Malevolent Design - How Creationism's Divine Malevolence Co-opted Red Squirrels To Spread Leprosy in Medieval England

Lepers having magic spells cast over them

Mycobacterium leprae

Ancient Mycobacterium leprae genome reveals medieval English red squirrels as animal leprosy host: Current Biology

Few places in Europe or elsewhere were more pious than Medieval England, but still creationism's pestilential malevolence continued to make people suffer with diseases such as bubonic plague, tuberculosis and the related leprosy. Even the extreme measures taken by believers to atone for imaginary transgressions that had brought about the Black Death had failed to assuage the putative designer god who was believed to be visiting this pestilence upon people.

The superstitious Bible-based belief in evil spirits and 'sin' as the cause of disease led to the social stigma that made the disease so feared and led to the isolation of sufferers in lepper colonies, and often reduced to begging to stay alive. Poor nutrition and poor sanitation led to a worsening of the condition and, although these counter-measures were visibly ineffective, such was the belief in the Bible that it was inconceivable that the disease could be caused by anything other than 'sin' and evil demons being permitted to enter the victim.

The modern equivalent of this victim-blaming superstition can be found in the modern creationist tactic of blaming 'Sin' and 'genetic entropy' for parasites, with demons being replaced by 'entropy' to make it sound sciencey. It is of course, Bible-based superstition without supporting evidence.

And now, if you believe that stuff, there is evidence that creationism's putative designer god designed M. leprae to also infect red squirrels so they would act as a repository to spread leprosy. Red squirrels were common in those days and were often captured in the wild for pets or pelts. Their skins, when used for clothing, would have carried M. leprae and infected anyone who wore them - a brilliant strategy, if you hate people and want them to be sick, suffer and die.

Tell me all about leprosy caused by Mycobacterium leprae, particularly in Medieval England. Leprosy, caused by the bacterium Mycobacterium leprae, has a long and complex history, including its presence in Medieval England. Here's an overview:

Mycobacterium leprae:
Mycobacterium leprae is the bacterium responsible for causing leprosy, also known as Hansen's disease. It primarily affects the skin, peripheral nerves, mucosa of the upper respiratory tract, and the eyes. It is a slow-growing bacterium with an incubation period ranging from months to years.

Symptoms:
Leprosy can manifest in various forms, but the most common classifications are tuberculoid and lepromatous leprosy. Symptoms can include skin lesions, loss of sensation in affected areas, weakness and paralysis of muscles, and, in severe cases, disfigurement of the face and extremities.

Medieval England:
During Medieval times, leprosy was a widespread and feared disease in Europe, including England. The lack of medical understanding and social stigma surrounding the disease led to leprosaria, or leper houses, being established to isolate those afflicted. These institutions provided some care for leprosy sufferers but also served to segregate them from the general population.

Social Stigma:
Leprosy carried a heavy social stigma during Medieval times. It was often associated with sin and divine punishment, leading to ostracization and discrimination against those with the disease. Lepers were often banned from participating in normal societal activities and were required to wear distinctive clothing or carry bells to announce their presence, further marking them as outcasts.

Treatment:
Treatment of leprosy in Medieval England was rudimentary at best. Herbal remedies and poultices were commonly used, but they had limited efficacy. Some religious orders provided care for lepers, but there was little understanding of the disease's cause or effective treatment methods.

Decline:
The decline of leprosy in England and other parts of Europe began in the late Middle Ages and continued into the Renaissance period. The reasons for this decline are not entirely clear but likely include improvements in living conditions, better nutrition, and the establishment of more effective public health measures. Additionally, with the emergence of other diseases like the Black Death, leprosy gradually faded from prominence.

Modern Understanding and Treatment:
In modern times, leprosy is much better understood, and effective treatments are available, including multi-drug therapy. The social stigma associated with the disease has diminished significantly, although pockets of discrimination still exist in some regions.

In summary, leprosy caused by Mycobacterium leprae was a significant public health concern in Medieval England, characterized by social stigma, segregation of sufferers, and limited understanding and treatment options.

