Regional, social, and evolutionary perspectives on treponemal infection in the Southeastern United States

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.

A singular case of advanced caries sicca in a pre-Columbian skull from East Tennessee

OBJECTIVE

Documentation of an advanced case of tertiary stage treponemal disease.

MATERIALS

The well-preserved cranium and mandible of an adult male (Burial G) from the Early Woodland period (900 BCE-200 CE) Wilhoite site (40GN10) from east Tennessee.

METHODS

Macroscopic examination of the cranio-facial periostosis on Burial G for pathognomonic indicators of treponemal disease.

RESULTS

There are extensive contiguous nodular lesions on the frontal, parietals, temporals, and occipital bones. The frontal squama additionally exhibits radial scaring and circumvallate cavitating lesions. Radial scars are also present on both zygomatic bones and the endocranial surface of the calotte. There is rounding of the nasal margins in addition to periostosis on the palate.

CONCLUSIONS

Burial G unequivocally exhibits the pathognomonic reactive changes of caries sicca, radial scarring, and cavitating lesions.

SIGNIFICANCE

The Early Woodland date in combination with the advanced degree of pathognomonic reactive change is exceptional, and to date, without parallel in the pre-Columbian archaeological record of North America. Any case approaching the severity displayed here is invariably late prehistoric.

LIMITATIONS

The absence of postcrania does not permit assessment of frailty or synergism of secondary conditions.

SUGGESTIONS FOR FURTHER RESEARCH

More comprehensive documentation of pre-Columbian treponemal cases is merited.

Congenital syphilis in the skeleton of a child from Poland (Radom, 18th–19th century AD)

An incomplete skeleton of a 3-year-old child with suspected congenital syphilis was found in the Radom area of Poland. Squama frontalis and zygomatic bones are characterized by significant bone loss. Radiographic pictures show a geographic destructive lesion of a serpiginous shape surrounded by a zone of reactive osteosclerosis in the squama frontalis. The radiographic findings included a slight widening and contour irregularities of the distal humeral metaphyses. The appearance of teeth did not suggest Hutchinson teeth, but the examination of the permanent molars showed signs of mulberry molars. Two teeth were tested for the presence of mercury. Chemical analysis did not indicate mercury accumulation (enamel: 0.07 μg/g, dentine: 0.14 μg/g, bone: 0.11 μg/g). Mercury values obtained for the examined samples were similar to those that are typical of healthy teeth in today’s individuals.

Brief communication: preliminary radiocarbon dates from Florida crania in Hrdlička's gulf states catalog

Aleš Hrdlička produced a tremendous amount of data in his career, much of which was published in a series of catalogs by the US National Museum. The Gulf States catalog, for example, contains raw craniometric data for over 700 individuals from the state of Florida alone. However, many of these skeletons are poorly sourced by Hrdlička, thus limiting their utility in modern bioarchaeological analyses where context is critical. In particular, the age of the skeletal material is often based solely on associated material culture and information on the sites themselves is not presented by Hrdlička. To address this impasse we attempted radiocarbon dates for 10 of the largest Florida sites published in the Gulf States catalog. In addition, archival data in the form of unpublished field notes and personal correspondence were accessed to better contextualize the radiocarbon dates and to provide some guidance on the degree of temporal variability at the sites. Eight AMS radiocarbon dates were successful. Archival data was of variable quality per site. In some cases very little is known about the provenience of the specimens. In other cases, however, individual burials could be allocated to specific strata within specific mounds. The relevance of using published raw data is discussed with respect to the Howells and Boas Immigrant datasets and the impact the dissemination of these resources has had on the discipline.

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.

How does a riverine setting affect the lifestyle of shellmound builders in Brazil?

The contact of inland and coastal prehistoric groups in Brazil is believed to have been restricted to regions with no geographical barrier, as is the case in the Ribeira de Iguape valley. The inland osteological collection from the riverine shellmound Moraes (5800-4500 BP) represents a unique opportunity to test this assumption for this region. Despite cultural similarities between riverine and coastal shellmounds, important ecological and site distribution differences are expected to impact on lifestyle. The purpose of this study is thus to document and interpret health and lifestyle indicators in Moraes in comparison to coastal shellmound groups. Specifically we test if the rare evidence of fish and mollusc remains in the riverine shellmound led to (a) higher caries rates and (b) lower auditory exostosis frequency and (c) if the small size of the riverine shellmound translates into reduced demographic density and thus rarity of communicable infectious diseases. Of the three hypotheses, (a) was confirmed, (b) was rejected and (c) was partly rejected. Bioanthropological similarities between Moraes and coastal shellmounds include auditory exostoses with equally high frequencies; significantly more frequent osteoarthritis in upper than in lower limbs; cranial and dental morphological affinities and low frequencies of violent trauma. However, there are also important differences: Moraes subsisted on a much broader protein diet and consumed more cariogenic food, but showed a stature even shorter than coastal groups. Thus, despite the contact also suggested by treponematoses in both site types, there was enough time for the people at the riverine site to adapt to local conditions.