Malaria and Rome: A History of Malaria in Ancient Italy by Robert Sallares (beach read .TXT) 📕

erTiber

Riv

Todi

Orvieto

Spoleto

Lago di

M O N T I VO L S I N I

Corbara

Bolsena

L a g o d i

Lugnano in

B o l s e n a

Teverina

L a g o d i

Terni

Amelia

Visentium

A l v i a n o

Nami

Acquarossa

Tuscania

Viterbo

Ocriculum

Rieti

M O N T I C I M I N I

L a g o d i

Collevecchio

V i c o

Falerii Novi

Blera

Falerii Veteres

Sutri

Nepi

San Giovenale

Monterosi

L a g o d i

Capena

B ra c c i a n o

Tolfa

Baccano

Lucus Feroniae

iber

T

Nomentum

Pyrgi

Veii

iver

Caere (Cerveteri)

(Isola Farnese)

R

Tivoli

Map 2. Umbria and northern Lazio

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Ecology of malaria

10. Part of the ruins of the Roman villa of Poggio Gramignano, near Lugnano in Teverina, Umbria, with Alessandro Dimiziani. The infant cemetery, which was established in the ruins of the villa in the fifth century , is the source for the first malaria epidemic in the ancient world to be documented archaeologically and through the use of ancient DNA.

labourers from the Marche sometimes became infected in the nineteenth century. In 1832 a local doctor, Angelo Sorgoni, made the very interesting observation that the migrant farm workers from the Marche, who could only have experienced P. vivax malaria in the Marche (unlike the natives of the region around Narni, where P. falciparum malaria also occurred) were more severely affected by attacks of pernicious malaria ( P. falciparum) and required higher doses of quinine for treatment than the inhabitants of Narni. This situation suggests a degree of endemicity of P. falciparum malaria in south-western Umbria in the early nineteenth century sufficient to lead to the build-up of some acquired resistance in adults in the local population.⁵⁶

David Soren and his colleagues have interpreted a child cemetery dating to the fifth century , excavated recently in the ruins of ⁵⁶ Doni (1667: 91, 115); Foschi (1983: 112) on Narni; Sorgoni (1832). Procopius, BG 1.17.6–11

described the site of the town of Narni itself, which was healthy as it is situated on a hill (244

metres above sea level). Pezzella (1997: 109, 159) recorded references to quartan fever in early modern texts of herbal medicine from Umbria.

Ecology of malaria

67

11. PCR products amplified from the Lugnano bones with oligonucleo-tide primers for malaria 18S ribosomal DNA. Video print taken by Susan Gomzi. See Sallares and Gomzi (2001) for further discussion.

an abandoned villa at Poggio Gramignano near Lugnano in Teverina, not far from the Tiber in southern Umbria, as the result of an epidemic of P. falciparum malaria.⁵⁷ The site of the cemetery (185

metres above sea level) is located about 3.5 kilometres away from the river Tiber, which is visible in the distance down gently sloping land, a typical location for malaria in western central Italy. The location of the corresponding settlement is not known, but it was probably closer to the river. The dead, who were apparently buried over a short period of time, were almost all infants, neonates, or foetuses. The foetuses were the product of miscarriages of pregnant women, especially primigravidae, who are particularly vulnerable to malaria owing to suppression of the immune system during the last two trimesters, while infants and young children usually bear the brunt of direct mortality from P. falciparum malaria. Numerous studies have shown that P. falciparum malaria can cause an extremely high rate of miscarriages in pregnant women in areas of seasonal transmission with epidemic malaria. One survey of a series of cases ⁵⁷ Soren et al. (1995); Soren and Soren (1999).

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Ecology of malaria

in the United States in the first half of the twentieth century yielded a foetus mortality rate of 60%. Similarly many abortions occurred in pregnant women during the Monte Cassino epidemic in 1944, the last major malaria epidemic in the history of modern Italy.⁵⁸

The circumstantial evidence derived from the archaeological excavations for this interpretation of the Lugnano cemetery is currently being supplemented by studies of ancient DNA from the bones. One of the skeletons has yielded ribosomal DNA from P. falciparum, confirming its presence at Lugnano in the fifth century . Mario Coluzzi told the author that A. labranchiae occurred as far up the Tiber valley as Orte, only a few kilometres from Lugnano, as recently as the time of the Second World War. Further north it was replaced by A. atroparvus. Consequently the Lugnano epidemic in the fifth century  occurred on the edge of the geographical distribution of both A. labranchiae and P. falciparum. It suggests that both had reached their maximum distributions in western central Italy by the mid-fifth century . In the past the town of Lugnano in Teverina itself was probably immune from malaria, since it is situated 450 metres above sea level. However, there are plenty of mosquitoes, which were observed by the author on a visit to the area, in the surrounding lowlands, but only Culex mosquitoes occur in the region today.⁵⁹

Other literary sources from late antiquity show that marshy environments were still feared then. Palladius duly made the standard observations that marshy and pestilential land should be avoided.⁶⁰ He then added a more interesting comment:

In any event a marsh must be avoided, especially if it faces south or west and tends to dry up during the summer, because of the pestilence or hostile little animals which it generates.⁶¹

Palladius’ observation of the extreme peril posed by marshes which desiccate during the summer leads on to consideration of the exact requirements of Anopheles mosquitoes for breeding pur-

⁵⁸ McFalls (1984: 118); Zei et al. (1990); Dobson (1997: 340–2); Barbosa and Arjona (1935: 11–18); Torpin (1941); Diagne et al. (2000) showed that the period of increased susceptibility to malaria continues for about two months after birth.

⁵⁹ Sallares and Gomzi (2001); Sallares et al. (2002); North (1896: 24) observed that the vicinity of Orte is particularly vulnerable to Tiber floods.

⁶⁰ Palladius, opus agriculturae 1.5.5, ed. Rodgers (1975): situs vero terrarum neque planus, ut stagnet; 1.5.6: qui ager