Leprosy in the early medieval Lauchheim community

Abstract

Leprosy was a well-recognized and dreaded disease in medieval Europe (5th-15th century AD). It is reported to have reached Germany with the Roman invasion. A much larger fraction than previously assumed appears to have been affected by leprosy in the medieval period. This article estimates the frequency (i.e., the prevalence at death) of leprosy among adult people buried in the Lauchheim early medieval cemetery. Seven different dichotomous osteological lesions indicative of leprosy are analyzed, and it is possible to score at least one of these conditions on 110 adult skeletons (aged 15 or more). The scores were transformed to a statistic--lambda (lambda)--indicating the likelihood that the person to whom the skeleton belonged suffered from leprosy. The analyses indicate that 16% (95% confidence interval: 9-23%) of adult people in Lauchheim died with osteological signs of leprosy. Leprosy was significantly more prevalent among men than women. The lambda statistic indicates that people who died with signs of leprosy did not differ in the distribution of age at death from those who did not have such signs. Some of the leprosy-related lesions had a statistically significant nonrandom dispersal on the cemetery; but there is no clear pattern to this and the significant results could be easily attributed to a type-1 error in the statistical analysis.

Detection of Mycobacterium leprae DNA from Archaeological Skeletal Remains in Japan Using Whole Genome Amplification and Polymerase Chain Reaction

“…Although subperiostal exostoses and/or hypertrophy accompanied by swelling or porotic hyperosteosis of the fibula are reported as the typical signs of leprosy [6], [7], the presence of M. leprae DNA in the fibula was somewhat surprising to us because apparent fibular lesion is not common in leprosy patients at present. It is well known that the common fibular nerve is one of the sites preferably affected by M. leprae, which causes foot drop in the patient [30].…”

“…Additionally, in advanced cases M. leprae infection causes specific osteological deformations in the areas of the nasal aperture, anterior nasal spine and alveolar process on the premaxilla, cortical areas of the tibia and fibula, distal ends of the metatarsals and diaphyses of the phalanges that may include both direct and reactive changes [6], [7], [8], [9], [10]. Paleopathological diagnosis of leprosy has been made solely based on these macroscopic changes in skeletal remnants.…”

Convento di San Francesco a Folloni: the function of a Medieval Franciscan Friary seen through the burials

“…Once this frequency is estimated, individual skeleton disease status can be assessed-of course as probability statements. This approach has been developed and described previously [15][16][17].…”

An Epidemiological Approach to Paleopathology

“…The outlook is, in fact, unexpectedly bright. While considerable work remains to be done, progress has been made in recent years toward reaching this ambitious goal (Usher 2000;Boldsen 2001Boldsen , 2005aBoldsen , 2005bBoldsen , 2008DeWitte and Wood 2008;DeWitte and Bekvalac 2010;also Lynnerup and Boldsen, Chapter 25 in this volume).…”

“…One such research effort has focused on leprosy in medieval Europe (Boldsen 2001(Boldsen , 2005a(Boldsen , 2005b(Boldsen , 2008Boldsen and Mollerup 2006). The means of measuring the effects of leprosy on medieval European populations, using archaeological skeletal samples, is based on Usher's (2000) model featuring three states: well, sick, and dead (Figure 7.3).…”