Skeletal Evidence for Leprosy in India by the Second Millenium B.C.

Abstract

Leprosy 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.

Advances in the Immunology and Genetics of Leprosy

“…Leprosy is an ancient disease caused by Mycobacterium leprae or Mycobacterium lepromatosis infection, which mainly impairs skin and peripheral nerves and can even result in disability (1). The pathogens of leprosy have accompanied and affected humans for more than 4,000 years (2,3), and over 200,000 new cases of leprosy are still reported each year worldwide (4) despite the application of multidrug therapy by the Word Health Organization. Because of the severe consequences caused by leprosy, including appearance changes and disabilities, leprosy is still a significant public health issue, especially in countries such as Brazil, India, and Indonesia, where the disease is still prevalent.…”

Evolutionary history ofMycobacterium lepraein the Pacific Islands

“…The oldest probable skeletal evidence of leprosy comes from Balathal, India, dating to 2000 BCE [16], although there is a skeleton from Europe with possible rhinomaxillary signs of leprosy dating to 1500 years earlier [17]. The oldest written record of leprosy is described in the Suchruta samhita, an Indian text from around 600 BCE (described in [18,19]).…”