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Mongillo J, Zedda N, Rinaldo N, Bellini T, Manfrinato MC, Du Z, Yang R, Stenseth NC, Bramanti B. Differential pathogenicity and lethality of bubonic plague (1720-1945) by sex, age and place. Proc Biol Sci 2024; 291:20240724. [PMID: 39045692 PMCID: PMC11267469 DOI: 10.1098/rspb.2024.0724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 06/05/2024] [Accepted: 06/17/2024] [Indexed: 07/25/2024] Open
Abstract
COVID-19 brought back to the attention of the scientific community that males are more susceptible to infectious diseases. What is clear for other infections-that sex and gender differences influence both risk of infection and mortality-is not yet fully elucidated for plague, particularly bubonic plague, although this knowledge can help find specific defences against a disease for which a vaccine is not yet available. To address this question, we analysed data on plague from hospitals in different parts of the world since the early eighteenth century, which provide demographic information on individual patients, diagnosis and course of the disease in the pre-antibiotic era. Assuming that the two sexes were equally represented, we observe a worldwide prevalence of male cases hospitalized at any age, a result which seems better explained by gender-biased (thus cultural) behaviours than biological sex-related factors. Conversely, case fatality rates differ among countries and geographic macro-areas, while globally, lethality appears slightly prevalent in young females and older adults (regardless of sex). Logistic regression models confirm that the main risk factor for bubonic plague death was the geographical location of the cases and being older than 50 years, whereas sex only showcased a slight trend.
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Affiliation(s)
- J. Mongillo
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara44121, Italy
| | - N. Zedda
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara44121, Italy
| | - N. Rinaldo
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara44121, Italy
| | - T. Bellini
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara44121, Italy
- University Strategic Center for Studies on Gender Medicine, University of Ferrara, Ferrara44121, Italy
| | - M. C. Manfrinato
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara44121, Italy
| | - Z. Du
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People‘s Republic of China
| | - R. Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People‘s Republic of China
| | - N. C. Stenseth
- Center for Pandemics and One Health Research, Sustainable Health Unit (SUSTAINIT), Faculty of Medicine, University of Oslo, Oslo0316, Norway
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo0316, Norway
- Vanke School of Public Health, Tsinghua University, Beijing100084, People‘s Republic of China
| | - B. Bramanti
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara44121, Italy
- University Strategic Center for Studies on Gender Medicine, University of Ferrara, Ferrara44121, Italy
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo0316, Norway
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Franklin ER, Mitchell PD, Robb J. The Black Death in Hereford, England: A demographic analysis of the Cathedral 14th-century plague mass graves and associated parish cemetery. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:452-466. [PMID: 37650443 DOI: 10.1002/ajpa.24838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES This study explores the paleoepidemiology of the Black Death (1348-52 AD) mass graves from Hereford, England, via osteological analysis. Hereford plague mortality is evaluated in the local context of the medieval city and examined alongside other Black Death burials. METHODS The Hereford Cathedral site includes mass graves relating to the Black Death and a 12th-16th century parish cemetery. In total, 177 adult skeletons were analyzed macroscopically: 73 from the mass graves and 104 from the parish cemetery. Skeletal age-at-death was assessed using transition analysis, and sex and stress markers were analyzed. RESULTS The age-at-death distributions for the mass graves and parish cemetery were significantly different (p = 0.0496). Within the mass graves, young adults (15-24 years) were substantially over-represented, and mortality peaked at 25-34 years. From 35 years of age onwards, there was little variation in the mortality profiles for the mass graves and parish cemetery. Males and females had similar representation across burial types. Linear enamel hypoplasia was more prevalent within the mass graves (p = 0.0340) whereas cribra orbitalia and tibial periostitis were underrepresented. CONCLUSIONS Mortality within the Hereford mass graves peaked at a slightly older age than is seen within plague burials from London, but the overall profiles are similar. This demonstrates that young adults were disproportionately at risk of dying from plague compared with other age groups. Our findings regarding stress markers may indicate that enamel hypoplasia is more strongly associated with vulnerability to plague than cribra orbitalia or tibial periostitis.
