Treponemal Disease Research Articles

Treponemal infection in Peru's Early Colonial period: A case of complex lesion patterning and unusual funerary treatment

This study describes a series of skeletal lesions observed in a mid 16th century individual of an old adult female from the Early Colonial Period of northern coastal Peru. This fragmented skeleton revealed evidence of complex, active, and systemic chronic infection that included multiple pathological foci on the cranial vault, extensive pathological new bone formation in both arms, the sternum, ribs, left scapula, clavicles, femora, and fibulae, which was paralleled by extensive endosteal obliteration of affected long bone medullary cavities. Differential diagnosis included hematogenous osteomyelitis, Paget's disease, fluorosis, melorheostosis, endosteal hyperostosis, and hypertrophic osteoarthropathy. Simultaneous periosteal and endosteal bone deposition of the clavicles, in addition to patterns of florid bone deposition on long bones and superficial cavitation, point most directly to treponemal disease. Co-morbidity with a non-specified respiratory disease and well-healed fractures of the tibiae are also considered. We also relate this person's illness to the highly informal disposal of their body to underscore how social perceptions of disease may have shaped this unusual and informal funerary ritual. Ultimately, this research cautions against overly “tibia-centric” thinking regarding treponemal syndromes, raises questions regarding the history and nature of treponemal disease in Peru, and highlights cross-disciplinary connections between paleopathology and mortuary archaeology.

Subsistence and Settlement Correlates of Treponemal Disease: Temporal Patterns in Pre-Columbian East Tennessee

After ca 1000 BC, coinciding with the transition to sedentism, tertiary stage treponemal disease apparently becomes osteologically pervasive in pre-Columbian North America. However, varying interobserver treponemal disease diagnostic thresholds, sampling error and the possibly ecosensitive nature of the pre-Columbian nonvenereal treponemal disease variants (i.e. yaws and treponarid) prevents subsistence-settlement pattern from becoming a reliable predictor of treponemal disease prevalence. This is particularly true of later prehistory with the transition from horticulture to intensive, maize-based agriculture. To address whether treponemal disease visibility does vary across this specific subsistence-settlement threshold, subadults (4+ years of age) and adults from 11 late prehistoric sites (N = 997) from the same geographic area of East Tennessee were sampled for the presence of treponemal disease. Six sites (N = 279) primarily date to the Late Woodland period (AD 700–900) and culturally belong to what is referred to as the Hamilton mortuary complex. The sample is archaeologically characterised as horticulturalist with presumably a dispersed farmstead or hamlet settlement pattern. Six sites (N = 718) date to the Late Mississippian (AD 1300–1550, Dallas phase) and are maize-intensive agriculturalists with a large, aggregate village settlement pattern. The sites were examined using three different levels of treponemal disease diagnostic confidence. Treponemal disease raw frequency does indeed differ across the levels of diagnostic confidence between the total Late Woodland horticulturalist sample (4.3–5.5%) and total Late Mississippian maize agriculturalist sample (5.4–6.5%). The meaning is complex as the Dallas phase sample may have a socially segregated elite; the mound-interred (1.8%) relative to the village-interred (6.1–7.4%) exhibited significantly fewer cases of treponemal disease. Tentatively, treponemal disease visibility does appear to co-associate with sedentism and perhaps (if the mound-interred Dallas individuals are elites) also aggregated settlement. Copyright © 2013 John Wiley & Sons, Ltd.

