The retrospective diagnosis of leprosy

Clinical and paleopathological complementarities in the medical archive of the Hospital ‐ Colónia Rovisco Pais (HCRP), Tocha, Portugal, and in the skeletal collection from the medieval leprosarium of St. Jørgen’s, Odense, Denmark

Duration: 2004 ‐ 2008

Abstract: According to historical sources, leprosy was a common disease during medieval times. Nevertheless, the palaeopathological testimonies are not acquiescent with historical depictions, since there is a scarcity of human skeletal remains with evidences of this socially stigmatized and dreadful infectious disease. This research aimed to correlate clinical and paleopathological data collected from: a) 300 clinical files from patients – with lepromatous (LL) and tuberculoid (LT) leprosy – screened between 1947 ‐ 1985 at the Hospital ‐ Colony Rovisco Pais (HCRP) – the last Portuguese leprosarium; b) 191 skeletons from St. Jørgen’s leprosarium cemetery (13th ‐ 16th/17th centuries), Odense, Denmark. Osseous lesions were present in 13.0% (39/300) of the HCRP leprosy patients, mainly in those with LT (84.6% [33/39]). The risk of LT patients develop bone changes was 6.8 times higher (OR=6.77; IC95%=2.60 ‐ 18.67) than LL ones. The Odense skeletons revealed a minimum prevalence of leprosy of 32.5% (62/191), applying Andersen and Manchester (1992) and Ortner (2003) criteria, and a maximum prevalence of 42.9% (82/191), adding Møller ‐ Christensen’s (1967) criteria. The comparison between lesions distribution in both samples demonstrated the viability of distinguishing LL from LT in human skeletons and unveils the potential of medical archives to paleopathological studies. The possibility of LT identification in the archaeological record brings new challenges to the understanding of leprosy evolution and history.

Coordinator: Ana Luísa Santos, CIAS

Participants: Vítor Miguel Jacinto Matos

Partner institutions:

Financial support: Fundação para a Ciência e Tecnologia  ‐  SFRH/BD/16155/2004