Subadult health and disease in prehistoric Tonga, Polynesia

A calvarial osteolytic lesion of probable vascular origin in a Maya juvenile from the Classic Period ( 250-900 CE)

OBJECTIVE

This case study evaluates a focal osteolytic lesion in the right sulcus sinus transversi of an isolated os occipitale.

MATERIALS

The os occipitale is from a juvenile from the Cueva de Sangre at the Classic Period (250-900 CE) site of Dos Pilas, Guatemala METHODS: The lesion was examined macroscopically, microscopically, and radiographically.

RESULTS

The oval lesion has a well-circumscribed margin, endocranial origin, and involves cortical destruction of the inner and outer tables. Subperiosteal bone reaction around the lesion is present on the ectocranial surface. Skeletal evidence of increased vascularity, diploë expansion, and perimortem fracture near the lesion are not observed.

CONCLUSIONS

The lesion appears to reflect a response to the presence of an expansile process that has caused pressure erosion. The anatomical location of the lesion and the endocranial origin suggest a probable vascular anomaly, such as a vascular malformation.

SIGNIFICANCE

This case study represents one of the few bioarchaeological evaluations of probable vascular anomaly in a juvenile. As such, it expands our knowledge about vascular anomalies in the past and provides a comparative and core reference for guiding future paleopathological investigations on cranial osteolytic lesions.

LIMITATIONS

The skeletal assemblage is commingled and fragmentary preventing the assessment of the distribution of lesions across the skeleton.

SUGGESTIONS FOR FUTURE RESEARCH

Further scrutiny of bioarchaeological collections is needed to better understand the distribution of vascular anomalies in the past.

Bone loss markers in the earliest Pacific Islanders

Kingdom of Tonga in Polynesia is one of the most obese nations where metabolic conditions, sedentary lifestyles, and poor quality diet are widespread. These factors can lead to poor musculoskeletal health. However, whether metabolic abnormalities such as osteoporosis occurred in archaeological populations of Tonga is unknown. We employed a microscopic investigation of femur samples to establish whether bone loss afflicted humans in this Pacific region approximately 3000 years ago. Histology, laser confocal microscopy, and synchrotron Fourier-transform infrared microspectroscopy were used to measure bone vascular canal densities, bone porosity, and carbonate and phosphate content of bone composition in eight samples extracted from adult Talasiu males and females dated to 2650 BP. Compared to males, samples from females had fewer vascular canals, lower carbonate and phosphate content, and higher bone porosity. Although both sexes showed evidence of trabecularised cortical bone, it was more widespread in females (35.5%) than males (15.8%). Our data suggest experiences of advanced bone resorption, possibly as a result of osteoporosis. This provides first evidence for microscopic bone loss in a sample of archaeological humans from a Pacific population widely afflicted by metabolic conditions today.

Advancing the understanding of treponemal disease in the past and present

Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age-old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co-evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. pallidum subspecies related to the treponeme causing pinta? The current state of scholarship in specific areas is reviewed with recommendations made to stimulate future work. Understanding treponemal biology, genetic relationships, epidemiology, and clinical manifestations is crucial for vaccine development today and for investigating the distribution of infection in both modern and past populations. Paleopathologists must improve diagnostic criteria and use a standard approach for recording skeletal lesions on archaeological human remains. Adequate contextualization of cultural and environmental conditions is necessary, including site dating and justification for any corrections made for marine or freshwater reservoir effects. Biogeochemical analyses may assess aquatic contributions to diet, physiological changes arising from treponemal disease and its treatments (e.g., mercury), or residential mobility of those affected. Shifting the focus from point of origin to investigating who is affected (e.g., by age/sex or socioeconomic status) and disease distribution (e.g., coastal/ inland, rural/urban) will advance our understanding of the treponemal disease and its impact on people through time.