Treponemal Disease, Tuberculosis and Subsistence‐settlement Pattern in the Late Woodland Period West‐central Illinois

AbstractIn later pre‐Columbian prehistory (post AD 1000), the adaptation and intensification of maize agriculture and its correlate of aggregate village settlement (i.e. Mississippianization) is temporally and geographically variable. In the Midwest, consequential to the florescence of the major ceremonial centre of Cahokia (AD 1050–1300), the Mississippi River Valley alluvial plain in Illinois, known as the American Bottom, became a core area of this subsistence‐settlement change. Much archaeological research has traced aspects of this transition in the Lower and Middle Illinois River Valley, but little is known outside of these areas. A skeletal sample from the remote hinterland area of the Upper Mississippi River in west‐central Illinois was examined for arguable paleopathological correlates of sedentism (treponemal disease) and Mississippianization (tuberculosis). The Schroeder Mounds (AD 900–1100) adult skeletal sample (N = 53) exhibited a high frequency of treponemal disease (13.2–15.1%). This result is consistent with paleopathological literature linking a 9+ % pre‐Columbian North American prevalence with sedentism, challenging archaeologically based inferences that the hinterland was occupied by mobile forager‐horticulturalists. A hallmark of Mississippianization is the presence of diagnostic cases of tuberculosis. No cases were observed in the Schroeder sample, suggesting a pre‐Mississippian subsistence‐settlement pattern. Copyright © 2013 John Wiley & Sons, Ltd.

Temporal and Spatial Distribution of Treponemal Infection in South Florida: An Epidemiological Approach

AbstractBioarchaeological analysis of the MDM site (8DA11) in Miami, Florida (ad 400–1200) has identified human skeletal remains with lesions suggestive of and consistent with treponematosis. A population and epidemiological approach was utilised to compare the MDM site to geographically neighbouring skeletal samples from the Highland Beach mound (8PB11) (ad 600–1200) and Fort Center (8GL12) (ad 1–500/1000). These samples were then integrated with data from previous research on proliferative skeletal lesion prevalence on the Gulf Coast of Florida. Population comparisons suggest a higher prevalence of proliferative skeletal lesions in Atlantic coastal populations as opposed to the nearest sampled site from the interior (p < 0.00001), a trend seemingly different from Gulf Coast populations. This investigation details the presence of treponemal disease in the Everglades archaeological region likely as early as ad 400, and the southern terminus in the contiguous United States that treponematosis has been reported. Copyright © 2013 John Wiley & Sons, Ltd.

Pre-Columbian treponemal infection in Denmark?- a paleopathological and archaeometric approach

The aim of this paper is to investigate five new cases of possible treponematosis in early medieval Denmark. A total of 1018 skeletons from Danish and present day German cemeteries have been examined, and five candidates of pre-Columbian individuals have been selected from three Danish burial sites on Funen, Jutland and Zealand. The five individuals with a possible infection with treponematoses have been analysed anthropological and chemically.Two of the skeletons exhibited cranial lesions, i.e. serpiginous and focal superficial cavitation. The other three only displayed periosteal reactions of varying degrees on the postcranial skeleton. Computed tomography scans showed focal obliteration of the periosteum on the long bones as well as on the affected skulls. Radiocarbon dates and stable isotope analyses indicate that three of the four analysed skeletons predate AD 1493. High levels of mercury in three of the individuals suggest that medical treatment with Hg-containing medicine took place.Considering the climate and geography at the sites, venereal syphilis might be the treponemal disease causing the pathologies on the skeletal remains. However, the historical background, the bone lesions and their prevalence point to the presence of a less aggressive, maybe non-venereal, form of treponematosis. Consequently, the hypothesis that pre-Columbian venereal syphilis existed among the analysed skeletal material is rejected with the help of various archaeometric analyses.

Isotopic tracing of the impact of mobility on infectious disease: The origin of people with treponematosis buried in hull, England, in the late medieval period