The evidence that red squirrels acted as a zoonotic repository for the bacteria, Mycobacterium leprae, comes from research by a team co-led by Christian Urban of the Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland, Alette A. Blom of Department of Environmental Sciences, University of Basel, Basel, Switzerland and Charlotte Avanzi of Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA. They have published their findings, open access in the Cell Press journal Current Biology:

Highlights

• Genetic evidence of M. leprae infection in medieval English red squirrels
• Ancient M. leprae squirrel strain related to ancient human strains in the same city
• Results suggest a yet-undetected circulation of M. leprae in medieval animal hosts
• First One Health approach for M. leprae about a medieval animal strain

Summary
Leprosy, one of the oldest recorded diseases in human history, remains prevalent in Asia, Africa, and South America, with over 200,000 cases every year.^1,2 Although ancient DNA (aDNA) approaches on the major causative agent, Mycobacterium leprae, have elucidated the disease’s evolutionary history,^3,4,5 the role of animal hosts and interspecies transmission in the past remains unexplored. Research has uncovered relationships between medieval strains isolated from archaeological human remains and modern animal hosts such as the red squirrel in England.^6,7 However, the time frame, distribution, and direction of transmissions remains unknown. Here, we studied 25 human and 12 squirrel samples from two archaeological sites in Winchester, a medieval English city well known for its leprosarium and connections to the fur trade. We reconstructed four medieval M. leprae genomes, including one from a red squirrel, at a 2.2-fold average coverage. Our analysis revealed a phylogenetic placement of all strains on branch 3 as well as a close relationship between the squirrel strain and one newly reconstructed medieval human strain. In particular, the medieval squirrel strain is more closely related to some medieval human strains from Winchester than to modern red squirrel strains from England, indicating a yet-undetected circulation of M. leprae in non-human hosts in the Middle Ages. Our study represents the first One Health approach for M. leprae in archaeology, which is centered around a medieval animal host strain, and highlights the future capability of such approaches to understand the disease’s zoonotic past and current potential.

Graphical abstract

Results and discussion
During the COVID-19 pandemic, the zoonotic potential of both new and millennia-old re-emerging infectious diseases and their multidrug resistance took center stage in modern society.^{1,8,9,10,11,12,13,14,15} This calls for the development of new perspectives and scientific tools for disease characterization, prediction, and eradication. Interdisciplinary and collaborative approaches, such as One Health studies,¹⁶ have come to the forefront to better understand disease dynamics and the complexity of factors that lead to adverse health outcomes.

Although zoonotic diseases have become increasingly prominent in modern health agendas, historical zoonoses have received scant attention, despite the potential importance of earlier transmission events in shaping past and present health landscapes.^17,18 Essential in the evolution and persistence of zoonotic pathogens are animal hosts,¹⁹ which have been largely omitted from most studies on past diseases due to the lack of pathological and genetic research on zooarchaeological remains.²⁰ Without full pathogen genomes from archaeological animals, our understanding of long-term disease dynamics and animal-pathogen-human-environment interactions is hindered, as these are essential for contextualizing current trends and identifying potential spillover or reemergence risks.

Leprosy is mainly caused by M. leprae and to a lesser extent by M. lepromatosis and can lead to chronic infection, nerve damage, blindness, anosmia, alopecia, and dry skin in humans.²¹ Left untreated, it can cause various distinctive and impairing lesions, making it a frequently described disease in historical sources.^22,23,24 Humans are the main host for both agents, though M. leprae does infect wild armadillos in the Americas and wild chimpanzees in West Africa, and both agents have been found in British red squirrels from Brownsea Island.^5,6,25,26 These modern red squirrels harbor a medieval M. leprae strain, insinuating a historic transmission event.6 Even today, however, the mode of transmission between people, let alone the mode and direction of transmission between different potential animal hosts, is poorly understood. As an obligate intracellular pathogen, survival outside a host is unlikely, making the coexistence of animal and human hosts a likely factor in leprosy persistence. M. leprae has also been found in soil and water, suggesting a possible environmental component in the chain of transmission, though specifics remain unknown.²⁷ A better understanding of the significance, type, and contribution of all hosts in transmission is essential in leprosy eradication.^2,28 This, combined with potential historic interspecies transmission, makes leprosy an excellent focus for a first deep-time One Health pilot study. We present such a One Health approach by studying the historic and archaeological context of ancient cases of leprosy in humans and squirrels. We reconstruct four medieval M. leprae genomes, including a 2.2-fold average coverage genome isolated from a red squirrel bone, and contextualize them with ancient and modern data to decipher possible modes of transmission in medieval England and potential risk factors for transmission and evolution in this animal host today.