Juvenile scurvy from Late Medieval Knin, Croatia

In this study, we examine the scurvy associated skeletal lesions among juveniles from the late Medieval site Uzdolje-Grablje in Croatia. The study aims to establish a demographic pattern of scurvy using existing diagnostic criteria. The sample consists of 16 well-preserved and fairly complete juveniles, excavated from a cemetery dating to 1420-1920. Skeletal remains were analyzed macroscopically for signs of porosity and new bone formation. Scurvy is diagnosed using the "Ortner criteria" of cranial and postcranial lesions. Depending on the location of the lesions, individuals were diagnosed with either scurvy or possible scurvy. Half of the individuals in our sample are diagnosed with scurvy, with additional 25% being diagnosed with possible scurvy. Along with porotic lesions, all individuals diagnosed with scurvy/possible scurvy showed new bone formation on at least one skeletal element. The occurrence of lesions associated with scurvy in our sample is unusually high. Instead of focusing solely on diet and insufficient intake of the vitamin C, a more likely explanation lies in the synergy between diet, exposure to infections, and the environment.

Viral infections, neonatal mortality and the mystery of the Athenian Agora: An interview with Professor of Anthropology Maria Liston

Although excavated almost 80 years ago, the infants' ‘bone well’ of the Athenian Agora in Athens, Greece and its contents were never thoroughly evaluated and published, until only recently, when a re-analysis of the whole excavation findings was performed. The well dates back to the third quarter of the 2nd century BC and contained at least 449 infants. The project, which explored the causes of neonatal mortality, found that one-third of infants' deaths were attributed to neonatal meningitis, based on the presence of bone disposition on the endocranial surface of the studied skulls. Despite the non-specific differential diagnostic approach of this pathophysiological finding in neonates, the determination of the causes of neonatal mortality in the Athenian Agora is really an impressive scientific attempt and can be a valuable lesson to all neonatal and peadiatric health professionals. According to Professor Maria Liston, Associate Professor of Anthropology at the University of Waterloo in Canada, who was the principal investigator of the skeletons from the infants' ‘bone well’ of the Athenian Agora, neonatal meningitis was the most frequently detected cause of neonatal mortality. Viral diseases unquestionably contributed to neonatal mortality, she adds and highlights that further research is required in collaboration with physicians for the better understanding and interpretation of various archaeological findings related to neonatal mortality. In the context of the 3rd Workshop on Paediatric Virology, which will be held in October 7th, 2017 in Athens, Greece, Professor Liston will reveal the role of neonatal and paediatric viral infections in the Hellenic antiquity.

Scurvy at the agricultural transition in the Atacama desert (ca 3600-3200 BP): nutritional stress at the maternal-foetal interface?

Studies of contemporary populations have demonstrated an association between decreased dietary diversity due to resource scarcity or underutilization and an increase in diseases related to poor micronutrient intake. With a reduction of dietary diversity, it is often the women and children in a population who are the first to suffer the effects of poor micronutrient status. Scurvy, a disease of prolonged vitamin C deficiency, is a micronutrient malnutrition disorder associated with resource scarcity, low dietary diversity, and/or dependence on high carbohydrate staple-foods. The aim of this paper is to assess the potential impact of nutritional transition on the prevalence of diseases of nutritional insufficiency in an archaeological sample. Here, we report palaeopathological findings from an Early Formative Period transitional site located in coastal Northern Chile (Quiani-7). The subadult cohort from this site is composed of four perinates who exhibit a number of non-specific skeletal changes suggestive of a systemic pathological condition. One of these is associated with an adult female exhibiting diagnostic skeletal lesions of scurvy. We argue that the lesions exhibited by these perinates may represent maternal transmission of vitamin C deficiency but acknowledge that there are difficulties in applying current diagnostic criteria for scurvy to individuals this young.

