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Human parasites in the Roman World: health consequences of conquering an empire


The archaeological evidence for parasites in the Roman era is presented in order to demonstrate the species present at that time, and highlight the health consequences for people living under Roman rule. Despite their large multi-seat public latrines with washing facilities, sewer systems, sanitation legislation, fountains and piped drinking water from aqueducts, we see the widespread presence of whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides) and Entamoeba histolytica that causes dysentery. This would suggest that the public sanitation measures were insufficient to protect the population from parasites spread by fecal contamination. Ectoparasites such as fleas, head lice, body lice, pubic lice and bed bugs were also present, and delousing combs have been found. The evidence fails to demonstrate that the Roman culture of regular bathing in the public baths reduced the prevalence of these parasites. Fish tapeworm was noted to be widely present, and was more common than in Bronze and Iron Age Europe. It is possible that the Roman enthusiasm for fermented, uncooked fish sauce (garum) may have facilitated the spread of this helminth. Roman medical practitioners such as Galen were aware of intestinal worms, explaining their existence and planning treatment using the humoural theory of the period.

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* Corresponding author. Department of Archaeology and Anthropology, University of Cambridge, The Henry Wellcome Building, Fitzwilliam Street, Cambridge CB2 1QH, UK. E-mail:
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E. Anastasiou and P. D. Mitchell (2013 a). Simplifying the process of extracting parasitic worm eggs from cesspool and latrine sediments: a trial comparing the efficacy of widely used techniques for dissaggregation. International Journal of Paleopathology 3, 204207.

E. Anastasiou and P. D. Mitchell (2013 b). Paleopathology and genes: investigating the genetics of infectious diseases in excavated human skeletal remains and mummies from past populations. Gene 528, 3340.

E. Anastasiou , K. O. Lorentz , G. J. Stein and P. D. Mitchell (2014). Prehistoric schistosomiasis parasite found in the Middle East. Lancet Infectious Diseases 14, 553554.

A. Araújo , K. Reinhard and L. F. Ferreira (2015). Paleoparasitology – human parasites in ancient material. Advances in Parasitology 90, 349387.

B. Arriaza , V. Standen , K. Reinhard , A. Araújo , J. Heukelbach and K. Dittmar (2013). On head lice and social interaction in archaic Andean coastal populations. International Journal of Paleopathology 3, 257268.

J. Baeten , E. Marinova , V. De Laet , P. Degryse , D. De Vos and M. Waelkens (2012). Faecal biomarker and archaeobotanical analyses of sediments from a public latrine shed new light on ruralisation in Sagalassos, Turkey. Journal of Archaeological Science 39, 11431159.

A. G. Bobrov , O. Kirillina , V. Vadyvaloo , B. J. Koestler , A. K. Hinz , D. Mack , C. M. Waters and R. D. Perry (2015). The Yersinia pestis HmsCDE regulatory system is essential for blockage of the oriental rat flea (Xenopsylla cheopis), a classic plague vector. Environmental Microbiology 17, 947959.

G. Bosi , M. B. Mazzanti , A. Florenzano , I. M. N'siala , A. Pederzoli , P. Rinaldi , P. Torri and A. M. Mercuri (2011). Seeds/fruits, pollen and parasite remains as evidence of site function: piazza Garibaldi – Parma (N Italy) in Roman and Mediaeval times. Journal of Archaeolgical Science 38, 16211633.

F. Bouchet , S. Harter , J. C. Paicheler , A. Araújo and L. F. Ferreira (2002). First recovery of Schistosoma mansoni eggs from a latrine in Europe (15th–16th centuries). Journal of Parasitology 88, 404405.

F. Bouchet , S. Harter and M. Le Bailly (2003). The state of the art of palaeoparasitology research in the Old World. Memorias do Instituto Oswaldo Cruz 98(Suppl. 1), 92102.

I. Chouikha and B. J. Hinnebusch (2012). Yersinia-flea interactions and the evolution of the arthropod-borne transmission route of plague. Current Opinion in Microbiology 15, 239246.

H. E. M. Cool (2006). Eating and Drinking in Roman Britain. Cambridge University Press, Cambridge, UK.

R. I. Curtis (1984). Salted fish products in ancient medicine. Journal of the History of Medicine and Allied Sciences 39, 430445.