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Affiliation(s)
| | - Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | - John Robb
- Department of Archaeology, University of Cambridge, Cambridge, UK
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Pasini A, Rinaldo N, Bramanti B, Gualdi-Russo E. Technical note: Application and potentiality of quantitative ultrasonometry for the evaluation of bone mineral density status. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 181:140-154. [PMID: 36824053 DOI: 10.1002/ajpa.24711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/10/2023] [Accepted: 01/24/2023] [Indexed: 02/25/2023]
Abstract
The evaluation of bone mineral density (BMD) is an important task in paleopathology. Techniques commonly applied in bone quantity assessment, such as DXA or radiogrammetry (XR), suffer from several limitations when applied to skeletal remains. In recently published research, we developed a new methodology and new reference curves for the evaluation of BMD on human skeletal remains, applying for the first time Quantitative Ultrasonometry (QUS), a user-friendly, portable, and reliable clinical technique. This study aims to apply this new methodology to an archeological sample and to compare the results with those obtained through XR. We apply QUS and XR to a sample of 104 adults from Medieval Italian cemeteries. Fragility fractures were recorded. Descriptive statistics and comparisons between sexes, age-at-death cohorts, and individuals with and without fragility fractures were performed. Moreover, univariate and multivariate logistic regression models were used to define the parameters most predictive of fracture risk in past populations. The comparison between sexes showed no significant results concerning BMD parameters, whereas a decrease in BMD with increasing age is confirmed. The comparison between fracture and non-fracture individuals and the logit model demonstrated that QUS parameters, especially UBPI, are more reliable predictors of fracture risk in comparison to XR. Our results confirmed that QUS is a valuable technique that can be efficiently applied to archeological remains, also considering its portability. We also propose a modification of the previously published QUS standard curves, to easily assess osteopenia and osteoporosis in archeological material.
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Affiliation(s)
- Alba Pasini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Barbara Bramanti
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy.,University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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The plague’s impact paleodemographic and genetic measures in 15th to 16th century Gdańsk. ANTHROPOLOGICAL REVIEW 2022. [DOI: 10.18778/1898-6773.85.1.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Yersinia pestis caused plagues and haunted Gdańsk several times during the 15th and 16th centuries. This study focuses on the following demographic effects: 1/ distributions of deceased by age in a plagued city, 2/ parameters of the life tables, 3/ estimation of the natural increase. To assess genetic effects of the plague, measures of the opportunity for natural selection were considered. Skeletal remains of 283 people from the 15th – 16th century ossuary 3009 from the Dominican Monastery in Gdańsk provided research material. Yersinia pestis DNA in this skeletal material has already been found (Morozowa et al. 2017, 2020). Distributions of the deceased by age in the study sample were compared with those for Gdańsk before the plague and with those for the mass burial of plague victims in the 14th century Lübeck. Neither catastrophic mortality was found in the material studied, nor selective nature of the plague with regard to sex and age had been demonstrated. Using the Weiss method, the rate of natural increase r=–0.005 was reconstructed. With the wide dating range of the ossuary and the fact that it contains results of both the epidemic and “normal” mortality, the natural increase value at this level seems justified. There was a deterioration in the values of life tables parameters, especially life expectancy. Newborn life expectancy dropped to 19.5–22.6 years and for a 20-year-old to 17.7 years. The measures of opportunity for natural selection also deteriorated primarily due to child mortality: the biological state index Ibs values were low (within the 0.3–0.4 range) and values of the Im Crow’s index about 1.0. Natural selection also acted on adults as evidenced by values of the gross potential reproduction rate Rpot below 0.7. Demographically the study sample was at the level of the early Middle Ages rather than the Rennaisance.