Growth and health status of children and adolescents in medieval Central Europe

Subadult growth and health have been analyzed in three cemetery samples from medieval Poland, including two early-urban sites: Cedynia dated to the 10t-14th centuries AD, and Ostrów Lednicki dated to the 13th-15th centuries AD, and a rural site Słaboszewo dated to the 14th-17th centuries AD. The nutritional status was not expected to have substantially differed among the settlements, due to the culturally induced undiversified diet of children, and predominant share of medium-to-low status individuals. However, city life and village life were supposed to differ in factors correlated with the spread of infections, and as such it was expected to find significant differences in respiratory health among early-urban and rural dwellers.The prevalences of diet-dependent diseases, scurvy and rickets, were found to be statistically indistinguishable among the three studied populations, while higher frequency of skeletal signs of poor respiratory health was observed in early-urban Cedynia than rural Słaboszewo. Slightly lower prevalences of skeletal stress indicators were found for the rural than the early-urban site. Skeletal growth profiles and the dynamics of long bone growth were found to be remarkably similar for the early-urban samples (Cedynia and Ostrów Lednicki), with the rural subadults having the shortest diaphyseal lengths, and lower growth dynamics.It can be concluded that adverse factors associated with the urban settlement were more detrimental to respiratory health than those in the village. A variety of factors are potentially responsible for this pattern, including population density, building structure, quality of air and water, sanitation, and occupation. Perhaps, the key factor in response to environmental and socio-cultural constraints was the stability of living conditions in the village, which allowed the inhabitants to develop sufficient adaptive mechanisms. In contrast, the history of strongholds such as Cedynia was changeable due to political situation, military threats and migrations of people.

Isotopic evidence of human mobility and diet in a prehistoric/protohistoric Fijian coastal environment (c. 750-150 BP)

OBJECTIVES

Bourewa, on the southwest coast of Viti Levu in Fiji, is a multi-period site that contained burials dated to the later Vuda Phase (750-150 BP), a period of climatic fluctuations that potentially impacted the availability of food resources. We aim to investigate diet and movement at this site during a time of possible ecological pressure and political change.

MATERIALS AND METHODS

We analyzed δ(13) C, δ(15) N, and (87) Sr/(86) Sr of these Vuda Phase individuals (n = 25) interred at the site. By analyzing dentin and bone, both childhood diet and the diet within the past few years of adults' lives were examined.

RESULTS

The paleodietary results suggested that adult diets consisted largely of low trophic level marine organisms. Dentin and bone isotopic values differed significantly: childhood diet involved consumption of more higher trophic level terrestrial foods. Most individuals displayed (87) Sr/(86) Sr ratios expected of people living along a marine coastline. However, a few individuals displayed (87) Sr/(86) Sr ratios and paleodietary values (δ(13) Cdentin , δ(15) Ndentin ) suggestive of living further inland or consuming a more terrestrial-based childhood diet.

DISCUSSION

The results are compared with past studies of sites from Fiji and nearby archipelagoes, placing our interpretations into a wider regional context. The Bourewa community appears to have consumed more low trophic level marine foods than any nearby site, possibly because terrestrial foods were more difficult to acquire. Interpreting the childhood diet is challenging due to the paucity of ethnohistoric literature on Fijian childhood; small meals outside of communal mealtimes or feeding children terrestrial animal protein as a means of cultural buffering are potential explanations.

Pacific Populations, Metabolic Disease and 'Just-So Stories': A Critique of the 'Thrifty Genotype' Hypothesis in Oceania

Pacific populations have long been observed to suffer a high burden of metabolic disease, including obesity, type 2 diabetes and gout. The 'Thrifty Genotype' hypothesis has frequently been used to explain this high prevalence of disease. Here, the 'Thrifty Genotype' hypothesis and the evolutionary background of Pacific populations are examined. We question its relevance not only in the Pacific region but more generally. Not only has the hypothesis not been explicitly tested, but most archaeological and anthropological data from the Pacific fundamentally do not support its application.