R. I. Curtis (1988). Spanish trade in salted fish products in the 1st and 2nd centuries AD. International Journal of Nautical Archaeology and Underwater Exploration 17, 205210.

G. C. Da Rocha , S. Harter , M. Le Bailly , A. Araújo , L. F. Ferreira , M. Serra-Freire and F. Bouchet (2006). Paleoparasitological remains revealed by seven historic contexts from ‘Place d'Armes’, Namur, Belgium. Memórias do Instituto Oswaldo Cruz 101(Suppl. 2), 4352.

A. Florenzano , A. M. Mercuri , A. Pederzoli , P. Torri , G. Bosi , L. Olmi , R. Rinaldi and M. B. Mazzanti (2012). The significance of intestinal parasite remains in pollen samples from medieval pits in the Piazza Garibaldi of Parma, Emilia Romagna, Northern Italy. Geoarchaeology 27, 3447.

V. Forbes , F. Dussault and A. Bain (2013). Contributions of ectoparasite studies in archaeology with two examples from the North Atlantic region. International Journal of Paleopathology 3, 158164.

L. Frías , D. Leles and A. Araújo (2013). Studies on protozoa in ancient remains – a review. Memorias do Instituto Oswaldo Cruz 108, 112.

C. L. M. Gonçalves , V. L. da Silva , C. M. de Andrade , K. Reinhard , G. C. Da Rocha , M. Le Bailly , F. Bouchet , L. F. Ferreira and A. Araújo (2004). Amoebiasis distribution in the past: first steps using an immunoassay technique. Transactions of the Royal Society of Tropical Medicine and Hygiene 98, 8891.

M. L. C. Gonçalves , A. Araújo , R. Duarte , J. P. Pereira da Silva , K. Reinhard , F. Bouchet and L. F. Ferreira (2002). Detection of Giardia duodenalis antigen in coprolites using a commercially available enzyme-linked immunosorbent assay. Transactions of the Royal Society of Tropical Medicine and Hygiene 96, 640643.

A. Gunn and S. J. Pitt (2012). Parasitology: an Integrated Approach. Wiley-Blackwell, Chichester, UK.

R. J. Hankinson (2008). The Cambridge Companion to Galen. Cambridge University Press, Cambridge, UK.

M. Harbeck , L. Seifert , S. Hänsch , D. W. Wagner , D. Birdsell , K. L. Parise , I. Wiechmann , G. Grupe , A. Thomas , P. Keim , L. Zöller , B. Bramanti , J. M. Riehm and H. C. Scholz (2013). Yersinia pestis DNA from skeletal remains from the 6th century AD reveals insights into Justinianic Plague. PLoS Pathogens 9, e1003349.

H. Heinonen-Tanski and C. van Wijk-Sebesma (2005). Human excreta for plant production. Bioresource Technology 96, 403411.

R. C. Hoffman (2003). A brief history of aquatic resource use in medieval Europe. Helgoland Marine Research 59, 2230.

P. D. Horne (2002). First evidence of Enterobiasis in ancient Egypt. Journal of Parasitology 88, 10191021.

A. K. Hufthammer and L. Walløe (2013). Rats cannot have been intermediate hosts for Yersinia pestis during medieval plague epidemics in northern Europe. Journal of Archaeological Science 40, 17521759.

L. H. Jaeger and A. M. Iniguez (2014). Molecular paleoparasitological hybridization approach as effective tool for diagnosing human intestinal parasites from scarce archaeological remains. PLoS ONE 9, e105910.

P. K. Jensen , P. D. Phuc , L. G. Knudsen , A. Dalsgaard and F. Konradsen (2008). Hygiene versus fertiliser: the use of human excreta in agriculture – a Vietnamese example. International Journal of Hygiene and Environmental Health 211, 432439.

F. Jirsa and V. Winiwarter (2010). Eingeweidewürmer in Galens Schriften [Intestinal helminths in the works of Galen]. Wiener Klinische Wochenschrift 122(3 Suppl.), 1418.

