title: A migration-driven model for the historical spread of leprosy in medieval Eastern and Central Europe.
abstract: 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 6th-11th century AD, from Central and Eastern Europe and Byzantine Anatolia. Analysis of ancient DNA and bacterial cell wall lipid biomarkers revealed Mycobacterium leprae in skeletal remains from 6th-8th century Northern Italy, 7th-11th century Hungary, 8th-9th century Austria, the Slavic Greater Moravian Empire of the 9th-10th century and 8th-10th century Byzantine samples from Northern Anatolia. These data were analyzed alongside findings published by others. M. leprae is an obligate human pathogen that has undergone an evolutionary bottleneck followed by clonal expansion. Therefore M. leprae genotypes and sub-genotypes give information about the human populations they have infected and their migration. Although data are limited, genotyping demonstrates that historical M. leprae from Byzantine Anatolia, Eastern and Central Europe resembles modern strains in Asia Minor rather than the recently characterized historical strains from North West Europe. The westward migration of peoples from Central Asia in the first millennium may have introduced different M. leprae strains into medieval Europe and certainly would have facilitated the spread of any existing leprosy. The subsequent decline of M. leprae in Europe may be due to increased host resistance. However, molecular evidence of historical leprosy and tuberculosis co-infections suggests that death from tuberculosis in leprosy patients was also a factor.
authors: Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, UK. Electronic address: h.donoghue@ucl.ac.uk.
authors: Helen D
authors: HD
authors: Donoghue
authors: Department of Microbial and Cellular Science, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
authors: G
authors: G
authors: Michael Taylor
authors: University of Szeged, Mályva utca 23, H-6771 Szeged, Hungary.
authors: Antónia
authors: A
authors: Marcsik
authors: Department of Biological Anthropology, University of Szeged, Hungary.
authors: Erika
authors: E
authors: Molnár
authors: Department of Biological Anthropology, University of Szeged, Hungary.
authors: Gyorgy
authors: G
authors: Pálfi
authors: Department of Anthropology, Natural History Museum, Budapest, Hungary.
authors: Ildikó
authors: I
authors: Pap
authors: Department of Anthropology, Natural History Museum, Vienna, Austria.
authors: Maria
authors: M
authors: Teschler-Nicola
authors: School of Archaeology and Earth Institute, Belfield, University College Dublin, Dublin 4, Ireland.
authors: Ron
authors: R
authors: Pinhasi
authors: Department of Anthropology, Hacettepe University, Ankara, Turkey.
authors: Yilmaz S
authors: YS
authors: Erdal
authors: Department of Anthropology, National Museum, Prague, Czech Republic.
authors: Petr
authors: P
authors: Velemínsky
authors: Department of the Archaeology of Landscape and Archaeobiology, Institute of Archaeology, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
authors: Jakub
authors: J
authors: Likovsky
authors: Laboratorio di Bioarcheologia e Osteologia Forense, Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Via Selmi 3, 40126 Bologna, Italy; Centro Fermi, Piazza del Viminale 1, 00184 Rome, Italy.
authors: Maria Giovanna
authors: MG
authors: Belcastro
authors: Laboratorio di Bioarcheologia e Osteologia Forense, Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Via Selmi 3, 40126 Bologna, Italy; ADES, UMR 7268 CNRS/Université de la Méditerranée/EFS, Université de la Méditerranée, CS80011, Bd Pierre Dramard,13344 Marseille Cedex 15, France.
authors: Valentina
authors: V
authors: Mariotti
authors: Laboratorio di Bioarcheologia e Osteologia Forense, Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Via Selmi 3, 40126 Bologna, Italy.
authors: Alessandro
authors: A
authors: Riga
authors: Department of Archaeology, Foggia University, Tivoli, Italy; Anthropological Service of S.B.A.L. (Ministry of Culture), Rome, Italy.
authors: Mauro
authors: M
authors: Rubini
authors: Department of Archaeology, Foggia University, Tivoli, Italy.
authors: Paola
authors: P
authors: Zaio
authors: Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors: Gurdyal S
authors: GS
authors: Besra
authors: Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors: Oona Y-C
authors: OY
authors: Lee
authors: Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors: Houdini H T
authors: HH
authors: Wu
authors: Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors: David E
authors: DE
authors: Minnikin
authors: Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK.
authors: Ian D
authors: ID
authors: Bull
authors: Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, UK.
authors: Justin
authors: J
authors: O'Grady
authors: Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, UK; Department of Anatomy and Anthropology Sackler Medical School, Tel Aviv University, Israel.
authors: Mark
authors: M
authors: Spigelman
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D005260:Female; D005838:Genotype; D049691:History, Medieval; D063426:Human Migration; D006801:Humans; D007918:Leprosy / Q000453:epidemiology* / Q000266:history / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009166:Mycobacterium leprae / Q000235:genetics; D010164:Paleopathology; D055815:Young Adult
keywords: Ancient DNA; Genotyping; Human migrations; Lipid biomarkers; Mycobacterium leprae; Mycobacterium tuberculosis