Assessing human diet and movement in the Tongan maritime chiefdom using isotopic analyses

The rise of stratified societies fundamentally influences the interactions between status, movement, and food. Using isotopic analyses, we assess differences in diet and mobility of individuals excavated from two burial mounds located at the `Atele burial site on Tongatapu, the main island of the Kingdom of Tonga (c. 500 - 150 BP). The first burial mound (To-At-1) was classified by some archaeologists as a commoner's mound while the second burial mound (To-At-2) was possibly used for interment of the chiefly class. In this study, stable isotope analyses of diet (δ13C, δ15N, and δ34S; n = 41) are used to asses paleodiet and 87Sr/86Sr ratios (n = 30) are analyzed to investigate individual mobility to test whether sex and social status affected these aspects of life. Our results show significant differences in diet between burial mounds and sexes. Those interred in To-At-2 displayed lower δ13C values, indicating they ate relatively more terrestrial plants (likely starchy vegetable staples) compared with To-At-1 individuals. Females displayed significantly lower δ15N values compared with males within the entire assemblage. No differences in δ34S values were observed between sexes or burial mound but it is possible that sea spray or volcanism may have affected these values. One individual displayed the strontium isotopic composition representative of a nonlocal immigrant (outside 2SD of the mean). This suggests the hegemonic control over interisland travel, may have prevented long-term access to the island by non-Tongans exemplifying the political and spiritual importance of the island of Tongatapu in the maritime chiefdom.

A likely case of scurvy in a rural Early Classic Maya burial from Actun Uayazba Kab, Belize

A Maya burial of a late adolescent (Burial 98-3) found in the rockshelter entrance of Actun Uayazba Kab (AUK), Belize, displays a combination of lesions that is consistent with scurvy. Signs include large, active lesions on the posterior surfaces of maxilla; relatively mild porotic hyperostosis along the midline of the skull on the parietals and occipital; cribra orbitalia; potential pinprick lesions on the greater wings of sphenoid and temporal; reactive lesions on the palate, temporal lines of frontal and parietals, and external and internal surfaces of zygomatics; small lesions on the popliteal surfaces of both femora; and periodontal disease. Identification of scurvy at AUK potentially informs the analysis of other primary burials and scattered bone found there and at other nearby sites, which often reveal evidence of nonspecific lesions that are usually attributed to anemia and infection, but that are also consistent with scurvy. The social and ecological context of this Protoclassic (0-AD 300) individual, who lived in a rural agricultural community with no evidence of complex social hierarchy, contrasts with typical discussions of disease among the Maya, which tend to focus on the degrading effects of overcrowding and resource deficiencies. While scurvy has been largely overlooked in the Maya area, this study supports earlier arguments for its presence that were based largely on clinical and ethnographic analogies and suggests the need to incorporate scurvy into broader synergistic models of ancient health.

Anemia and childhood mortality: Latitudinal patterning along the coast of pre-Columbian Peru

Hrdlicka ([1914] Smithson. Inst. Misc. Collect. 61:1-69) reported that pre-Columbian skeletal material from the coastal lowland Andean region exhibited a high frequency of porotic hyperostosis, a pathological condition of bone that generally is thought to indicate childhood anemia. While subsequent studies tended to reinforce this conclusion, factors implicated in the condition have yet to be fully explored in the region as a whole. This study explores regional and intravalley variation as one step in establishing biocultural variables that increase the apparent risk of childhood anemia. The study sample includes 1,465 individuals: 512 from Peruvian collections housed at the Field Museum of Natural History, and 953 from systematically excavated contexts from Moquegua, Peru. Environmental stressors, such as parasites and disease, rather than specific dietary practices were found to be more likely associated with childhood anemia in these coastal Andean samples. The study supports cribra orbitalia as an earlier expression of porotic hyperostosis and suggests that porotic hyperostosis, as recorded here, cannot be easily dismissed as a result of cranial shape modification. No clear temporal patterns were observed. Finally, the study establishes that comparing data for children and adults can reveal the relative association between childhood anemia and mortality. Childhood mortality associated with anemia was elevated where the presence of tuberculosis or tuberculosis-like conditions was more common and the presence of water-borne pathogens was negligible. In contrast, those buried at lower altitudes, closer to the coast, and consuming mainly marine resources were less likely to die in childhood with anemia than in the other contexts studied.