Treponematosis has been one of the most studied and debated infectious diseases in paleopathology, particularly from the standpoint of its origin, evolution, and transmission. This study links evidence for treponematosis in skeletons from the 14th-16th century AD cemetery of the Augustinian friary of Hull Magistrates Court, England, with data from stable isotope analysis to test the hypothesis that the people with treponemal disease buried at this site were not locally born and raised. The objective is to explore the potential of using stable isotope data to track the place of origin and extent of mobility of individuals with an infectious disease. Dental enamel samples of 12 skeletons were selected for strontium ((87) Sr/(86) Sr ratio) and oxygen (δ(18) O) stable isotope analysis based on the presence (six - diseased) or absence (six - controls) of bone changes associated with treponemal disease. The oxygen isotope ratios of all but three individuals (1047, 1121, 823) overlapped at two standard deviations with the inferred local precipitation range, and only one individual (1216) had a strontium isotope ratio outside the regional range. Two of the four had probable/possible treponemal bone changes. Those with treponemal bone changes were not demonstrably more likely to be migrants than those without such lesions. However, because of extensive documentary evidence for trade with the Baltic Sea area, and for merchants from towns such as Stralsund, Danzig and Elbing being in Hull, it is very plausible that the four migrants came from the Baltic area or even southern Sweden.

Correspondence: Probable and Possible Cases of Treponematosis: A Response to the Comment ‘A Possible (But not Probable) Case of Treponemal Disease’ by Harper, Zuckerman and Armelagos

International Journal of OsteoarchaeologyVolume 23, Issue 5 p. 628-629 Commentary Correspondence: Probable and Possible Cases of Treponematosis: A Response to the Comment ‘A Possible (But not Probable) Case of Treponemal Disease’ by Harper, Zuckerman and Armelagos S. Mays, Corresponding Author S. Mays Archaeological Science, English Heritage, Fort Cumberland, Portsmouth, PO4 9LD UK Correspondence to: Archaeological Science, English Heritage, Fort Cumberland, Eastney, Portsmouth P049LD. e-mail: [email protected]Search for more papers by this authorS. Vincent, S. Vincent Archaeological Science, English Heritage, Fort Cumberland, Portsmouth, PO4 9LD UKSearch for more papers by this author S. Mays, Corresponding Author S. Mays Archaeological Science, English Heritage, Fort Cumberland, Portsmouth, PO4 9LD UK Correspondence to: Archaeological Science, English Heritage, Fort Cumberland, Eastney, Portsmouth P049LD. e-mail: [email protected]Search for more papers by this authorS. Vincent, S. Vincent Archaeological Science, English Heritage, Fort Cumberland, Portsmouth, PO4 9LD UKSearch for more papers by this author First published: 16 September 2011 https://doi.org/10.1002/oa.1282Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume23, Issue5September/October 2013Pages 628-629 RelatedInformation

"Like a virgin": Absence of rheumatoid arthritis and treponematosis, good sanitation and only rare gout in Italy prior to the 15th century.

This study was conducted to test several hypotheses: 1. That rheumatoid arthritis and syphilis were New World diseases, only transmitted to the Old World subsequent to the passages of Christopher Columbus; 2. To indirectly test the hypothesis that lead poisoning was prevalent in Roman Italy by looking for its byproduct, gout; 3. To test the hypothesis of compromised sanitation in ancient Italy, on the basis of spondyloarthropathy frequency; and 4. To assess variation of trauma frequencies in ancient Italy, by examining frequency of focal periosteal reaction. Skeletons from sites ranging from the Bronze Age to the Black Plague epidemic of 1485-1486 were macroscopically evaluated for focal periosteal reaction and for the cardinal signs of rheumatoid arthritis, treponemal disease, gout and spondyloarthropathy. Examination of 688 individuals revealed low frequency of focally distributed periosteal reaction (bumps) in sites dated from the 3400-700 years before present, sharply increasing in the 15th century. Diffuse periosteal reaction was present only as isolated occurrences secondary to hypertrophic osteoarthropathy and sabre shin reaction was notably absent. Erosive disease was uncommon and always oligoarticular in distribution. No marginal erosions were present, with the exception of an isolated metatarsal with classic overhanging edge sign of gout. Subchondral erosions, peripheral joint fusion and axial skeletal involvement identified spondyloarthropathy frequencies of 1-3%, independent of the antiquity of the site. Italy, prior to Columbus was like a virgin. Rheumatoid arthritis and treponemal disease (specifically syphilis) were not present, further supporting the contention that they are New World-derived diseases. Periosteal signs of minor trauma were rare prior to fifteenth century plague times. This suggests a potential role of domestic (as opposed to outside environment activities) in is development. The hypothesis for a role of lead poisoning in the demise of the Roman Empire is falsified by the rarity of gout. The frequency of spondyloarthropathy was significantly below that found in sanitarily challenged populations, suggesting high standards of hygiene in ancient Italy.

