The origin and antiquity of syphilis (treponematosis), in southeast Asia

The pausible reasons for the paucity of skeletal evidence regarding the contraversal issue on the origin and antiquity of treponematosis (syphilis) in southeast Asia, suggest a lack of thorough investigation into the skeletal biology of the several remains that were excavated. According to an estimate the skeletal remains of about 69.5 per cent (107) of the prehistoric sites were not reported and even the remaining 30.5 per cent were not thoroughly investigated for paleopathological aspects. The two recent studies of possible evidence of treponematosis during megalithic (Iron Age) period supports the Old World hypothesis that the disease was prevalent during pre-Columbian period in India.     

New approaches to the study of disease in archeological New World populations.

One of the objectives of paleopathology is to clarify the role of disease in the evolution of human groups. The recovery of DNA and immunoglobulins from archeological human skeletal tissue offers a method for enhancing and expanding our knowledge about the presence and significance of disease in past human populations. DNA also might reveal the presence of genetic disease. Immunoglobulins recovered from archeological bone indicate some of the diseases to which an individual was exposed during life. This information also provides supporting evidence for anatomical observations of skeletal disease. This is illustrated by the identification of treponemal antibody in an archeological skeleton that has gross lesions suggestive of treponematosis. Similar biochemical methods could be applied to other research problems to clarify the presence of various syndromes of the inflammatory erosive arthropathies, such as rheumatoid arthritis, in New World archeological populations. Some of these syndromes are associated with DNA sequences and specific proteins that are recoverable from archeological skeletal tissue.     

Treponematosis in regional and chronological perspective from central Gulf Coast Florida

Examination of five central Gulf Coast Florida archaeological skeletal series (n = 547) from the late prehistoric and early historic periods reveals the presence of pathological lesions characteristic of treponemal infection. These skeletal remains of native American populations represent a crucial time regarding hypotheses about the exchange of syphilis between the Old and New World or the mutation of one treponemal infection into another. Comparison of the lesions with those observed in modern studies of treponemal infection does not support an interpretation of veneral syphilis. The data from this study and from other archaeological skeletal series indicate the presence of a treponemal disease prior to European contact. The skeletal elements from Florida do not suggest that the disease changed dramatically following contact with Europeans. It is possible that cases of nonspecific postcranial pathology can be explained by the presence of this disease in the Florida populations. This study indicates that a treponemal disease was endemic throughout the region by at least A. D. 1000. © 1993 Wiley-Liss, Inc.     

Prehistoric tuberculosis in america: adding comments to a literature review

Tuberculosis is a prehistoric American human disease. This paper reviews the literature and discusses hypotheses for origins and epidemiological patterns of prehistoric tuberculosis. From the last decades, 24 papers about prehistoric tuberculosis were published and 133 cases were reviewed. In South America most are isolated case studies, contrary to North America where more skeletal series were analyzed. Disease was usually located at the deserts of Chile and Peru, Central Plains in USA, and Lake Ontario in Canada. Skeletal remains represent most of the cases, but 16 mummies have also been described. Thirty individuals had lung disease, 19 of them diagnosed by the ribs. More then 100 individuals had osseous tuberculosis and 26 also had it in other organs. As today, transmission of the infection and establishment of the disease were favored by cultural and life-style changes such as sedentarization, crowding, undernutrition, use of dark and insulated houses, and by the frequency of interpersonal contacts. The papers confirm that despite previous perceptions, tuberculosis seems to have occurred in America for millennia. It only had epidemiological expression when special conditions favored its expansion. Occurring as epidemic bursts or low endemic disease, it had differential impact on groups or social segments in America for at least two millennia.     

Patterns of anemia and infection from medieval York,England

An assessment of the presence and patterns of porotic hyperostosis and periosteal reactions in the skeletal population (n = 1,014) from St. Helen-on-the-Walls, York, are used to examine health and disease in urban medieval England. The analyses of these two lesions indicate that 58% of the population display evidence of porotic hyperostosis and that 21.5% of the population display periosteal reactions. Through differential diagnosis it is asserted that porotic hyperostosis is associated with iron-deficiency anemia, and that periosteal reactions may be the result of endemic treponematosis and/or non-specific infection, including parasitic infestation. An association between the presence of remodeled lesions and adulthood is noticeable for both porotic hyperostosis and periosteal reactions, as is a pattern of increased average age at death for those displaying both conditions. © 1993 Wiley-Liss, Inc.     

