While the interaction between humans and their parasites is well studied today, taking a long view of infection throughout human evolution helps to place the current picture in context and identify trends in infection over time. After considering how early technologies may have facilitated the transmission of parasites to humans, we examine the association between humans and parasites through time using archaeological and genetic evidence. Techniques such as microscopy, immunoenzymatic assays and DNA analysis have identified a range of protozoa, helminths and ectoparasites in our ancestors. Evidence is discussed for the origins and impact upon societies through time for protozoa causing malaria, leishmaniasis, Chagas’ Disease and diarrhoeal illnesses, helminths such as schistosomiasis, soil-transmitted helminths, Taenia tapeworms, fish tapeworms and liver flukes, and ectoparasites such as fleas, body lice and pubic lice. Prevalence studies show widespread infection for some parasites, such as 36% with falciparum malaria in ancient Egypt, and 40% with Chagas disease in prehistoric Peru and northern Chile. Humans have been responsible for the inadvertent spread of a range of parasites around the world, ranging from African heirloom parasites with early human migrations to the introduction of malaria and schistosomiasis to the Americas with the transatlantic slave trade in the 1600s–1800s. It is clear that the epidemics due to bacterial pathogens spread by ectoparasites since the Bronze Age must have had major impacts upon past societies, particularly for bubonic plague and epidemic typhus.

Ulrich von Hutten (1488–1523), a renowned sixteenth-century German humanist, documented the symptoms of the epidemic that swept through Europe starting around 1495, commonly known as the French Disease. While it has traditionally been associated with venereal syphilis, Dutch tropical physician Willem F. R. Essed proposed in 1933, largely unnoticed to this day, that this new disease might instead be tropical yaws. This study establishes a clear link between Hutten’s reported symptoms and yaws, especially in its secondary and tertiary stages. The skeleton discovered in 1968 on Ufnau Island in Lake Zurich where Hutten died and was buried, exhibits distinct bone manifestations of ancient treponematosis with a pattern more consistent with yaws than syphilis. Furthermore, the correspondence between Hutten’s main symptoms and the lesions observable on the 1968 skeleton further confirms the identification of these human remains. The historical evidence of yaws significantly contributes to our understanding of this early modern epidemic.

The question posed is how deep-time perspectives contribute to tackling contemporary One Health challenges, improving understanding and disease mitigation. Using evidence from the field of paleopathology, it is possible to explore this question and highlight key learning points from the past to focus the minds of those making healthcare policy decisions today. In previous centuries urbanization led to poorer health for a wide range of indicators, including life expectancy, sanitation and intestinal parasites, airway disorders such as maxillary sinusitis, metabolic diseases such as rickets, and even conditions resulting from clothing fashions such as bunions. Modern concerns regarding the quality of urban air and rivers show we have still to incorporate these lessons. When we consider major infectious diseases affecting past societies such as bubonic plague, tuberculosis and leprosy, interaction between humans and wild mammal reservoirs was key. Wild red squirrels in Britain today remain infected by the medieval strain of leprosy that affected people 1,500 years ago. It is clear that the One Health focus on the interaction between humans, animals and their environment is important. Eradicating zoonotic infectious diseases from humans but not these reservoirs leaves the door open to their spread back to people in the future.

Coccidioidomycosis is an infectious fungal disease endemic in Bolivia's Gran Chaco region that is caused by inspiration of the spores of Coccidiodes species. It is a respiratory pathology that can spread to the skeleton and produce diffuse lytic lesions in different parts of the body. This disease has rarely been described in historic populations, and we present here a new case of coccidioidomycosis in a mummified human individual. It corresponds to a female individual with an age at death of 25–35 years, dated to the Tiwanaku epoch of the thirteenth century AD. It was found inside a sepulchral cave near the city of Ulloma in western Bolivia. Radiographic examination shows numerous osseous lytic lesions with central cavitation concentrated on the cranial table and vertebral bodies. The observed condition could correspond to the secondary phase of coccidioidomycosis. This diagnosis is noteworthy because coccidioidomycosis was mainly described as a male work-related disease and has never been found in ancient western Bolivia.

Las enfermedades infecciosas fueron señaladas como la causa principal de muerte en las sociedades pasadas. Sin embargo, hasta el momento son escasos los conocimientos acerca del modo en que afectaron a las poblaciones humanas del sur de Sudamérica. El objetivo de este trabajo es estudiar el impacto que las enfermedades infecciosas tuvieron sobre las poblaciones de cazadores-recolectores que habitaron Patagonia Austral, a partir de la identificación, descripción e interpretación de lesiones óseas en restos humanos del Holoceno medio y tardío (aproximadamente 5200-100 años aP). Se analizaron macroscópicamente 54 individuos hallados en 50 sitios arqueológicos, sobre los cuales se describieron presencia, localización, lateralidad, tipo de formación de hueso nuevo (woven, lamelar, mixto) y distribución de las lesiones óseas. Se registraron lesiones diagnósticas y altamente compatibles con infecciones óseas en ocho (14,8%) individuos (sin diferencias entre sexos y edades), seis de los cuales (75,0%) provienen del sur de Tierra del Fuego. Cuatro individuos presentaron lesiones compatibles con osteomielitis y dos con tuberculosis (un no-adulto y un adulto). Esto último representa un hallazgo relevante para discutir la presencia de tuberculosis en poblaciones pasadas y su evolución en América. Los resultados presentados sugieren además que las evidencias de procesos infecciosos pueden ser recurrentes en análisis específicos sobre muestras esqueletales de cazadores-recolectores.

This article emerged as the human species collectively have been experiencing the worst global pandemic in a century. With a long view of the ecological, economic, social, and political factors that promote the emergence and spread of infectious disease, archaeologists are well positioned to examine the antecedents of the present crisis. In this article, we bring together a variety of perspectives on the issues surrounding the emergence, spread, and effects of disease in both the Americas and Afro-Eurasian contexts. Recognizing that human populations most severely impacted by COVID-19 are typically descendants of marginalized groups, we investigate pre- and postcontact disease vectors among Indigenous and Black communities in North America, outlining the systemic impacts of diseases and the conditions that exacerbate their spread. We look at how material culture both reflects and changes as a result of social transformations brought about by disease, the insights that paleopathology provides about the ancient human condition, and the impacts of ancient globalization on the spread of disease worldwide. By understanding the differential effects of past epidemics on diverse communities and contributing to more equitable sociopolitical agendas, archaeology can play a key role in helping to pursue a more just future.

This article reviews the most relevant data regarding evidence of stress and disease in native populations from Southern Patagonia and proposes future directions for paleopathological research. It focuses on the disease patterns in hunter-gatherer societies and the changes produced by contact and colonization. Studies of oral pathologies show a high frequency of dental attrition and low frequency of caries and antemortem tooth loss. Individuals with terrestrial dietary patterns show evidence of higher mechanical stress in the spine than those who participated in marine economies, based on the prevalence of Schmorl's nodes and vertebral osteophytosis. Porotic hyperostosis is more prevalent in individuals who had a marine diet and is probably related to nutritional impairment and parasitic infections. A higher frequency of metabolic stress was identified in individuals who lived in missions, perhaps because of declining quality in diet, hygiene, and living conditions. Paleoparasitological studies identified several species of parasites associated with human skeletons and terrestrial fauna. Moreover, recent studies suggested that treponematosis and tuberculosis were present in Patagonia since at least 1000 years BP. Future paleopathological research should increase the size and quality of studied samples and apply new methods and interpretive criteria. Detailed research into infections, degenerative joint diseases, and trauma (including violence episodes) has rarely been conducted.