The origin and antiquity of syphilis revisited: An Appraisal of Old World pre‐Columbian evidence for treponemal infection

For nearly 500 years, scholars have argued about the origin and antiquity of syphilis. Did Columbus bring the disease from the New World to the Old World? Or did syphilis exist in the Old World before 1493? Here, we evaluate all 54 published reports of pre-Columbian, Old World treponemal disease using a standardized, systematic approach. The certainty of diagnosis and dating of each case is considered, and novel information pertinent to the dating of these cases, including radiocarbon dates, is presented. Among the reports, we did not find a single case of Old World treponemal disease that has both a certain diagnosis and a secure pre-Columbian date. We also demonstrate that many of the reports use nonspecific indicators to diagnose treponemal disease, do not provide adequate information about the methods used to date specimens, and do not include high-quality photographs of the lesions of interest. Thus, despite an increasing number of published reports of pre-Columbian treponemal infection, it appears that solid evidence supporting an Old World origin for the disease remains absent.

A case of treponematosis from pre-Columbian Chaco Canyon, New Mexico

Although numerous cases of treponemal infection have been identified in prehispanic New World skeletal remains, none has been reported from Chaco Canyon, New Mexico. Chaco Canyon was the epicentre of a broad culture system that spanned the Four Corners region of the pre-Columbian Southwestern United States. A burial recovered from the central Great House of Chaco Canyon, Pueblo Bonito, exhibits lesions indicative of treponematosis. However, the pathological condition of this individual has heretofore been only tentatively diagnosed because the skeleton was collected from a commingled context and distributed across four separate catalogue numbers. Now reassociated, these remains exhibit a pattern of pathological changes strongly indicative of treponemal disease. This case not only adds to the growing body of literature on the clinical expression and geographic distribution of pre-Columbian treponematosis, but also demonstrates the utility of painstaking reassociation of commingled human remains. Copyright © 2009 John Wiley & Sons, Ltd.

Large lytic cranial lesions: A differential diagnosis from pre‐Angkorian Cambodia

ABSTRACTA late pre‐Angkorian period, c. 350 BC ‐ 200 AD, cemetery has been excavated in the village of Phum Snay, in northwestern Cambodia. In addition to the cemetery sample, a large sample of stratigraphically unprovenanced human skeletal material was uncovered in the village through extensive looting over the last 5–10 years. Both sample sets were available for study but the latter is comprised of only isolated bone elements. The differential diagnosis of the cause of lesions in one isolated cranial vault from this sample is presented here. Widespread, primarily lytic, lesions are concentrated on the frontal and anterior parietal bones, with an additional large lesion on the occipital bone. Lesions vary in size ranging from approximately 5–30 mm in diameter. A detailed description of these lesions is given and a differential diagnosis is presented that includes infectious disease, such as osteomyelitis, tuberculosis and treponemal disease, and also several forms of cancer including metastatic carcinoma, meningioma and multiple myeloma, and finally Langerhans Cell Histiocytosis. The diagnosis is difficult, given the lack of material, but it is suggested that one of the forms of Langerhans Cell Histiocytosis is the most likely candidate. The presence of such large and diffuse lesions is unusual in prehistoric Southeast Asia so the significance of this is also discussed. Copyright © 2010 John Wiley & Sons, Ltd.

