A migration-driven model for the historical spread of leprosy in medieval Eastern and Central Europe

Helen D. Donoghue*, G. Michael Taylor, Antónia Marcsik, Erika Molnár, Gyorgy Pálfi, Ildikó Pap, Maria Teschler-Nicola, Ron Pinhasi, Yilmaz S. Erdal, Petr Velemínsky, Jakub Likovsky, Maria Giovanna Belcastro, Valentina Mariotti, Alessandro Riga, Mauro Rubini, Paola Zaio, Gurdyal S. Besra, Oona Y.C. Lee, Houdini H.T. Wu, David E. MinnikinIan D. Bull, Justin O'Grady, Mark Spigelman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

43 Citations (Scopus)


Leprosy was rare in Europe during the Roman period, yet its prevalence increased dramatically in medieval times. We examined human remains, with paleopathological lesions indicative of leprosy, dated to the 6th-11th century AD, from Central and Eastern Europe and Byzantine Anatolia. Analysis of ancient DNA and bacterial cell wall lipid biomarkers revealed Mycobacterium leprae in skeletal remains from 6th-8th century Northern Italy, 7th-11th century Hungary, 8th-9th century Austria, the Slavic Greater Moravian Empire of the 9th-10th century and 8th-10th century Byzantine samples from Northern Anatolia. These data were analyzed alongside findings published by others. M. leprae is an obligate human pathogen that has undergone an evolutionary bottleneck followed by clonal expansion. Therefore M. leprae genotypes and sub-genotypes give information about the human populations they have infected and their migration. Although data are limited, genotyping demonstrates that historical M. leprae from Byzantine Anatolia, Eastern and Central Europe resembles modern strains in Asia Minor rather than the recently characterized historical strains from North West Europe. The westward migration of peoples from Central Asia in the first millennium may have introduced different M. leprae strains into medieval Europe and certainly would have facilitated the spread of any existing leprosy. The subsequent decline of M. leprae in Europe may be due to increased host resistance. However, molecular evidence of historical leprosy and tuberculosis co-infections suggests that death from tuberculosis in leprosy patients was also a factor.

Original languageEnglish
Pages (from-to)250-256
Number of pages7
JournalInfection, Genetics and Evolution
Publication statusPublished - 1 Apr 2015
Externally publishedYes

Bibliographical note

Funding Information:
Work carried out by AM was supported by the Hungarian Széchenyi project (5/081). EM and GP gratefully acknowledge the support of the Hungarian Scientific Research Fund OTKA (OTKA Grants Nos. K78555 and NN78696 ). The Czech Republic Ministry of Culture supported the DNA analysis of the Prusanky sample (DKRVO 2014/19, National Museum, 0002327). GSB has a James Bardrick Personal Research Chair and a Royal Society Wolfson Research Merit Award. DEM was a recipient of an Emeritus Fellowship from The Leverhulme Trust . The Leverhulme Trust Project Grant F/00 094/BL supported the mycolipid study (GSB, DEM, OY-CL). The UK National Environmental Research Council (NERC) provided funding for the mass spectrometry facilities at Bristol (Contract No. R8/H12/15; www.lsmsf.co.uk ). The Austrian Scientific Research Fund (Lise Meitner-Programme) supported RP for the project “Health and demography among populations from the Late Avar and Arabian Periods 9th–13th centuries” (Grant M715-B06 ).

Publisher Copyright:
© 2015 Elsevier B.V.


  • Ancient DNA
  • Genotyping
  • Human migrations
  • Lipid biomarkers
  • Mycobacterium leprae
  • Mycobacterium tuberculosis


Dive into the research topics of 'A migration-driven model for the historical spread of leprosy in medieval Eastern and Central Europe'. Together they form a unique fingerprint.

Cite this