Abstract
BackgroundLeprosy is a chronic infectious disease caused by Mycobacterium leprae that affects almost 250,000 people worldwide. The timing of first infection, geographic origin, and pattern of transmission of the disease are still under investigation. Comparative genomics research has suggested M. leprae evolved either in East Africa or South Asia during the Late Pleistocene before spreading to Europe and the rest of the World. The earliest widely accepted evidence for leprosy is in Asian texts dated to 600 B.C.Methodology/Principal FindingsWe report an analysis of pathological conditions in skeletal remains from the second millennium B.C. in India. A middle aged adult male skeleton demonstrates pathological changes in the rhinomaxillary region, degenerative joint disease, infectious involvement of the tibia (periostitis), and injury to the peripheral skeleton. The presence and patterning of lesions was subject to a process of differential diagnosis for leprosy including treponemal disease, leishmaniasis, tuberculosis, osteomyelitis, and non-specific infection.Conclusions/SignificanceResults indicate that lepromatous leprosy was present in India by 2000 B.C. This evidence represents the oldest documented skeletal evidence for the disease. Our results indicate that Vedic burial traditions in cases of leprosy were present in northwest India prior to the first millennium B.C. Our results also support translations of early Vedic scriptures as the first textual reference to leprosy. The presence of leprosy in skeletal material dated to the post-urban phase of the Indus Age suggests that if M. leprae evolved in Africa, the disease migrated to India before the Late Holocene, possibly during the third millennium B.C. at a time when there was substantial interaction among the Indus Civilization, Mesopotamia, and Egypt. This evidence should be impetus to look for additional skeletal and molecular evidence of leprosy in India and Africa to confirm the African origin of the disease.
Highlights
Leprosy is a debilitating but treatable disease caused by infection with Mycobacterium leprae
While it has long been thought that leprosy originated in the Old World [5], less is known about the origin and prehistoric transmission routes for leprosy than other related infectious diseases [53]
As the Sanskrit word kushtha referred to a plant used to treat leprosy and tuberculosis [7], the Atharva Veda is the earliest text to infer a connection between the two conditions, at least in terms of treatment
Summary
Leprosy is a debilitating but treatable disease caused by infection with Mycobacterium leprae. An understanding of the origin and transmission routes of this disease can potentially lead to new insights about the evolution of infectious diseases and eradication efforts. The disease is difficult to culture in vitro and much about leprosy is still poorly understood, including the origin, initial transmission routes, and timing for the spread of the disease in the Old World. The earliest textual references to leprosy are found in protohistoric texts, including the Egyptian Ebers papyrus dated to 1550. Leprosy is a chronic infectious disease caused by Mycobacterium leprae that affects almost 250,000 people worldwide. The timing of first infection, geographic origin, and pattern of transmission of the disease are still under investigation. The earliest widely accepted evidence for leprosy is in Asian texts dated to 600 B.C
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