So much for my plan to do monthly reading updates. I think quarterly might be more feasible. It seems like the fall has flown by and was not as productive as I would have liked. Isn’t that always the way?
So I’m currently working my way through Cameron’s Anglo-Saxon Medicine and then next up will be the brand new second edition of Mitchell’s A History of the Later Roman Empire AD 284-641.
Matilda Holmes, Animals in Saxon and Scandinavian England: Backbones of Economy and Society. Sidestone press, 2014 (reviewed here)
Prokopius, The Secret History and Related Texts. Anthony Kaldellis, ed. Hackett, 2010.
David Quammen. Ebola: A Natural and Human History of a Deadly Virus. 2014. (excerpted, adapted and updated from his Spillover)
Setzer, T. J. (2014). Malaria detection in the field of paleopathology: A meta-analysis of the state of the art. Acta Tropica, 140, 97–104. doi:10.1016/j.actatropica.2014.08.010 (summarized here)
Christina Lee. (2014). Invisible enemies: the role of epidemics in the shaping of historical events in the early medieval period in. Social Dimensions of Medieval Disease and Disability, 1–17.
Sallares, R. (2006). Role of environmental changes in the spread of malaria in Europe during the Holocene. Quaternary International, 150(1), 21–27. doi:10.1016/j.quaint.2006.01.005
Sallares, R., Bouwman, A., & Anderung, C. (2004). The spread of malaria to Southern Europe in antiquity: new approaches to old problems. Medical History, 48(3), 311–328.
Collins, W. E., & Jeffery, G. M. (2007). Plasmodium malariae: Parasite and Disease. Clinical Microbiology Reviews, 20(4), 579–592. doi:10.1128/CMR.00027-07
Schreg, Rainer. (2014) “Ecological Approaches in Medieval Rural Archaeology” European Journal of Archaeology, 17 (1), 83-119.
Flaherty, E. (2014). Assessing the distribution of social–ecological resilience and risk: Ireland as a case study of the uneven impact of famine. Ecological Complexity, 19, 35–45. doi:10.1016/j.ecocom.2014.04.002
SHARPE, W. D., & Isidore of Seville. (1964). Isidore of Seville: the Medical Writings. An English Translation with an Introduction and Commentary. Transactions of the American Philosophical Society, New Series, 54(2), 1–75.
Carter, R., & Mendis, K. N. (2002). Evolutionary and Historical Aspects of the Burden of Malaria. Clinical Microbiology Reviews, 15(4), 564–594. doi:10.1128/CMR.15.4.564-594.2002
I’ve also spent quite a bit of time this autumn reading the pre-print editions of the contributions to Pandemic Disease in the Medieval World: Rethinking the Black Death edited by Monica Green in the inaugural edition of The Medieval Globe, which I’m honored to be a contributor to. Watch this space for more news on this special issue very soon.
Malaria is arguably one of the most influential infectious diseases in human history. Its been with us as long as we have been human, but as Teddi Setzer shows us in her recent review of detection methods, our abilities to find it in the past leaves a lot to be desired.
The standard method of looking for malaria involves searching for signs of anemia on the skeleton on the hypothesis that the anemia caused by malaria leaves these marks. This is not as clear as it might seem. There have been very few skeletal studies of modern people who have been diagnosed with malaria. There is no medical need; there are much more reliable methods of diagnosing malaria in a living person (or recent cadaver). So, it is unclear how often these lesions form in malaria patients. Other causes of anemia and even scurvy can cause the same or very similar lesions as well. The number of malarial infections and/or relapses also effect bone changes. Plasmodium falciparium produces a short, virulent disease that may kill before bone changes develop. On the other extreme, a single P. malariae infection can relapse for life, although the anemia is not as severe. Osteology must be correlated with other information to support the diagnosis.
Cribra orbitalia and porotic hyperostosis are the two main indicators sought. Both are caused by bone marrow expansion in an attempt to compensate for the loss of red blood cells. Cribra orbitalia is pitting and extra bone growth in the orbits of the eyes, as seen in the photo. Porotic hyperostosis causes pitting and thinning of the compact bone ‘shell’ that covers the cranial bones. A correlation of nutritionally informed osteology with later epidemiology and mosquito incidence in England reviewed in a previous post shows that a convincing case can be made for malaria in ancient remains.
Detection of human genetic traits selected for by malaria such as the Duffy blood group, sickle cell trait, thalassemias, and glucose-6-phosphatase deficiency (G6PD) can with supporting information suggests that the population was once under selection by malaria. Balanced polymorphisms like sickle cell trait can remain in a population for centuries after the selection is gone (by either ecological change or by migration away from the malarious region). While there are some skeletal indicators of some hemoglobinopathies, human ancient DNA analysis would be a more secure method of diagnosis. Care has to be taken to distinguish skeletal changes made by malaria’s hemolytic anemia and the hemoglobinopathy anemias.