On the origins of New World paleopathology

Many of the lesions found in American Indian bones do not resemble those found in human bones from the Old World, suggesting that the American Indians suffered from a distinct group of illnesses. If Old World pathogens did not follow man to the New World, what were the sources of pre-Columbian Indian diseases? As in the Old World, humans were susceptible to diseases endemic in the local animal populations. Exposure to these diseases varied with culturally conditioned animal contacts. As the New World population increased, the probability for disease increased, to the point where it is likely that even in pre-Columbian times, disease rather than war or climatic changes may have been a major influence in changing settlement patterns. The generalization that the only Old World plants and animals found in the New were those brought by man seems to hold as true for the pre-Columbian disease organisms as it is for larger forms of life.     

Possible paleopathological evidence of treponematosis from a megalithic site at Agripalle,India

An Iron Age (megalithic) skull recovered from a cist burial complex at Agripalle, Andhra Pradesh, India, exhibits extensive erosion of the calvarium, areas of sclerotic diploe, irregular osteitic and periosteitic lesions, and deep ulcerations with a granulomatous appearance of nodular foci due to bone remodeling. These lesions are found over the entire surface, but are less severe in the temporal region and in the occipital region below lambda. There is extensive ulceration and destruction of the orbital roof and the nasopalatine region. A thick bony mass representing a healed lesion is present on the nasal margin. Comparison with the pathologic skeletal series of Ortner and Putschar ([1981] Smithson. Contrib. Anthropol. 28:180–218), Steinbock ([1976] Paleopathology: Diagnosis and Interpretation, pp. 86–169), and Calvin ([1964] Bones and Disease: Evidence of Disease and Abnormality in Early Man) indicates that these findings warrant a diagnosis of an advanced stage of treponematosis. The material from Agripalle, together with similar specimens recovered from the sites of Bhimbetka (Iron Age) and Inamgaon (Chalcolithic), furnish additional evidence supporting the hypothesis of the prehistoric antiquity of treponemal disease in both the New and Old Worlds. © 1996 Wiley-Liss, Inc.     

Modeling the prehistoric Maori population

Skeletal and comparative evidence of mortality is combined with fertility estimates for the precontact Maori population of New Zealand to determine the implied rate of precontact population growth. This rate is found to be too low to populate New Zealand within the time constraints of its prehistoric sequence, the probable founding population size, and the probable population size at contact. Rates of growth necessary to populate New Zealand within the accepted time span are calculated. The differences between this minimum necessary rate and the skeletally derived rate are too large to result solely from inadequacies in the primary data. Four alternative explanations of this conundrum are proposed: 1) skeletal evidence of precontact mortality is highly inaccurate; 2) skeletal evidence of fertility is severely underestimating actual levels; 3) there was very rapid population growth in the earliest part of the sequence up to 1150 A.D., from which no skeletal evidence currently is available; or 4) the prehistoric sequence of New Zealand may have been longer than the generally accepted 1,000-1,200 years. These alternatives are examined, and a combination of the last two is found to be the most probable. The implications of this model for New Zealand prehistory and Oceanic paleodemography are discussed.     

A possible case of pre-Columbian treponematosis from New York State

This paper presents evidence for what is believed to be the first reported case of pre-Columbian treponematosis in northeastern North America. The temporal position of the skeletal material, salvaged from a site in New York State, is determined on the basis of archeological evidence.     

Rib lesions in a prehistoric Puebloan sample from southwestern Colorado

An unusually high frequency of periosteal lesions of visceral rib surfaces was observed in a small, prehistoric skeletal series from southwestern Colorado. Lesions of this type have been concordant with pulmonary tuberculosis in three studies of human skeletal collections with known cause of death, and in a recent clinical investigation of rib dimensions in living patients with lung disorders. Diseases such as pneumonia and actinomycosis have also been found to cause these lesions, but in much lower frequencies. Archaeological evidence suggests that Puebloan farmers of Sleeping Ute Mountain's southern piedmont, from which the sample is drawn, endured unusually harsh environmental conditions punctuated by severe drought and exacerbated by escalating warfare. It is argued here that these environmental stressors increased susceptibility to an opportunistic respiratory infection reminiscent of tuberculosis, and possibly also some form of pneumonia, resulting in high rates of active disease previously noted only in historic Puebloan peoples.     

