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Medical researchers excavated remains of an individual said to have died due to leprosy. The mystery of the medieval pilgrim and leprosy unearthed is just the beginning steps that medical researchers need to take in order to understand the relationship between leprosy, medieval pilgrimages in Europe, and the transmission of leprosy. Was it all a series of unfortunate events culminating in a leprosy epidemic during the Middle Ages?

A group of medical researchers examined remains of a pilgrim buried from St. Mary Magdalen at Winchester. St. Mary Magdalen has known leprosarium during the medieval times. The site is a treasure cove for the medical researchers as it has a high number of burials displaying skeletal lesions characteristics of leprosy. Furthermore, the remains have well-preserved biomolecular markers of the disease, including DNA and mycolipids.

Just like the rest of the remains in the leprosarium's cemetery, the individual dug up was buried in a chalk-cut anthropomorphic grave. Along with the remains, a scallop shell was found in the left pelvis. The scallop shell indicates the traditional and well-documented symbol of a pilgrim who has made a journey to the shrine of St. James in Spain.

Based on the analysis, the individual is a young adult male who might have died around the ages of 18 to 25 years old. Radiocarbon dating placed the individual around the eleventh to early twelfth century, a time when pilgrimages were at a height in Europe.

During the osteological examination, the medical researchers noted that the cranium and facial features displayed were typical of the skeletal features of northern European populations. It is possible that the medieval pilgrim's origin is that outside of the British Isles. In addition, geochemical isotopic analyses carried out on tooth enamel confirmed that the individual buried was not from the Winchester region and it was not possible to pinpoint the origins of the remains.

Further analyses found evidence that meant the individual was someone of means and prestige. The individual indicated someone who consumed a richer diet compared to the rest of the remains in the cemetery. Moreover, the grave of the individual was in perfect condition and remain unmoved during all the changes at St. Mary Magdalen.

The skeletal remains of the individual showed minimal skeletal evidence of leprosy, which was confined to the bones of the feet and legs. It might mean that individual suffered from multiple soft tissue lesions marking the individual as a someone with leprosy although it left little traces on the bones.

Genotyping of the Mycobacterium Leprae strain showed it came from the 2F lineage. The leprosy strain in the 2F lineage is associated today with leprosy cases from South-Central and Western Asia. The 2F leprosy strain in the individual would also suggest that the young male was widely traveled or indicating his foreign origin.

Even though there are still mysteries yet to be uncovered with how and when the pilgrim contacted leprosy, the details of the research, published in PLOS Neglected Tropical Diseases, demonstrates the huge potential of the multidisciplinary approach to learning more and understand leprosy especially in regards to medieval pilgrimages and its transmission.