H. K. Kenward (1999). Pubic lice (Pthirus pubis L.) were present in Roman and Medieval Britain. Antiquity 73, 911915.

R. Khairat , M. Ball , C.-C. H. Chang , R. Bianucci , A. G. Nerlich , M. Trautmann , S. Ismail , G. M. L. Shanab , A. M. Karim , Y. Z. Gad and C. M. Pusch (2013). First insights into the metagenome of Egyptian mummies using next-generation sequencing. Journal of Applied Genetics 54, 309325.

M. M. Kliks (1990). Helminths as heirlooms and souvenirs: a review of New World paleoparasitology. Parasitology Today 6, 93100.

A. O. Koloski-Ostrow (2015). The Archaeology of Sanitation in Roman Italy: Toilets, Sewers, and Water Systems. University of North Carolina Press, Chapel Hill, USA.

S. Leach , M. Lewis , C. Chenery , G. Müldner and H. Eckardt (2009). Migration and diversity in Roman Britain: a multidisciplinary approach to the identification of immigrants in Roman York, England. American Journal of Physical Anthropology 140, 546561.

M. Le Bailly and F. Bouchet (2010). Ancient dicrocoeliasis: occurrence, distribution and migration. Acta Tropica 115, 175180.

M. Le Bailly and F. Bouchet (2013). Diphyllobothrium in the past: review and new records. International Journal of Paleopathology 3, 182187.

M. Le Bailly , S. Mouze , G. C. D. Rocha , J.-L. Heim , R. Lichtenberg , F. Dunand and F. Bouchet (2010). Identification of Taenia sp. in a mummy from a Christian necropolis in El-Deir, Oasis of Kharga, ancient Egypt. Journal of Parasitology 96, 213215.

D. Leles , A. Araújo , L. F. Ferreira , A. C. P. Vicente and A. M. Iñiguez (2008). Molecular paleoparasitological diagnosis of Ascaris sp. from coprolites: new scenery of Ascariasis in pre-Columbian South America times. Memorias do Instituto Oswaldo Cruz 103, 106108.

L. K. Little (2011). Plague historians in lab coats. Past and Present 213, 267290.

A. Locker (2007). In piscibus diversis; the bone evidence for fish consumption in Roman Britain. Britannia 38, 141180.

J. E. Mann (2012). Hippocrates, On the Art of Medicine. Brill, Leiden, The Netherlands.

P. D. Mitchell (2011). Retrospective diagnosis, and the use of historical texts for investigating disease in the past. International Journal of Paleopathology 1, 8188.

P. D. Mitchell (2013). The origins of human parasites: exploring the evidence for endoparasitism throughout human evolution. International Journal of Paleopathology 3, 191198.

P. D. Mitchell (2015 b). Human parasites in medieval Europe: lifestyle, sanitation and medical treatment. Advances in Parasitology 90, 389420.

G. Mowlavi , S. Kacki , J. Dupouy-Camet , I. Mobedi , M. Makki , M. F. Harandi and S. R. Naddaf (2014). Probable hepatic capillariosis and hydatidosis in an adolescent from the late Roman period buried in Amiens (France). Parasite 21, 9.

K. Y. Mumcuoglu (2008). Human lice: pediculus and pthirus. In Paleomicrobiology: Past Human Infections (ed. D. Raoult and M. Drancourt ), pp. 215222. Springer-Verlag, Berlin, Germany.

K. Y. Mumcuoglu and J. Zias (1988). Head lice, Pediculus humanus capitis (Anoplura: Pediculidae) from hair combs excavated in Israel and dated from the first century BC to the eighth century AD. Journal of Medical Entomology 25, 545547.

K. Y. Mumcuoglu , J. Zias , M. Tarshis , M. Lavi and G. D. Stiebe (2003). Body louse remains in textiles excavated at Masada, Israel. Journal of Medical Entomology 40, 585587.

T. P. O'Connor (2008). Pets and pests in Roman and medieval Britain. Mammal Review 22, 107113.

C. S. Oh , M. Seo , J. Y. Chai , S. J. Lee , M. J. Kim , J. B. Park and D. H. Shin (2010). Amplification and sequencing of Trichuris trichiura ancient DNA extracted from archaeological sediments. Journal of Archaeological Science 37, 12691273.