Ancient DNA detection of the malaria Plasmodium parasite has been disappointing. To date, only the tropical Plasmodium falciparium, that causes the most severe disease, has been detected by PCR. It is believed that attempts of detect the historically more common Plasmodium vivax have been stymied by the low parasite load in the blood. The difficulty in finding vivax aDNA is a reminder that pathogens really do need to be in high concentrations within the sample to overcome degradation and be detected by PCR or sequencing technology. As far as I know, there have not been attempts to detect the other three human malarial parasites– Plasmodium ovale, Plasmodium malariae and Plasmodium knowlesi — by aDNA analysis.
Modern medicine is devising an ever expanding array of tests for malaria diagnostics and prognostics. However, most of these tests all require fresh (soft) tissue or blood. Immunological methods have not been applied to malaria in archaeological material yet. The most promising detection method for malaria among the newer diagnostics is the detection of the iron containing waste product of the Plasmodium parasite hemozoin. When the parasite feeds on hemoglobin in the red blood cell, toxic iron waste products are processed into the biocrystal hemozoin and excreted into the tissues. In patients with reoccurring or multiple malaria infections, hemozoin will stain their bone marrow black and can be found in liver, spleen, brain and lungs. It can be detected microscopically (as seen above) or by mass spectrometer. Although some other blood parasites also excrete hemozoin, they can be distinguished from the malarial product.
Despite the advances in diagnosis for existing malaria patients taking advantage of new methods and technologies, archaeological detection has not enjoyed the same success. Building a case for malaria in the past, must rely on an array of data with knowledge of ecology, vectors, and nutritional status of the population in addition to osteological markers of anemia. Hopefully, the detection of hemozoin will eventually be the key to opening up biological studies of malaria in the past. If hemozoin can identify malaria victims, then perhaps focusing the ancient DNA work on hemozoin positive remains will be more successful breaking through the firewall to malaria’s evolution and historical epidemiology.
Setzer, T. J. (2014). Malaria detection in the field of paleopathology: A meta-analysis of the state of the art. Acta Tropica, 140, 97–104. doi:10.1016/j.actatropica.2014.08.010 (open access early edition; final edition)
Just a little update on my reading in August. I’ve been jumping around a bit reading on the history of malaria and wetlands. Lots of interesting bits and pieces!
John Aberth. An Environmental History of the Middle Ages: The Crucible of Nature, 2013.
Gregory of Tours (d. 594): Glory of the Confessors
Gregory of Tours (d. 594): The Life of the Fathers
Looking at what diseases people are seeking cures for primarily at the shrines of the saints.
William McNeill, Plagues and Peoples. 1976.
I reread this book about every ten years, so I’m working my way through it over lunch at work at the present. Odd to reread a book I first read in the late 1980s as a student. Its surprising how well it holds up, but it is now out of date in biology, history and anthropology. It really can’t be used to represent modern views on either infectious disease biology or history. We really need a new, updated edition! Just to give a few examples, HIV hadn’t even been identified in 1976 (as McNeill mentions in the preface of the 1998 edition) and antibiotic resistance and ‘(re)emerging infectious diseases’ were not considered critical problems (although both had begun to appear).
Robert Sallares, Malaria and Rome: A History of Malaria in Ancient Italy. 2002 (in progress)
Standout Papers – (more or less in order they were read)
Couser, J. (2010). The Changing Fortunes of Early Medieval Bavaria to 907 ad. History Compass, 8(4), 330–344. doi:10.1111/j.1478-0542.2009.00671.x
King, G., & Henderson, C. (2013). Living cheek by jowl: The pathoecology of medieval York. Quaternary International, xxx, 1–12. doi:10.1016/j.quaint.2013.07.032
Förster, F., Großmann, R., Hinz, M., Iwe, K., Kinkel, H., Larsen, A., et al. (2013). Towards mutual understanding within interdisciplinary palaeoenvironmental research: An exemplary analysis of the term landscape. Quaternary International, 312(C), 4–11. doi:10.1016/j.quaint.2013.07.045
Rippon, S. (2009). ‘Uncommonly rich and fertile’ or “not very salubrious?” The Perception and Value of Wetland Landscapes. Landscapes, 10(1), 39–60.
Bankoff, G. (2013). The“English Lowlands” and the North Sea Basin System: A History of Shared Risk. Environment and History, 19(1), 3–37.
Justin T. Noetzel. Monster, Demon, Warrior: St Guthlac and the Cultural Landscape of the Anglo-Saxon Fens. Comitatus: A Journal of Medieval and Renaissance Studies, Volume 45, 2014, pp. 105-131.
O’Sullivan, L., Jardine, A., Cook, A., & Weinstein, P. (2008). Deforestation, mosquitoes, and ancient Rome: Lessons for today. BioScience, 58(8), 756–760.