A Mediaeval Case of Lepromatous Leprosy from 13–14th Century Orkney, Scotland

doi:10.1006/jasc.1999.0532

Journal of Archaeological Science

Volume 27, Issue 12, December 2000, Pages 1133-1138

https://doi.org/10.1006/jasc.1999.0532 Get rights and content

Abstract

Erosion in the 1960s resulted in exposure of human skeletal remains from a Norse Christian cemetery at Newark Bay, Orkney, Scotland. One set of remains showed osteological evidence of advanced lepromatous leprosy, but the absence of bones from the lower limbs precluded definitive diagnosis. The aim of the present study was to determine whether Mycobacterium leprae could be detected in bone extracts, as a means of confirming the diagnosis of leprosy. Bone samples were examined from the suspected leprosy case and from a second contemporary burial thought to be free of disease. DNA was amplified by polymerase chain reaction (PCR) using primers specific for a repetitive element (RLEP) characteristic of M. leprae. Additional PCR tests specific for Mycobacterium tuberculosis and for amelogenin (a human gene suitable for sex determination) were also applied to the samples. M. leprae DNA was detected only in the skull sample from the suspected leprosy case. The DNA sequence was identical to that found in present day isolates of M. leprae. Positive results were obtained only using a PCR reaction designed to amplify relatively short stretches of DNA (<175 bp), suggesting the microbial DNA had undergone extensive fragmentation. There was no evidence of M. tuberculosis DNA in bones from the leprosy suspect or control individual. The ability to recover ancient samples of DNA provides an opportunity to study long-term evolutionary changes that may affect the epidemiology of microbial pathogens.

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An important adjunct to palaeopathological analysis has therefore been provided by the detection and sequencing of M. leprae DNA, which is sometimes preserved in archaeological skeletons displaying osteological lesions and has also occasionally been detected in skeletons free from such lesions (Donoghue et al., 2017). Initially, ancient DNA typing was used mainly to support osteological identifications of leprosy (Rafi et al., 1994; Taylor et al., 2000, 2006; Donoghue et al., 2001, 2005; 2015; Inskip et al., 2015), but with increasing knowledge of genomic diversity among extant M. leprae strains it has become possible to contextualise ancient DNA data within an evolutionary scheme for the bacterium (Schuenemann et al., 2018). The M. leprae genome is 3.27 Mb, substantially smaller than the 4.42 Mb genome of Mycobacterium tuberculosis, and contains a relatively high number of pseudogenes, indicative of reductive evolution (Singh and Cole, 2011).
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The earliest recorded case of lepromatous leprosy in continental Croatia
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Cases of lepromatous leprosy have occasionally been recorded in prehistoric and antique series (Molto, 2002; Mariotti et al., 2005; Robbins et al., 2009; Köhler et al., 2017), but the vast majority of cases in Europe occurred during the Medieval period. Cases are reported from Italy (Belcastro et al., 2005; Rubini and Zaio, 2009; Rubini et al., 2012), Portugal (Antunes-Ferreira et al., 2013), Hungary (Pálfi, 1991; Marcsik et al., 2002; Pálfi et al., 2002; Donoghue et al., 2015), the Czech Republic (Strouhal et al., 2002; Likovsky et al., 2006), Scandinavia (Andersen, 1969; Arcini, 1999; Boldsen, 2005; Boldsen and Mollerup, 2006), and the United Kingdom (Manchester, 1981; Roberts, 1986, 2002; Farley and Manchester, 1989; Taylor et al., 2000; Rawcliffe, 2006). Four cases, dated to the period between the 8th–9th centuries CE have been recorded in Croatia (Šlaus, 2006).
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Regular ArticleA Mediaeval Case of Lepromatous Leprosy from 13–14th Century Orkney, Scotland

Abstract

Journal of Archaeological Science

Journal of Archaeological Science

Cambridge Encyclopedia of Palaeopathology

Radiocarbon dating and marine reservoir correction of Viking age and Medieval Christian burials from Orkney

Antiquity

Clinical manifestation of leprous rhinitis

Annals of Otology, Rhinology and Laryngology

The Palaeopathology of early British man: An essay on the problems of diagnosis and analysis

Journal of the Royal Anthropological Institute of London

On a mycoform structure in Orkney, and its relevance to possible further interpretations of so-called souterrains

Bulletin of the Institute of Archaeology, London

Digging Up Bones. 3rd edition

Sectionsbefunde aus dem leprosarium zu Riga

St Petersberg Medicinsche Wochenscrift

The Medieval Hospitals of England

Two Anglo-Saxon cemeteries at Beckford, Hereford and Worcester

CBA Research Volume

The Mycobacterium leprae genome: Systematic sequence analysis identifies key catabolic enzymes, ATP-dependent transport systems and a novel polA locus associated with genomic variability

Molecular Microbiology

Macrophage NRAMPI and its role in resistance to microbial infections

Inflammation Research

The cemetery of the Hospital of St James and St Mary Magdelene, Chichester

World Archaeology

Tuberculosis and Leprosy: Evidence for interaction of disease

Regular Article
A Mediaeval Case of Lepromatous Leprosy from 13–14th Century Orkney, Scotland