A possible case of treponemal disease from England dating to the 11th–12th century AD

ABSTRACTThis short report describes a human skeleton from an archaeological site in England showing signs of treponemal disease. A radiocarbon determination indicates that it is firmly pre‐Columbian in date. The implications for recent debates concerning the origin of treponemal disease in Europe are discussed. Copyright © 2010 John Wiley & Sons, Ltd.

Differential visibility of treponemal disease in pre‐Columbian stratified societies: Does rank matter?

Treponemal disease is known to be associated with the compromised community health of permanent village settlement. This association explains its high visibility in the village-based, arguably chiefdom level, agriculturalist societies of late prehistoric (AD 1300-1600) North America. Within chiefdom-level societies, health differences have often been demonstrated between mortuary-defined "elite" and "nonelite" individuals. This theoretically should predict status-based differences in treponemal disease visibility. The prediction is tested in a five-site osteological sample (N = 650) from the Dallas phase (AD 1300-1550), a simple mortuary-defined two-tiered presumptive chiefdom level maize agriculturalist socioeconomic context from lower east Tennessee. The Dallas phase results affirm a general pre-Colombian North American pattern of no sex differences and display comparable adult to subadult frequencies. The study also reveals that given a sufficient sample size, "elites" do indeed exhibit a significantly lower frequency of tertiary stage treponemal disease. This can be attributed to better baseline health, which has been previously demonstrated in this sample. It may also be affected by the mortuary inclusion of achieved status individuals whose good health may have facilitated sociopolitical advancement. Another pattern that emerged is an apparent young adult age bias in disease visibility. This suggests that tertiary treponemal disease morbidity may either directly or synergistically factor in early adult age at death. Future research will address the veracity of this association.

Apple Down 152: A putative case of syphilis from sixth century AD Anglo‐Saxon England

This report describes a putative case of a treponemal infection observed on a skeleton of a young male adult from the Apple Down Anglo-Saxon cemetery dating to the sixth century AD, accompanied by grave goods indicative of a high status burial. The skeleton is well preserved and almost complete. The pathological evidence includes an extensive area of lytic destruction to the frontal bone of the skull, widespread profuse bilateral symmetrical periosteal reaction affecting scapulae, clavicles, arms, legs, hands, feet and ribs. There is also evidence of gummatous destruction on some of the long bones. Application of a differential diagnosis of all probable diseases exhibiting the individual symptoms leads to a clear conclusion that the person was infected with a treponemal pathogen. The skeleton shows none of the stigmata associated with the congenital form of treponemal disease. We propose that the evidence suggests a possible case of venereal syphilis rather than one of the endemic forms of treponemal disease. This diagnosis is based on the geographical pathogen range, the apparent low prevalence of the disease, significant social upheaval at the time, the high social status and early age of death of the individual.

Ancient Skeletal Evidence for Leprosy in India (2000 B.C.)

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.

Paget's disease in pre‐contact Florida? Revisiting the Briarwoods site in Gulf coast Florida

AbstractThis report presents results of a reanalysis addressing the presence of Paget's disease (Osteitis deformans) in the pre‐contact Safety Harbour Briarwoods site (8PA66), a burial mound in Pasco County along Gulf coast Florida, dating around 1000–1500 AD. Due to the paucity of published histological and radiological analyses as well as the suspect nature of this Paget's disease report, a new study was conducted. The diagnosis was suspect for three reasons. First, the original diagnosis was based on five skeletal fragments from five different burials making the results questionable. Secondly, Paget's disease is very similar to treponemal disease and can possibly be misdiagnosed. The characteristic histological mosaic pattern found in Paget's disease provides the most definitive differential diagnosis. Thirdly, Paget's disease is found primarily in European populations and this is a pre‐contact site. Histological sections from the suspected Pagetic bones were analysed for the presence of the mosaic pattern. Macroscopic and microscopic analyses were unable to support or deny the presence of Paget's disease due to the fragmentary nature of the skeletal elements as well as extensive diagenesis resulting from exposure to the environment. The presence of Paget's disease could not be confirmed or refuted at Briarwoods due to extensive taphonomic damage. However, it is suggested that the presence of treponemal disease should be investigated because although not originally reported, the presence of saber‐shin tibiae consistent with this disease are present at this site. Copyright © 2009 John Wiley & Sons, Ltd.