The people of Jabuticabeira II: reconstruction of the way of life in a Brazilian shellmound

Sambaquis are huge shellmounds built along almost the entire Brazilian coast between 8000 and 600 years ago. In the present article, 14 osteological markers from 89 individuals excavated at the Sambaqui Jabuticabeira II (2890+/-55/2186+/-60 BP) are analyzed in order to reconstruct the population's health status and way of life. The present palaeopathological findings (such as lower frequency of degenerative joint diseases in legs, as compared to arms, and the rarity of traumas) together with archaeological findings support the idea of nearby resource abundance and infrequent interpersonal competition. The presence of auditory exostoses mainly in males corroborates previous findings indicating the importance of marine resources. The low caries frequency and the high degrees of dental wear point to a diet poor in cariogenic food, and rich in abrasives such as sand, shell fragments and phytoliths. This suggests a broader diet, based on marine protein as well as plants, than previously thought. The etiology of cribra orbitalia could be explained by gastrointestinal parasites or other sources of physiological stress. These parasites, in turn, could have led to higher frequencies of infectious diseases, either by the debilitation of the immune system or by the direct contact with infectious agents. Despite the periods of illness various individuals experienced, the daily life among the builders of the Sambaqui Jabuticabeira II seems to have been relatively easy due to the abundance and predictability of resources and the paucity of violent traumas.

Skeletal pathology in a prehistoric Pacific Island sample: Issues in lesion recording, quantification, and interpretation

This paper presents a profile of evidence of disease in a skeletal sample from Taumako Island, Southeast Solomon Islands, Melanesia, and aims to increase awareness of the prehistoric Pacific Island disease environment. It also addresses issues of lesion recording, quantification, and interpretation. Two methodologies for the determination of lesion prevalence were applied, one based on prevalence in observable individuals and one in skeletal elements. The aim of these methodologies was to provide objective data on skeletal lesions in this sample, with transparency in methods for application in comparative studies. The types of lesions observed were predominantly osteoblastic and affecting multiple bones, particularly in the lower limbs. The individual analysis yielded a prevalence of lesions affecting 56.4% of the postcranial sample from birth to old age. As expected, the skeletal element analysis yielded a lower prevalence, with 15.0% of skeletal elements affected. The skeletal element analysis also revealed a pattern of greater lower limb involvement, with a predilection for the tibia. The pattern of skeletal involvement was similar in both analyses, suggesting the validity of employing either method in paleopathological studies. A differential diagnosis of the lesions included osteomyelitis, treponemal disease, and leprosy. Metabolic disease was also considered for subadult lesions. Based on lesion type, skeletal distribution, and epidemiology of lesions in the sample, an etiology of yaws (Treponema pertenue) was suggested as responsible for nearly half the adult lesions, while multiple causes, including yaws, were suggested for the lesions in subadults.

Syphilis 2001--a palaeopathological reappraisal

The origin and subsequent spread of the treponematoses, especially that of venereal syphilis, has been the subject of considerable scientific attention. Various theories were put forth and palaeopathological specimens were used for their validation in recent times. One influential contribution was the paper by Baker & Armelagos in 1988. Numerous new findings and results on both sides of the Atlantic call for a new evaluation of the available osseous material. A review of the recent literature leads to the suggestion of a worldwide distribution of non-venereal treponemal disease since the emergence of Homo and to a first epidemic outbreak of venereal syphilis in Europe of the late 15th and the early 16th century, which was a time of change and enormous sexual liberty. Old World specimens with pathological alterations attributed to venereal syphilis and dated to precolumbian times seem to invalidate the Columbian theory and call for a more differentiated analysis of the phenomenon of syphilis than a theory based on a single factor can provide. With the help of molecular methods which now allow a positive identification of Treponema pallidum pallidum, causative agent of venereal syphilis, in palaeopathological material, it seems possible to elucidate the matter of origin and spread of syphilis further and to evaluate previous diagnoses of treponemal disease.