Osteoarcheological and biomolecular evidence of leprosy from an 11-13th century CE Muslim cemetery in Europe (Orosháza, Southeast Hungary).

Orosháza site no. 10 (Southeast Hungary) contains the partially excavated archaeological remains of an 11-13th century CE Muslim merchant village and its cemetery located in close proximity to Christian villages of the same era. The skeleton of a young woman (grave no. 16) from the last phase of the cemetery use was identified with rhinomaxillary lesions associated with lepromatous leprosy. The right parietal bone also exhibited signs of cranial trauma, possibly caused by symbolic trepanation, a well-known ritual practice in the 9-11th century CE Carpathian Basin. The retrospective diagnosis of the disease was supported by ancient DNA analysis, as the samples were positive for Mycobacterium leprae aDNA, shown to be of genotype 3. Contrary to the general practice of the era, the body of the young female with severe signs of leprosy was interred among the regular graves of the Muslim cemetery in Orosháza, which may reflect the unique cultural background of the community.

Archival, paleopathological and aDNA-based techniques in leprosy research and the case of Father Petrus Donders at the Leprosarium 'Batavia', Suriname.

OBJECTIVE: We assessed whether Petrus Donders (died 1887), a Dutch priest who for 27 years cared for people with leprosy in the leprosarium Batavia, Suriname, had evidence of Mycobacterium (M.) leprae infection. A positive finding of M. leprae ancient (a)DNA would contribute to the origin of leprosy in Suriname. MATERIALS: Skeletal remains of Father Petrus Donders; two additional skeletons excavated from the Batavia cemetery were used as controls. METHODS: Archival research, paleopathological evaluation and aDNA-based testing of skeletal remains. RESULTS: Neither archives nor inspection of Donders skeletal remains revealed evidence of leprosy, and aDNA-based testing for M. leprae was negative. We detected M. leprae aDNA by RLEP PCR in one control skeleton, which also displayed pathological lesions compatible with leprosy. The M. leprae aDNA was genotyped by Sanger sequencing as SNP type 4; the skeleton displayed mitochondrial haplogroup L3. CONCLUSION: We found no evidence that Donders contracted leprosy despite years of intense leprosy contact, but we successfully isolated an archaeological M. leprae aDNA sample from a control skeleton from South America. SIGNIFICANCE: We successfully genotyped recovered aDNA to a M. leprae strain that likely originated in West Africa. The detected human mitochondrial haplogroup L3 is also associated with this geographical region. This suggests that slave trade contributed to leprosy in Suriname. LIMITATIONS: A limited number of skeletons was examined. SUGGESTIONS FOR FURTHER RESEARCH: Broader review of skeletal collections is advised to expand on diversity of the M. leprae aDNA database.

The effect of leprotic infection on the risk of death in medieval rural Denmark.

INTRODUCTION: Paleopathological studies of leprosy in Danish skeletal collections show that many individuals suffered from this stigmatized disease during the Middle Ages. This study examines the risk of death associated with leprotic infection in individuals from the Danish rural cemetery of Øm Kloster (AD 1172-1536). Specifically, we modeled the influence of leprotic infection on age-specific mortality accounting also for sex and social status (lay person / monastic). MATERIALS AND METHODS: The sample consisted of 311 adult individuals from the Øm Kloster skeletal collection housed at the Institute of Forensic Medicine, University of Southern Denmark (ADBOU). We modeled morbidity and mortality using a three-state illness-death model with the following parameterizations for the three transition hazards: (1) nonlesioned to lesioned: constant; (2) nonlesioned to dead: Gompertz-Makeham; and (3) lesioned to dead: Gompertz-Makeham, directly proportional to the hazard of the well to dead transition. RESULTS: The mortality hazard of lesioned individuals exceeded that of nonlesioned individuals by a factor of 1.4 (40%) across all individuals, 1.7 for females, 1.0 for males, 1.3 for lay persons, and 1.7 for monastics. Overall, 15% of the sample died with skeletal manifestations of leprosy, though it is likely that a higher percentage of the population carried the bacterium. DISCUSSION: This study improves understanding of past health and population dynamics focusing on a chronic infectious disease. The methods employed could informatively be applied to larger analyses of community health from skeletal collections by incorporating more than one disease into the multistate model and inferring individual frailty using various skeletal markers.