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Guellil M, Rinaldo N, Zedda N, Kersten O, Gonzalez Muro X, Stenseth NC, Gualdi-Russo E, Bramanti B. Bioarchaeological insights into the last plague of Imola (1630-1632). Sci Rep 2021; 11:22253. [PMID: 34782694 PMCID: PMC8593082 DOI: 10.1038/s41598-021-98214-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/31/2021] [Indexed: 12/30/2022] Open
Abstract
The plague of 1630-1632 was one of the deadliest plague epidemics to ever hit Northern Italy, and for many of the affected regions, it was also the last. While accounts on plague during the early 1630s in Florence and Milan are frequent, much less is known about the city of Imola. We analyzed the full skeletal assemblage of four mass graves (n = 133 individuals) at the Lazaretto dell'Osservanza, which date back to the outbreak of 1630-1632 in Imola and evaluated our results by integrating new archival sources. The skeletons showed little evidence of physical trauma and were covered by multiple layers of lime, which is characteristic for epidemic mass mortality sites. We screened 15 teeth for Yersinia pestis aDNA and were able to confirm the presence of plague in Imola via metagenomic analysis. Additionally, we studied a contemporaneous register, in which a friar recorded patient outcomes at the lazaretto during the last year of the epidemic. Our multidisciplinary approach combining historical, osteological and genomic data provided a unique opportunity to reconstruct an in-depth picture of the last plague of Imola through the city's main lazaretto.
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Affiliation(s)
- Meriam Guellil
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, 0316, Oslo, Norway.
- Institute of Genomics, Estonian Biocentre, University of Tartu, 51010, Tartu, Estonia.
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121, Ferrara, Italy.
| | - Nicoletta Zedda
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121, Ferrara, Italy
| | - Oliver Kersten
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, 0316, Oslo, Norway
| | | | - Nils Chr Stenseth
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, 0316, Oslo, Norway
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121, Ferrara, Italy
| | - Barbara Bramanti
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, 0316, Oslo, Norway.
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121, Ferrara, Italy.
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Godde K, Hens SM. An epidemiological approach to the analysis of cribra orbitalia as an indicator of health status and mortality in medieval and post-medieval London under a model of parasitic infection. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 174:631-645. [PMID: 33528042 DOI: 10.1002/ajpa.24244] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 01/03/2021] [Accepted: 01/19/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Many individuals living in medieval and post-medieval London suffered issues with sanitation, food insecurity, infectious disease, and widespread exposure to parasites from a multitude of sources, causing increased risk of death for many inhabitants. We examine this stressful environment and its relationship with various demographic and temporal dimensions, using cribra orbitalia (CO) as an indicator of stress, to model an increased risk of dying under the expectations of our proposed parasitic model of infection. MATERIALS AND METHODS We analyze the relationship between CO and mortality across seven medieval and post-medieval cemeteries from London by the covariates of sex, status, and age-at-death. A survival analysis (Cox regression) and a binomial logit estimated hazard and odds ratios of dying with CO across age-at-death, sex, status, and time-period within single statistical models. In addition, we provide new Bayesian age-at-death estimates for post-medieval samples. RESULTS The models show the rate of CO decreased over time and age-at-death, regardless of sex or status; post-medieval individuals were ~72% less likely to die with lesions than their medieval counterparts. Further, individuals with CO had ~1% decrease in risk of dying with CO per year of age. DISCUSSION These results suggest increased mortality risk for those with lesions indicative of anemia (CO), and selective mortality of younger individuals during the medieval period. Despite sex-specific nutritional and occupational hazards, and status-based access to resources, the prevalence of CO was similar across sex and status, which suggests living with parasitic infection that caused anemia was an everyday reality for medieval and post-medieval Londoners.
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Affiliation(s)
- Kanya Godde
- Anthropology Program, University of La Verne, La Verne, California, USA
| | - Samantha M Hens
- Department of Anthropology, California State University, Sacramento, California, USA
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Byard RW. A forensic evaluation of plague - a re-emerging infectious disease with biowarfare potential. MEDICINE, SCIENCE, AND THE LAW 2020; 60:200-205. [PMID: 32192402 DOI: 10.1177/0025802420908483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Plague is an acute infectious disease caused by the gram-negative cocco-bacillus Yersinia pestis. It has been responsible for 200 million deaths throughout history with three major pandemics. There are three forms: bubonic, septicaemic and pneumonic, each carrying a significant mortality rate. The usual transmission is from fleas carried by rodents. Recently, it has been listed as one of the reemerging infectious diseases globally, with a potential use in bioterrorism. At autopsy there may be lymphadenopathy, fulminant pneumonia or diffuse interstitial pneumonitis. However any organ may be affected with myocarditis, meningitis, pharyngitis and hepatic and splenic necrosis. The lethality of plague with the resurgence in numbers of cases, development of antibiotic resistance, recent occurrence in urban areas and the lack of a vaccine make it a disease not to be missed in the mortuary.