Technical note: A revised radiocarbon date for a case of treponemal disease from Safed, Israel, from the 15th Century AD

Technical note: A revised radiocarbon date for a case of treponemal disease from Safed, Israel, from the 15th Century AD

Adding insult to injury: opportunistic treponemal disease in a scalping survivor

AbstractAlthough the taking of scalps is arguably a perimortem trophy‐taking behaviour, cases of scalping survival are occasionally reported in the historical documents of the American Colonial Period and the 19th century westward expansion. Survival cases are also detected in pre‐Columbian bioarchaeological contexts. Although scalp avulsion injuries can heal without complication, often the process is compromised by secondary osteomyelitis, usually attributable to environmentally ever‐present Staphylococcal or Streptococcal bacteria. A scalping survivor case from the late prehistoric (AD 1200–1600) Hampton site (40RH41) of East Tennessee unusually displays infectious sequelae in the area denuded by scalp avulsion which are pathognomonic for treponemal disease (caries sicca, stellate scarring). This infection is probably a reflection of the easy opportunity afforded by the large size of the wound bed, poor post‐trauma hygiene, and direct inoculation of the diploë by a ubiquitous Treponema. Copyright © 2008 John Wiley & Sons, Ltd.

The Myth of syphilis: the natural history of treponematosis in North America

Exploring the long-standing question of the origins of syphilis, this book proposes a new understanding of the dynamic interactions of disease and culture in the New World. It brings together a complete picture of the diverse pathological evidence of a bacterial disease - treponematosis - manifest in the North American archaeological record at the time of Christopher Columbus's first journey, and it presents a strong argument against the earlier identification of modern venereal with indigenous North American treponemal disease. For almost 500 years, native North Americans have been blamed for giving the world syphilis and by implication accused of sexual immorality. Contributors to this volume identify and investigate the origins and various manifestations of all ranges of treponemal diseases across the continent and show that the true picture of disease evolution is both different and far more interesting than past scholarship suggests. They summarize current archaeological and historical information from a variety of regions and times, both before and after 1492, and consider closely the specific question of whether evidence exists for the presence of the venereal form of treponemal disease that would be equivalent to the venereal that ravaged 16th-century Europe. Their investigation challenges the unequivocal identification of all pre-Columbian treponemal disease as venereal syphilis.

Treponemal disease in the middle Archaic to early Woodland periods of the western Tennessee River Valley

The high frequency of late prehistoric New World treponemal disease is attributable to the demographic changes concomitant with the adoption of agriculture. However, these demographic changes in group mobility and site density episodically preceded intensive plant domestication, suggesting possible staggered temporal change in observed treponemal disease case frequency. Thirteen convincing and an additional two probable (N = 581) cases of treponemal disease were identified in an eight-site skeletal sample spanning the Middle (6,000-3,000 BCE) to Late (2,500-ca. 1,000 to 500 BCE) Archaic and Early Woodland (500 BCE-0 CE) periods from the western Tennessee River Valley. Treponemal disease cases are infrequent in both the Middle (3/115, 2.6%) and Late (2 to 4 cases, <or=1%, N = 378) Archaic horizons, and more frequent (8/88, 9.1%) in the Early Woodland horizon. As the subsistence economy across the Archaic-Woodland temporal boundary in the western Tennessee River Valley remained, as elsewhere, based on intensive hunting and collecting, the demographic corollaries of treponemal disease would apparently not be met. However, the traditional horizon marker of the Woodland period is the adoption of pottery, an activity associated with sedentism.