Category Archives: Malaria

Human Parasites of the Roman Empire

Last week photos of Roman toilets were splashed across the web breaking the news that the Romans were not a healthy as most people seem to have assumed. As with many public health interventions, the real value of a sanitation system is out of view (and out of mind) to most people. Its not the toilet that keeps us healthy; its the water treatment plant. Plumbing just moves waste with its microbes and parasites from one place to another.

Paleoparasitology specialist Piers Mitchell put the Roman public health system to the test by evaluating the evidence for human parasites in archaeological remains from before, during and after the Roman Empire. Comparisons before and after the empire are more difficult in North Africa and the Middle East because these areas had long standing sophisticated civilizations before the Roman empire. There is more clarity between civilizations in Europe since Celtic and Germanic societies did not have anything like Roman infrastructure. Contrary to his expectations, there were just as many parasites and ectoparasites in the Roman era as before or after.  In some cases the empire helped spread parasites across Europe. Relative amounts of parasites across times is difficult to ascertain for a huge variety of reasons. So while the same parasites were present, the degree of infestation would have varied by place and time period, and archaeology can’t reliably predict this.

The Roman achilles’ heel was their use of human waste for fertilizer and fecal contamination of rivers.  Human waste was added to the other manure and redistributed to farm fields and the watershed. What they could not have understood is that human waste is a greater risk for the transmission of human parasites and bacterial diseases. Mitchell also suggests that Roman bath water, that was rarely changed, could have transmitted worm eggs and other parasites. Aquaducts did bring in cleaner water to some of the larger cities but the system could be contaminated and not all Roman sites had access to water from aquaducts. Walter Scheidel (2015:8) has claimed that the city of Rome itself was an example of the”urban graveyard” effect with a very unhealthy population despite having a “heavily subsidized food and water supply”. Scheidel emphasizes the impact of malaria and gastrointestinal disease. We should also keep in mind that a large proportion of gastrointestinal disease would have been bacterial or viral.

Second century Roman mosaic of foodstuffs

As the mosaic to the left shows, the Romans did change agriculture throughout the empire. They spread Mediterranean preferences for cereals and more fish and other aquatic food sources. Mitchell suggests that the Roman love for fish products, especially the fermented fish sauce garum, probably help spread fish tapeworms found throughout the empire. Many parasites and bacterial spores have evolved to withstand preserving methods like smoking, pickling, and osmotic preservation (like salting or sugaring).  Whipworm was the most common parasite found, but round worms and tape worms were also common. Lancet liver flukes were widespread and indicate the (presumably accidental) consumption of ants.  Antibody based detection (ELISA) has been able to identify Entamoeba histolytica that causes the usually endemic amoebic dysentery (as opposed to the epidemic bacterial dysentery caused by Shigella species). Although not strictly speaking parasites, Mitchell notes an abundance of evidence for flies around cesspits suggesting that they contributed to the spread of diseases associated with fecal contamination. He also notes that schistosomiasis has not been identified in Roman Europe, even though it has been found in medieval European remains.

Turning to ectoparasites, Mitchell found ample evidence of head lice, body lice, public lice, human fleas and bed bugs across the Romanized world. Human fleas (pulex irritans) have been particularly well preserved in Roman, Anglo-Scandinavian and medieval York in Britain. Mitchell notes that human fleas and body lice were present in over 50 archaeological layers at York. He concludes that “the Roman habit of washing in public baths does not seem to have decreased their risk of contracting ectoparasites, compared with Viking and Medieval people who did not use public baths in the same way” (Mitchell 2016: 6). Mitchell suggests that there were enough ectoparasites to support particularly lice transmitted diseases. He notes that Plague of Justinian was transmitted by fleas but is non-committal on the likely specific vector.

In examining the impact of the Roman empire, Mitchell notes that the transition from a wide variety of zoonotic parasites to those primarily associated with human fecal contamination had already occurred before the Roman expansion out of Italy. This shift is paralleled elsewhere and is tied to shift from hunter-gathers to settled agriculture. Whipworm, roundworm and amoebic dysentery were the primary parasites of Roman Europe, while the Romans seem to have made a lesser impact on North Africa and the Middle East where endemic zones of parasites were well established.

