), and Imperial governance to a territory characterized by small dispersed farming communities, organized into tribal confederacies. The integration of Britain into the Empire was marked by the imposition of entirely new, and often unfamiliar, economic and social practices, and ways of living, particularly those from the Mediterranean and more distant parts of Continental Europe. These developments are evidenced by changes in the patterns of diseases and mortality risks observed post-Conquest in Britain’s population. However, research has shown that the bioarchaeological data are heterogeneous, revealing marked differences between towns, as well as between urban and rural settlements. This chapter seeks to understand the reasons for this heterogeneity, focusing on the theme of migration.
The Mouweiss site (Shendi area, about 250 km North of Khartoum) is a Nilotic city of the Meroitic period (4th century BCE to 4th century CE), which the Louvre Museum (Paris) began to excavate in 2007. This was a large settlement that included a palace, which was later destroyed. The ruined walls of the palace also housed a medieval necropolis. About thirty rather crudely fashioned pits dug directly into the rubble of the palace were excavated. Radiocarbon dating from the tombs suggests funerary occupation from the “early Christian” to the “classic Christian” period. A macroscopic examination of the skeletal remains of the individual in grave 13 revealed palaeopathological signs pointing to Rhinomaxillary syndrome. The cranium of this 40- to 50-year-old woman showed significant bone resorption, particularly in the nasal area. Associated with these lesions are several modifications of the hands and feet, namely phalangeal acro-osteolysis and destructive diaphyseal remodelling. Differential diagnostic testing, in particular for other infectious/inflammatory diseases, concluded that the type and distribution of the lesions displayed by the individual from grave 13 at Mouweiss were indicative of leprosy. These findings contribute new data to understand the distribution of this disease and new evidence for leprosy in Sudanese Nubia, where there are very few palaeopathological cases illustrating its presence.
Despite advances in DNA and molecular studies, relatively little is known about the early history of leprosy. Fanciful theories about disease transmission across the Indian Ocean world have contributed an element of empty speculation to the literature, and it is necessary to refocus on the actual evidence available. This chapter reviews the palaeopathological, archaeological and literary evidence and argues that DNA analysis has provided a great deal of new data on the history of leprosy, but the interpretation of this new evidence has proven to be problematic. Given the limitations of this rapidly developing DNA sequencing technology, there are still many unanswered questions about the role of the Indian Ocean world in the early history of leprosy. This chapter first defines leprosy, then evaluates the hypotheses for the early history of leprosy based on the literary and archaeological evidence, third analyses the claim that DNA evidence can fill some of the gaps in the literary and archaeological record and finally examines recent hypotheses that attempt to reconcile the literary, archaeological and DNA evidence for the early history of leprosy.
