Leprosy in individuals unearthed near the Ermida de Santo André and Leprosarium of Beja, Portugal

Abstract

Documentary sources refer to leprosy patients in the Portuguese territory since the first century AD, and in the Middle Ages around 70 leprosaria were established. However, prior to 2003 this historical evidence had not been confirmed by archeological findings. The excavation performed in monitoring the rehabilitation done by the Polis program in the area of the Ermida de Santo André (hermitage of Saint Andrew) allowed the exhumation of seven human skeletons, and commingled bones from at least three individuals, in the vicinity of the Beja leprosarium. The objective of this study is to present the paleopathological lesions relevant to the discussion of the differential diagnosis of leprosy. Macroscopic observation of the bones and scrutiny of lesions according to the paleopathological literature allowed the identification of a probable case of leprosy in an adult male, showing rhinomaxillary changes and concentric remodeling of hand and foot bones, and four possible cases (two young adults and two adults, all probably males), with a set of lesions in facial bones and skeletal extremities. The poor preservation of the bones precluded further confirmation of this diagnosis. According to historical data, the leprosaria functioned between the 14th and 16th centuries AD. The exact chronology of these findings was not determined either during the excavation or by radiocarbon dating because the bones presented poor collagen levels. In Portugal as a whole there are few osteological evidences of leprosy, and thus this study adds new information about this chronic infectious disease.

Mycobacterium leprae diversity and population dynamics in medieval Europe from novel ancient genomes

“…1). Direct dating of 14 individuals (Table 1) confirmed the archeological age estimations, except for sample PAVd'09_I.5 (Portugal) (Additional file 1: Supplementary Note 1) [1,21,30,31,35,50,.…”

“…Samples from a total of 41 individuals were investigated in this study (Additional file 1: Supplementary Note 1, Table S1 and S2) [1,21,30,31,35,50,. All but two individuals (JDS097 and BEL024) were previously associated with Hansen's disease due to either their archeological context or pathological lesions compatible with a diagnosis of Hansen's disease (Additional file 1: Supplementary Note 1) [1,21,30,31,35,50,, and archeologically dated from the Early Medieval period to the twentieth century (Table 1). Fifteen individuals were radiocarbon dated (Table 1, Additional file 1: Supplementary Note 2, Fig.…”

“…We were able to detect ancient M. leprae DNA in libraries from 20 (~48.8%) individuals from ten archeological sites, spanning the period of the sixth-seventh centuries CE to the twentieth century (Additional file 1: Supplementary Note 1, Table S1 and S2) [1,21,30,31,35,50,; 19 of these yielded sufficient M. leprae DNA for genome reconstruction. The individuals positive for M. leprae represent a variety of geographical regions located in six modern day European countries (Fig.…”

“…Of the archeological cemeteries not related to a leprosarium where Hansen's disease has been identified in skeletons, the majority show that infected people were buried in the common manner for their location and time period [1]. For medieval Europe, this includes, for example, Norwich, England [29]; Kirk Hill, Scotland [30,31]; multiple sites in Schleswig, Denmark/ Germany [32]; Seville [33] and Gijon in Spain [34]; Beja, Portugal [35], and Kaldus, Poland [36]-see also [1] for a global view.…”

Severe erosive polyarthritis in a human skeleton dated to the early modern period of Japan

“…In addition, reactive arthritis (ReA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA), which are all classified under a somewhat more nonspecific name of SA, need to be considered as well (Ortner, 2003;Rothschild and Behnam, 2005;Buckley, 2007;Tokunaga and Kubo, 2008;Waldron, 2009;Kacki et al, 2013;Antunes-Ferreira et al, 2013).…”