Malaria is the one parasitic disease I would have liked to see Mitchell discuss more. Mitchell notes that malarial aDNA has been found in Egypt and anemia possibly caused by malaria in Italy. He overlooks all the malaria work by Robert Sallares including malarial aDNA from Late Roman Italy and better anemia studies correlating with malaria have been done in Italy and Britain by Rebecca Gowland’s group. Yet, malaria is such a big topic that it would be hard to cover along with all the other parasites.


Mitchell, P. D. (2016). Human parasites in the Roman World: health consequences of conquering an empire. Parasitology, 1–11.

Scheidel, W. (2015). Death and the City: Ancient Rome and Beyond. Available at SSRN 2609651.

See also:

Hall, A., & Kenward, H. (2015). Sewers, Cesspits, and middens: a survey of the evidence of 2000 years of waste disposal in York, UK. In P. D. Mitchell (Ed.), Sanitation, latrines and intestinal parasites in past populations (pp. 99–120).

Summer reading


summer 2

The summer is officially over this week so its time for my quarterly reading update. I read a more eclectic mix of topics this summer than usual. These are just those that really stood out as being useful for my purposes. I hope you find something of interest!


  • Gregory Aldrete. Floods of the Tiber in Ancient Rome. 2006.
  • Robert Sallares, Malaria and Rome: A History of Malaria in Ancient Italy, 2002
  • Nukhet Varlik. Plague and Empire in the Early Modern Mediterranean: The Ottoman Experience 1347-1600. Cambridge UP, 2015
MA Thesis

Katharine Dean. Modeling plague transmission in Medieval European cities. (2015, June 1). MA Thesis.  Oslo.


  • Kimura, H., Saitoh, M., Kobayashi, M., Ishii, H., Saraya, T., Kurai, D., et al. (2015). Molecular evolution of haemagglutinin (H) gene in measles virus. Scientific Reports, 1–10. doi:10.1038/srep11648
  • Scheidel, W. (2015). Death and the City: Ancient Rome and Beyond. Available at SSRN 2609651.
  • Smith-Guzmán, N. E. (2015). The skeletal manifestation of malaria: An epidemiological approach using documented skeletal collections. American Journal of Physical Anthropology, n/a–n/a.
  • Sigl, M., Winstrup, M., McConnell, J. R., Welten, K. C., Plunkett, G., Ludlow, F., et al. (2015). Timing and climate forcing of volcanic eruptions for the past 2,500 years. Nature.

  • Kostick, C., & Ludlow, F. (2015). The dating of volcanic events and their impact upon European society, 400-800 CE (Vol. 5, pp. 7–30). Post-Classical Archaeologies.

  • Schats, R. (2015). Malaise and mosquitos: osteoarchaeological evidence for malaria in the medieval Netherlands. Analecta Praehistoricaleidensia, 45, 133–140.
  • Eisen, R. J., Dennis, D. T., & Gage, K. L. (2015). The Role of Early-Phase Transmission in the Spread of Yersinia pestis. Journal of Medical Entomology, tjv128–10.

Spring Reading

It has been a busy spring. I haven’t had a chance to blog as much as I would have liked to, but I have done quite a bit of reading. Some of my reading has been on the complex world of the first plague pandemic. To say that it was transformative would be an understatement.  One of the social questions for the first plague pandemic is how does plague and other natural disasters effect a population that is the midst of conversion?  When the Black Death came it encountered a fully Christian and Muslim world, but not so during the first pandemic. Most of Europe was not yet Christian in 541. There were some Jews, Christians of several varieties, Roman pagans, Germanic pagans, Celtic pagans, Zoroastrians, North African and Middle Eastern pagans, etc. Yet at the end of the pandemic period, Islam is born (and fast growing) and Christianity is dominant in Europe (and united by Rome). The plague began in a polytheistic world and ended in a monotheistic one. What role did the plague play, if any? Yet to be determined. This really isn’t a peripheral issue. Every writer of the first pandemic was involved in this transformation (winners and losers) in some way and it effected how they wrote about the plague and other calamities. So I have a lot of reading to do; below is a start and a few other things that caught my attention.


Marilyn Dunn. (2010) The Christianization of the Anglo-Saxons, c. 497- c.700: Discourses of Life, Death and Afterlife.