Human intestinal parasites in the past: new findings and a review

Almost all known human specific parasites have been found in ancient feces. A review of the paleoparasitological helminth and intestinal protozoa findings available in the literature is presented. We also report the new paleoparasitologic findings from the examination performed in samples collected in New and Old World archaeological sites. New finds of ancylostomid, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Trichostrongylus spp., Diphyllobothrium latum, Hymenolepis nana and Acantocephalan eggs are reported. According to the findings, it is probable that A. lumbricoides was originally a human parasite. Human ancylostomids, A. lumbricoides and T. trichiura, found in the New World in pre-Columbian times, have not been introduced into the Americas by land via Beringia. These parasites could not supported the cold climate of the region. Nomadic prehistoric humans that have crossed the Bering Land Bridge from Asia to the Americas in the last glaciation, probably during generations, would have lost these parasites, which life cycles need warm temperatures in the soil to be transmitted from host to host. Alternative routes are discussed for human parasite introduction into the Americas.     

Spondyloarthropathy identified as the etiology of Nubian erosive arthritis

Slight variation in manifestation of different diseases may allow a single individual with one disease to mimic the “classic” appearance of another, as evidenced by the frequent confusion of spondyloarthropathy with rheumatoid arthritis. Analysis of population occurrence of arthritis (rather than isolated skeletons) facilitates more precise diagnosis. Northeast Africans living around 2,000 years before present were clearly afflicted with a form of spondyloarthropathy. Lack of inclusion of spondyloarthropathy in the differential diagnosis of erosive arthritis led to past misclassification of Nubians as having rheumatoid arthritis. While evidence of spondyloarthropathy abounds in the literature of human skeletal disease, pre-Columbian Old World rheumatoid arthritis is still elusive. The current study further documents the absence of rheumatoid arthritis in Nubians, supporting the hypothesis that rheumatoid arthritis began in the New World. Am J Phys Anthropol 109:259–267, 1999. © 1999 Wiley-Liss, Inc.     

性病梅毒的古病理学研究回顾

在抗生素诞生以前的历史时期,密螺旋体属疾病蔓延于新旧大陆,是继免疫缺陷综合症之前人类无法治愈的性传染疾病。密螺旋体类疾病可分为：性病梅毒、地方性梅毒、雅司病、品他病4种。除品他外的3种疾病均会使骨骼发生特异性感染,最终造成骨骼形态上的特殊改变,其中以梅毒所造成的影响最为显著。考虑到目前国内尚未有学者对性病梅毒所引起的骨变异进行研究,本文通过梳理国外关于梅毒的古病理学研究成果,对性病梅毒的鉴定标准及起源等问题进行阐述。     

Palaeopathology and genes: Investigating the genetics of infectious diseases in excavated human skeletal remains and mummies from past populations

The aim of this paper is to review the use of genetics in palaeomicrobiology, and to highlight the importance of understanding past diseases. Palaeomicrobiology is the study of disease pathogens in skeletal and mummified remains from archaeological contexts. It has revolutionarised our understanding of health in the past by enabling a deeper knowledge of the origins and evolution of many diseases that have shaped us as a species. Bacterial diseases explored include tuberculosis, leprosy, bubonic plague, typhoid, syphilis, endemic and epidemic typhus, trench fever, and Helicobacter pylori. Viral diseases discussed include influenza, hepatitis B, human papilloma virus (HPV), human T-cell lymphotrophic virus (HTLV-1) and human immunodeficiency virus (HIV). Parasitic diseases investigated include malaria, leishmaniasis, Chagas' disease, roundworm, whipworm, pinworm, Chinese liver fluke, fleas and lice. Through a better understanding of disease origins and their evolution, we can place into context how many infectious diseases are changing over time, and so help us estimate how they may change in the future.     

Pre-Columbian treponemal disease from 14th century AD Safed,Israel, and implications for the medieval eastern Mediterranean

In 1912, 68 medieval crania were excavated from a cave at Safed in the eastern Mediterranean and brought to the United Kingdom. It is only recently that these skulls have been studied for evidence of disease. One adult individual demonstrates multiple lesions of the cranial vault, compatible with treponematosis. Radiocarbon dating suggests the year of death to be between 1290-1420 AD. This range equates to the mamluk period, just after the crusades. This is the oldest dated case of treponematosis in the Middle East, and the first to confirm its presence there before the epidemiologically important transatlantic voyage of Christopher Columbus. The finding has significant implications for our understanding of the introduction of the disease to the Middle East and of the medieval diagnosis of ulcerating skin conditions by medical practitioners in the Mediterranean world.     