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Affiliation(s)
- Roger W Byard
- School of Medicine, The University of Adelaide, Australia
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Godde K, Pasillas V, Sanchez A. Survival analysis of the Black Death: Social inequality of women and the perils of life and death in Medieval London. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 173:168-178. [PMID: 32472637 DOI: 10.1002/ajpa.24081] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/25/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Described as an indiscriminate killer by many chroniclers, the Black Death descended on London during the 14th century. To best understand the pattern of transmission among demographic groups, models should include multiple demographic and health covariates concurrently, something rarely done when examining Black Death, but implemented in this study to identify which demographic groups had a higher susceptibility. Female predisposition to the Black Death was also explored, focusing on whether social inequality added to vulnerability. MATERIALS AND METHODS Three attritional cemeteries from the Wellcome Osteological Research Database were compared with the Black Death cemetery, East Smithfield. A Cox proportional hazards regression estimated hazards ratios of dying of the Black Death, using transition analysis ages-at-death as the time variable, and sex and frailty as covariates. Additionally, a binomial logistic regression generated odds ratios for age-at-death, sex, and frailty. RESULTS The Cox model produced a significant hazards ratio for individuals deemed frail. Similarly, the logit model calculated significantly increased odds ratios for frail individuals, and decreased odds for individuals aged 65+. DISCUSSION The older individuals were not undergoing growth during times of great stress in London pre-dating the Black Death epidemic, which may explain the decreased odds of contracting the Black Death. Further, although women dealt with social inequality, which partially led to the demographic puzzle of the Medieval "missing" women, women's susceptibility to infection by the Black Death was not increased. The phenomenon of the missing women may be due to a combination of factors, including infant and child mortality and preservation.
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Affiliation(s)
- Kanya Godde
- Anthropology Program, University of La Verne, La Verne, California, USA
| | - Valerie Pasillas
- Anthropology Program, University of La Verne, La Verne, California, USA
| | - America Sanchez
- Anthropology Program, University of La Verne, La Verne, California, USA
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Galanaud P, Galanaud A, Giraudoux P, Labesse H. Mortality and demographic recovery in early post-black death epidemics: Role of recent emigrants in medieval Dijon. PLoS One 2020; 15:e0226420. [PMID: 31967994 PMCID: PMC6975534 DOI: 10.1371/journal.pone.0226420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 11/26/2019] [Indexed: 11/19/2022] Open
Abstract
Objective and methods We analyze the influence of population movement on susceptibility to death and resilience during two epidemics occurring in Dijon soon after the Black Death. Using a specific program designed to propose links between entries in annual tax registers, we define tentative heads of household, the elapsed time since their first registration and their ties with other persons within the city. Results During the 1400 epidemic heads of household who were registered for 1–3 years die in large numbers, whereas during years without epidemics, their death rate is lower than that of heads of household who were registered longer. Recent registration is an epidemic vulnerability factor only in association with a low taxation status, which, when isolated, does not influence mortality. A lack of familial ties within Dijon is another vulnerability factor among the recently registered. This suggests that poor, recent emigrants are more affected by epidemic mortality. In contrast, the mortality of recently registered heads of household is indistinct during a later epidemic occurring after several years of major famine that may have selected the more resistant emigrants and/or excluded the more miserable of them from our analysis. In contrast to the first one, this second epidemic is followed by rapid demographic recovery. This latter recovery is fully explained by the contribution of poor, newly registered heads of household without ties in Dijon. Conclusion Our results outline the interaction between population movement and low socioeconomic status on death susceptibility in historical plagues and show that poor recent emigrants may also be key players in the resilience of the population after an epidemic.
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Affiliation(s)
- Pierre Galanaud
- Université Paris-Saclay, Inserm, Inflammation, Microbiome and Immunosurveillance, Clamart, France
- * E-mail:
| | - Anne Galanaud
- Université de Bourgogne-Franche-Comté, Besançon, France
| | - Patrick Giraudoux
- Chrono-environnement, Université de Bourgogne-Franche-Comté, CNRS UMR6249, Besançon, France
| | - Henri Labesse
- Paris Sorbonne—Paris 4 Université, Institut des Sciences Humaines Appliquées, Paris, France
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