Marilyn Dunn (2013) Belief and Religion in Barbarian Europe, c. 350-700. Bloomsbury.

Peter Brown (2015) The Ransom of the Soul: Afterlife and Wealth in Early Christianity. Harvard University Press.

Peter Heather (2013) The Restoration of Rome: Barbarian Popes and Imperial Pretenders. Oxford University Press.


Balbir Singh and Cyrus Saneshvar (2013) Human Infections and Detection of Plasmodium knowlesi. Clinical Microbiology Reviews. 26 (2): 165-184.

Runfola, J. K., House, J., Miller, L., Coltron, L., Hite, D., Hawley, A., et al. (2015). Outbreak of Human Pneumonic Plague with Dog-to-Human and Possible Human-to-Human Transmission — Colorado, June–July 2014. MMWR. Morbidity and Mortality Weekly Report, 64(16), 429–434.

Smith-Guzmán, N. E. (2015). Cribra orbitalia in the ancient Nile Valley and its connection to malaria. International Journal of Paleopathology, 10, 1–12. doi:10.1016/j.ijpp.2015.03.001

Benovitz, N. (2014). The Justinianic plague: evidence from the dated Greek epitaphs of Byzantine Palestine and Arabia. Journal of Roman Archaeology. doi:10.1016/S1473-3099(13)70323-2)

Bernard Bachrach, (2007) Plague, Population, and Economy in Merovingian Gaul. Journal of the Australian Early Medieval Association. 3: 29-57.

Sarris, P. (2002). The Justinianic plague: origins and effects. Continuity and Change, 17(02), 169–182. doi:10.1017/S0268416002004137

Newfield, T. P. (2015). Human–Bovine Plagues in the Early Middle Ages. Journal of Interdisciplinary History, 46(1), 1–38. doi:10.1179/146141010X12640787648612

Inskip, S. A., Taylor, G. M., Zakrzewski, S. R., Mays, S. A., Pike, A. W. G., Llewellyn, G., et al. (2015). Osteological, Biomolecular and Geochemical Examination of an Early Anglo-Saxon Case of Lepromatous Leprosy. PLoS ONE, 10(5), e0124282. doi:10.1371/journal.pone.0124282.s001

Shanks, G. D., & White, N. J. (2013). The activation of vivax malaria hypnozoites by infectious diseases. The Lancet Infectious Diseases, 13(10), 900–906. doi:10.1016/S1473-3099(13)70095-1

Dick, H. C., Pringle, J. K., Sloane, B., Carver, J., Haffenden, A., Stephen Porter, H. A., et al. (2015). Detection and characterisation of Black Death burials by multi-proxy geophysical methods. Journal of Archaeological Science, 1–50. doi:10.1016/j.jas.2015.04.010

Lowell, J. L., Antolin, M. F., Andersen, G. L., Hu, P., Stokowski, R. P., & Gage, K. L. (2015). Single-Nucleotide Polymorphisms Reveal Spatial Diversity Among Clones of Yersinia pestis During Plague Outbreaks in Colorado and the Western United States. Vector Borne and Zoonotic Diseases (Larchmont, N.Y.), 15(5), 291–302. doi:10.1089/vbz.2014.1714

Neil, B. (2013). The Papacy in the Age of Gregory the Great. A Companion to Gregory the Great, 3–28.

Brogiolo, G. P. (2015). Flooding in Northern Italy during the Early Middle Ages: resilience and adaption. Post-Classical Archaeologies, 5, 47–68.

Kostick, C., & Ludlow, F. (2015). The dating of volcanic events and their impact upon European society, 400-800 CE. Post-Classical Archaeologies.  5, 7–30.

Riehm, J. M., Projahn, M., Vogler, A. J., Rajerison, M., Andersen, G., Hall, C. M., et al. (2015). Diverse Genotypes of Yersinia pestis Caused Plague in Madagascar in 2007. PLoS Neglected Tropical Diseases, 9(6), e0003844. doi:10.1371/journal.pntd.0003844.s002

Makundi, R. H., Massawe, A. W., Borremans, B., Laudisoit, A., & Katakweba, A. (2015). We are connected: flea–host association networks in the plague outbreak focus in the Rift Valley, northern Tanzania. Wildlife Research, 42(2), 196. doi:10.1071/WR14254