Osteological and molecular identification of Brucellosis in ancient Butrint, Albania

Ancient skeletal remains can harbor unique information about past civilizations at both the morphological and molecular levels. For instance, a number of diseases manifest in bone, some of which have been confirmed through DNA analysis, verifying their presence in ancient populations. In this study, anthropological analysis of skeletal remains from the ancient Albanian city of Butrint identified individuals with severe circular lytic lesions on their thoracic and lumbar vertebrae. Differential diagnosis suggested that the lesions resulted from pathologies known to affect these skeletal regions, such as tuberculosis (TB) or brucellosis. Relevant bones of two adolescent males from the 10th to 13th century AD that displayed the lesions, along with unaffected individuals, were collected in the field. Genetic screening of the skeletal samples for TB was repeatedly negative, thus additional testing for Brucella spp.-bacteria of livestock and the causative agent of brucellosis in humans-was conducted. Two Brucella DNA markers, the IS6501 insertion element and Bcsp31 gene, amplified from the affected vertebrae and/or ribs, whereas all unaffected individuals and control samples were negative. Subsequent DNA sequencing confirmed the presence of the brucellar IS6501 insertion element. On the basis of the skeletal lesions, negative tests for TB, and positive Brucella findings, we report a confirmed occurrence of brucellosis in archaeologically recovered human bone. These findings suggest that brucellosis has been endemic to the area since at least the Middle Ages.     

Phlebotomine sandflies and the spreading of leishmaniases and other diseases of public health concern

Phlebotomine sandflies transmit pathogens that affect humans and animals worldwide. We review the roles of phlebotomines in the spreading of leishmaniases, sandfly fever, summer meningitis, vesicular stomatitis, Chandipura virus encephalitis and Carrión's disease. Among over 800 species of sandfly recorded, 98 are proven or suspected vectors of human leishmaniases; these include 42 Phlebotomus species in the Old World and 56 Lutzomyia species in the New World (all: Diptera: Psychodidae). Based on incrimination criteria, we provide an updated list of proven or suspected vector species by endemic country where data are available. Increases in sandfly diffusion and density resulting from increases in breeding sites and blood sources, and the interruption of vector control activities contribute to the spreading of leishmaniasis in the settings of human migration, deforestation, urbanization and conflict. In addition, climatic changes can be expected to affect the density and dispersion of sandflies. Phlebovirus infections and diseases are present in large areas of the Old World, especially in the Mediterranean subregion, in which virus diversity has proven to be higher than initially suspected. Vesiculovirus diseases are important to livestock and humans in the southeastern U.S.A. and Latin America, and represent emerging human threats in parts of India. Carrión's disease, formerly restricted to regions of elevated altitude in Peru, Ecuador and Colombia, has shown recent expansion to non‐endemic areas of the Amazon basin.     

Climate and New World periosteal reaction patterns: implications for migration routes into the Western Hemisphere

The presence of the diseases yaws and bejel are indicated by periosteal reaction patterns. The distributions of these two diseases in ancient North American human populations show evidence of climatic influence. Those ancient populations lacking either yaws or bejel (the null periosteal reaction pattern) can be found in the coldest parts of the Cold Winter Regions. Those populations with yaws (the poly-ostotic periosteal reaction) can be found in the milder portions of the Cold Winter Regions. The populations with bejel (the pauci-ostotic periosteal reaction) are found either outside of or marginal to Cold Winter Regions. The Bering Strait area is considered to be the gateway to the ancient New World. The cold climates present in this area should have influenced the routes available for the diseases to spread from population to population or by migration of infected populations into the Western Hemisphere. It is suggested that the coastal route with its milder maritime climate was the route taken by yaws when it entered the New World. The presence of bejel in ancient North America presents a conundrum. The climate would have blocked the spread of the disease from Siberia to Alaska in either Late Glacial or Holocene times. This suggests that our present view of migration routes is incomplete.     

Seronegative spondyloarthropathies and diffuse idiopathic skeletal hyperostosis in ancient northern Chile

Bioarchaeological research of ancient Amerindians was undertaken to test the hypothesis that seronegative spondyloarthropathies (SNS) and diffuse idiopathic skeletal hyperostosis (DISH) existed in prehistoric South Americans. An osteological-radiographic model was developed from clinical literature and systematically applied to 504 archaeological human remains housed at the Universidad de Tarapacá in Arica, Chile, to search for evidence of these arthritides. The results showed that SNS existed with an average frequency of 7% for the adult sample and DISH averaged 4% in individuals over 40 years old. It was found that the antiquity of SNS date back at least 5,000 years in both New World and Old World populations. In contrast, the antiquity of DISH in the Americas is not clear because no previous studies have dealt with this subject; however, this research finds mild DISH cases dating back 4,000 years in northern Chile. It was also found that SNS and DISH exhibit a trend of increasing incidence with the advent of agro-pastoral activities and village formation. © 1993 Wiley-Liss, Inc.