White plague among the "forgotten people" from the Barbaricum of the Carpathian Basin-Cases with tuberculosis from the Sarmatian-period (3rd-4th centuries CE) archaeological site of Hódmezővásárhely-Kenyere-ér, Bereczki-tanya (Hungary)

PLoS One. 2024 Jan 10;19(1):e0294762. doi: 10.1371/journal.pone.0294762. eCollection 2024.

Abstract

Tuberculosis (TB) is a bacterial infection that is well-known in the palaeopathological record because it can affect the skeleton and consequently leaves readily identifiable macroscopic alterations. Palaeopathological case studies provide invaluable information about the spatio-temporal distribution of TB in the past. This is true for those archaeological periods and geographical regions from when and where no or very few TB cases have been published until now-as in the Sarmatian period (1st-5th centuries CE) in the Barbaricum of the Carpathian Basin. The aim of our paper is to discuss five newly discovered TB cases (HK199, HK201, HK225, HK253, and HK309) from the Sarmatian-period archaeological site of Hódmezővásárhely-Kenyere-ér, Bereczki-tanya (Csongrád-Csanád county, Hungary). Detailed macromorphological evaluation of the skeletons focused on the detection of bony changes likely associated with different forms of TB. In all five cases, the presence of endocranial alterations (especially TB-specific granular impressions) suggests that these individuals suffered from TB meningitis. Furthermore, the skeletal lesions observed in the spine and both hip joints of HK225 indicate that this juvenile also had multifocal osteoarticular TB. Thanks to the discovery of HK199, HK201, HK225, HK253, and HK309, the number of TB cases known from the Sarmatian-period Carpathian Basin doubled, implying that the disease was likely more frequent in the Barbaricum than previously thought. Without the application of granular impressions, the diagnosis of TB could not have been established in these five cases. Thus, the identification of TB in these individuals highlights the importance of diagnostics development, especially the refinement of diagnostic criteria. Based on the above, the systematic macromorphological (re-)evaluation of osteoarchaeological series from the Sarmatian-period Carpathian Basin would be advantageous to provide a more accurate picture of how TB may have impacted the ancestral human communities of the Barbaricum.

MeSH terms

  • Archaeology
  • Bone Diseases*
  • Humans
  • Hungary
  • Memory Disorders
  • Tuberculosis, Meningeal*
  • Tuberculosis, Osteoarticular*
  • Vegetables
  • Xanthosoma*

Grants and funding

This work was funded by the Cooperative Doctoral Programme for Doctoral Scholarships 2020 (grant agreement no. 1020404) of the Hungarian Ministry of Innovation and Technology to LK, by the University of Szeged Open Access Fund (grant agreement no. 6325) to OS, and by the Competence Centre of the Life Sciences Cluster of the Centre of Excellence for Inter-disciplinary Research, Development and Innovation of the University of Szeged to TT. This project received funding also from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement no. 856453 ERC-2019-SyG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.