Tuberculosis before and after the Black Death (1346 – 1353 CE) in the Hospital of St John the Evangelist in Cambridge, England

This article was published with Open Access under the Elsevier/Jisc Open Access agreement The authors would like to thank all of the members of the ‘After the Plague’ project, and the Cambridge Archaeological Unit for their help and support. We would also like to thank György Pálfi for organising the ICEPT-3 conference, at which the initial findings of this research were presented and for inviting us to contribute to this special issue. This research was funded by the Wellcome Trust (Award no 2000368/Z/15/Z) and St John's College, Cambridge.Peer reviewedPublisher PD

Caring for the injured : Exploring the immediate and long-term consequences of injury in medieval Cambridge, England

Open Access through the Elsevier Agreement Acknowledgments The authors would like to thank Trish Biers of the Duckworth Collection at the University of Cambridge as well as the anonymous reviewers and editors of this special issue (Ileana Mircarelli, Lorna Tilley, and Mary Ann Tafuri) for their comments on this manuscript. This research was generously funded by the Wellcome Trust (Award no 2000368/Z/15/Z) and St John’s College, Cambridge.Peer reviewedPublisher PD

An invasive Haemophilus influenzae serotype b infection in an Anglo-Saxon plague victim.

BACKGROUND: The human pathogen Haemophilus influenzae was the main cause of bacterial meningitis in children and a major cause of worldwide infant mortality before the introduction of a vaccine in the 1980s. Although the occurrence of serotype b (Hib), the most virulent type of H. influenzae, has since decreased, reports of infections with other serotypes and non-typeable strains are on the rise. While non-typeable strains have been studied in-depth, very little is known of the pathogen's evolutionary history, and no genomes dating prior to 1940 were available. RESULTS: We describe a Hib genome isolated from a 6-year-old Anglo-Saxon plague victim, from approximately 540 to 550 CE, Edix Hill, England, showing signs of invasive infection on its skeleton. We find that the genome clusters in phylogenetic division II with Hib strain NCTC8468, which also caused invasive disease. While the virulence profile of our genome was distinct, its genomic similarity to NCTC8468 points to mostly clonal evolution of the clade since the 6th century. We also reconstruct a partial Yersinia pestis genome, which is likely identical to a published first plague pandemic genome of Edix Hill. CONCLUSIONS: Our study presents the earliest genomic evidence for H. influenzae, points to the potential presence of larger genomic diversity in the phylogenetic division II serotype b clade in the past, and allows the first insights into the evolutionary history of this major human pathogen. The identification of both plague and Hib opens questions on the effect of plague in immunocompromised individuals already affected by infectious diseases

Employing radiography (X‐rays) to localize lesions in human skeletal remains from past populations to allow accurate biopsy, using examples of cancer metastases

Abstract: Clinical research into biomolecules from infectious diseases and cancers has advanced rapidly in recent years, with two key areas being DNA analysis and proteomics. If we wish to understand important diseases and their associated biomolecules in past populations, techniques are required that will allow accurate biopsy of lesions in excavated human skeletal remains. While locating lesions visible on the surface of a bone is simple, many lesions such as cancer metastases are located in the medulla of bones, unseen on visual inspection. Here, we use two novel image guided techniques to investigate how plain radiographs may improve accuracy in the localization of lesions within bones from medieval individuals. While both techniques were effective, we found the grid technique required fewer radiographs than the pointer technique to employ and so was responsible for a lower overall radiation dose. We then discuss methods available for biopsy in archeological bone and how the optimal location for the biopsy of malignant lesions will vary depending upon whether the tumor is blastic or lytic in nature. Limitations of this X‐ray guided approach include that not all cancer metastases are visible on plain radiographs, as erosion of cortical bone is frequently required for visualization of lytic metastases using this imaging modality

Violence in Hasmonean Judea: Skeletal evidence of a massacre from 2nd–1st century BCE Jerusalem

Funder: Darwin College, University of Cambridge; Id: http://dx.doi.org/10.13039/501100000595Abstract: During a salvage excavation conducted by the Israel Antiquities Authority, a mass grave containing the skeletal remains from 124 individuals, many with evidence of weapon injuries, was discovered in a water cistern outside the Old City of Jerusalem. Radiocarbon dates derived from human bone and the date of the material finds suggest the skeletal remains date to the end of the 2nd century or the beginning of the 1st century BCE. The aim of this research is to analyze the weapon injuries in order to reconstruct the nature and context of this violence. The human skeletal remains from 23 individuals recovered from the cistern were selectively retained and examined macroscopically in a laboratory setting. Silicone casts of selected weapon injuries (n = 5) were analyzed using scanning electron microscopy. Numerous examples of peri‐mortem blunt‐ and sharp‐force trauma were observed including evidence that at least 16 individuals were decapitated. The extent and nature of the observed injuries as well as the evidence of their haphazard deposition into the cistern suggest that these individuals were the victims of a massacre. As a highly visible act of violence, massacres are often used as a mechanism for social control. When contextualized, this skeletal assemblage is most likely evidence of a massacre that occurred during the reign of the Hasmonean king Alexander Jannaeus. This is the first archeological evidence for the use of socially sanctioned violence to legitimize the Hasmonean state and to maintain social control at the end of the 2nd century–early 1st century BCE

A probable case of multiple myeloma from Bronze Age China.

ObjectivePaleopathological evidence of cancer from past populations is rare, especially outside of Europe and North Africa. This study expands upon the current temporal and spatial distribution of cancer by presenting a probable case of multiple myeloma from Bronze Age China.MaterialThe human skeletal remains of an adult male from the Qijia culture horizon (1750-1400 BCE) of the Bronze Age cemetery of Mogou (), located in Gansu Province, Northwest China.MethodsThe human skeletal remains were assessed macroscopically and radiographically using plain x-rays.ResultsMultiple ovoid-shaped osteolytic lesions with sharply demarcated margins were observed. The axial skeletal had the greatest involvement, specifically the vertebrae, ribs, and sternum. Radiographic imaging revealed more extensive destruction of cancellous than cortical bone, indicating that the marrow was the focal point of the disease.ConclusionBased on the nature, distribution, and radiographic appearance of the lesions, the most likely diagnosis is multiple myeloma.SignificanceThis is one of the only cases of cancer identified in archaeological human skeletal remains from East Asia and is the first published case of a hematopoietic malignancy from mainland China. The analysis and publication of examples of neoplasia from areas that expand upon the current known temporal and spatial distribution is necessary in order to better reconstruct the history and evolution of cancer.LimitationsPoor skeletal preservation prevented the full extent of osteolytic lesions to be observed.Suggestions for future researchBy placing case studies such as this into a temporal and spatial framework, it is possible for future research to begin to interrogate possible underlying causes of cancer in ancient populations within the context of changing environmental conditions and subsistence strategies