The 82nd Annual Meeting of the American Association of Physical Anthropologists (2013)

The people behind the pox: paleoepidemiological approaches to treponemal disease


1Department of Anthropology and Middle Eastern Cultures, Mississippi State University, 2Department of Environmental Health Sciences, Columbia University

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Debate over the origin and antiquity of syphilis has long acted as a stimulus for research in biological anthropology and paleopathology. However, paleopathology has only been able to meaningfully address major questions about the evolution of health and disease by moving away from case studies towards population-based analyses. In keeping with this, we propose here a repositioning of this debate away from its historical focus on the diagnosis of individual cases and towards paleoepidemiological analysis of whole populations over multiple regions. Syphilis and the other treponematoses are infectious diseases, and clinical studies show that when present, they should infect a substantial portion of the population. Here, we present a discussion of the advantages and disadvantages of this approach. This features a series of short case studies focused on treponemal disease from the UK and other regions which feature original and re-analyzed data, and demonstrate how amassing large numbers of affected skeletons enables researchers to draw novel conclusions regarding host characteristics and disease manifestations. Additionally, we present novel paleoepidemiological calculations that demonstrate the sample sizes necessary to carry out such studies of treponemal disease, as preliminary results suggest that as few as 1% of skeletons derived from communities where these conditions were endemic may manifest skeletal involvement. This further serves to emphasize the need for collaborations among research teams to generate such samples. Finally, we discuss how a paleoepidemiological approach to the treponematoses can generate unique insights into their manifestations and evolution, with particular relevance to the health of modern populations.

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