P. J. Osborne (1971). An insect fauna from the Roman site at Alcester, Warwickshire. Britannia 2, 156165.

D. Raoult , O. Dutour , L. Houhamdi , R. Jankauskas , P.-E. Fournier , Y. Ardagna , M. Drancourt , M. Signoli , V. Dang La , Y. Macia and G. Aboudharam (2006). Evidence for louse-transmitted diseases in soldiers of Napoleon's Grand Army in Vilnius. Journal of Infectious Diseases 193, 112120.

E. E. Rácz , E. Pucu de Aráujo , E. Jensen , C. Mostek , J. J. Morrow , M. L. Van Hove , R. Bianucci , D. Willems , F. Heller , A. Aráujo and K. J. Reinhard (2015). Parasitology in an archaeological context: analysis of medieval burials in Nivelles, Belgium. Journal of Archaeological Science 53, 304315.

L. Salvadei , F. Ricci and G. Manzi (2001). Porotic hyperostosis as a marker of health and nutritional conditions during childhood: studies at the transition between Imperial Rome and the early Middle Ages. American Journal of Human Biology 13, 709717.

A. M. Schotthoefer , S. W. Bearden , J. L. Holmes , S. M. Vetter , J. A. Montenieri , S. K. Williams , C. B. Graham , M. E. Woods , R. J. Eisen and K. L. Gage (2011). Effects of temperature on the transmission of Yersinia pestis by the flea, Xenopsylla cheopis, in the late phase period. Parasites and Vectors 4, 191.

N. Searcey , K. J. Reinhard , E. Egarter-Vigl , F. Maixner , D. Piombino-Mascali , A. R. Zink , W. van der Sanden , S. L. Gardner and R. Bianucci (2013). Parasitism of the Zweeloo woman: dicrocoeliasis evidenced in a Roman period bog mummy. International Journal of Paleopathology 3, 224228.

L.-M. Shillito , I. D. Bull , W. Matthew , M. J. Almond , J. M. Williams and R. P. Evershed (2011). Biomolecular and micromorphological analysis of suspected faecal deposits at Neolithic Çatalhöyük, Turkey. Journal of Archaeological Science 38, 18691877.

L. Szidat (1944). Über die erhaltungsfähigkeit von helmintheneiern in vor- und frühgeschichtlichen moorleichen. Zeitschrift für Parasitenkunde 13, 265274.

T. -N. -N. Tran , C. L. Forestier , D. Drancourt , D. Raoult and G. Aboudharam (2011 a). Co-detection of Bartonella quintana and Yersinia pestis in an 11th–15th century burial site in Bondy, France. American Journal of Physical Anthropology 145, 489494.

C. Trompoukis , C. German and M. E. Falagas (2007). From the roots of parasitology: Hippocrates’ first scientific observations in helminthology. Journal of Parasitology 93, 970972.

D. M. Wagner , J. Klunk , M. Harbeck , A. Devault , N. Waglechner , J. W. Sahl , J. Enk , D. N. Birdsel , M. Kuch , C. Lumibao , D. Poinar , T. Pearson , M. Fourment , B. Golding , J. M. Riehm , D. J. Earn , S. DeWitte , J. M. Rouillard , G. Grupe , I. Wiechmann , J. B. Bliska , P. S. Keim , H. C. Scholz , E. C. Holmes and H. Poinar (2014). Yersinia pestis and the Plague of Justinian 541–543 AD: a genomic analysis. Lancet Infectious Diseases, 14, 319326.

P. L. Walker , R. Bathurst , R. Richman , T. Gjerdrum and V. A. Andrushko (2009). The causes of porotic hyperostosis and cribra orbitalia: a re-appraisal of the iron deficiency anaemia hypothesis. American Journal of Physical Anthropology 139, 109125.

P. J. Warnock and K. J. Reinhard (1992). Methods for extracting pollen and parasite eggs from latrine soils. Journal of Archaeological Science 19, 261264.

M. A. Zeder (2011). The origins of agriculture in the Near East. Current Anthropology 52, S221S235.

K. Zeigelbauer , B. Speich , D. Mäusezahl , R. Bos , J. Keiser and J. Utzinger (2012). Effect of sanitation on soil-transmitting helminth infection: systematic review and meta-analysis. PLoS Medicine 9, e1001162.

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