Abstract
AbstractLeprosy is a chronic infectious disease caused by Mycobacterium leprae that affects almost 500,000 people worldwide^1^. The timing of first infection, geographic origin, and pattern of transmission of the disease are unknown^1-3^. Comparative genomics research has recently suggested M. leprae evolved in East Africa or South Asia before spreading to Europe and the rest of the World^4-5^. The earliest accepted textual evidence indicates that leprosy existed in India by at least 600 B.C. and was known in Europe by 400 B.C.^6-7^. The earliest skeletal evidence was dated 300-200 B.C. in Egypt^8^ and Thailand^9^. Here, we report the presence of lepromatous leprosy in skeletal remains from Balathal, a Chalcolithic site (2300-1550 B.C.) in India^10-11^. A middle aged adult male skeleton demonstrates manifestations of facies leprosa and rhinomaxillary syndrome, degenerative joint disease, infectious involvement of the tibia (periostitis), and injury to the peripheral skeleton, often the result of skin anaesthesia. Paleopathological analysis indicates that lepromatous leprosy was present in India by 1800 B.C., a result which supports some translations of the Atharva Veda that reference leprosy and its treatment in hymns composed before the first millennium B.C.^12^. The presence of leprosy in Chalcolithic India suggests M. leprae may have been transmitted during the second or third millennium B.C., at a time when there was substantial interaction between South Asia, West Asia, and Northeastern Africa^13^. This evidence should be impetus to look for additional skeletal and molecular evidence of leprosy in human remains from this time period in India and Africa to confirm the origin of the disease.
Highlights
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, that affects almost 500,000 people worldwide.[1]
There is evidence that Leprosy was referenced in an Egyptian papyrus dated to 1550 B.C.,7 some translations suggest it is mentioned in ancient Indian hymns composed before the first millennium B.C.,12 and there may be references in the Old and New Testaments of the Bible[3] but this evidence is controversial.[3]
The earliest writings that have widely accepted references to the disease are from the South Asian texts Sushruta Samhita and Kautilya’s Arthashastra dated to the 6th century B.C. 2, 4th century accounts of the Greek author Nanzianos[5], a 3rd century Chinese text Shuihudi Qin Jian[6], and 1rst century A.D
Summary
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, that affects almost 500,000 people worldwide.[1].
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