Opportunities for transmission in the medieval era.
Extensive opportunities for transmission between humans and squirrels in the Middle Ages are visible in historic sources on the fur trade and petkeeping. Squirrel fur was by far the most widely used fur to trim and line garments in the High and Late Middle Ages.^29,30 In England, most of the skins came from Scandinavia, the Baltic, Eastern Europe, and Russia, along with Ireland, Scotland, and Italy. Squirrels would be trapped in the wild throughout the year and the skins would be transported for trade. Staggering quantities of squirrel skins were imported: for example, the English exchequer customs accounts for 1384 record 377,200 imported squirrel skins (with all other animal skins totaling less than 15,000). Vair, a way of laying out the backs and bellies of squirrel skins in a checked pattern (Figure 1), even became a heraldic tincture because it was so widely used in clothing.³¹ Medieval iconography is replete with individuals wearing garments lined with squirrel fur.³² Squirrels were also widely kept as pets. The practice is detailed in various sources, from records of episcopal visitations to the purchase of collars and leashes and the collared pet squirrels that abound in the margins of manuscripts.³³ Squirrels intended as pets were captured in the wild as kits and raised close to humans, often sitting on laps or shoulders.³⁴

Figure 1 Location of the leprosarium of St Mary Magdalen and Staple Gardens in Winchester (center circle), within the UK
Top right shows Antiochus IV Epiphanes wearing a tunic lined with vair (squirrel fur, with the backs and fronts laid out in a checked pattern) in a 12th century Bible (Bibliothèque municipal de Dijon, MS 14 f. 191). Bottom right shows the three human samples that tested positive for M. leprae. Top left shows red squirrel sample bone SGW_S3_1, a right fourth metatarsal from Staple Gardens that tested positive for M. leprae. Bottom left shows a red squirrel in a 15th century Book of Hours (Bibliothèque de l'Arsenal, MS 5088 réserve, f. 175v).

To reflect these opportunities for transmission, we chose Winchester, an important medieval city with connections to key trading routes, for our study. Historic records show that skinners were active in Winchester preparing and selling a wide variety of fur-lined garments. Records for 1417 attest the presence of a “skinners row” on Winchester’s High Street consisting of five stalls of skinners and one tailor’s stall.³⁵ A number of archaeological sites have been associated with animal fur processing, including squirrel fur.^36,37,38 One context is the furrier pit in Staple Gardens, from which squirrel bones were analyzed for this study (Figure 1). Moreover, the site of St Mary Magdalen in Winchester represents one of the best-studied leprosaria in the UK, with confirmed molecular evidence of M. leprae including four recovered M. leprae genomes from human remains.^5,39 As such, Winchester is an ideal location to assess potential transmission of M. leprae between humans and squirrels.

Identification of potential human and squirrel leprosy cases from medieval Winchester
St Mary Magdalen’s leprosarium offered remedial and palliative care to leprosy patients between the early 11th and late 15th centuries.^40,41 Many individuals buried at St Mary’s have leprosy-associated lesions (78.5% for the earlier phase, 41.4% for the later phase, and 17.6% for the chapel).^42,43 Several individuals with leprosy-related lesions have been genetically tested in previous studies.^{39,44,45,46,47} This study has focused on pathologically probable, non-characteristic, and non-pathological cases from burials unearthed in later field seasons. Multiple samples were taken from 11 individuals (Table S1). All samples were fully photographed prior to and after sampling, and pathological bone lesions were avoided when possible. See STAR Methods for a more in-depth site and skeleton description.

Less than two miles to the west, in the city center, lies Staple Gardens (Figure 1). This historic street dates to the 12th century and had at least one furrier shop between the 11th and 13th centuries. At this property, two pits containing a number of foot bones from cat, fox, squirrel, ferret/polecat, stoat, and unidentified small mammals were found. This pattern is typical of fur trading activities, as hands and feet often remained attached to the fur and were later removed in processing or were cut off first so that skin could be peeled off as a cone.^48,49 It remains unclear if and how squirrels would present osteological lesions due to M. leprae infection, though the lesions are likely to resemble those in humans.⁵⁰ Assuming the same low prevalence rate for skeletal lesions in squirrels as in humans (3%–5%), we focused on sampling bones with evidence for inflammation in the form of periosteal reactions (Figure S1) and sampled several bones without skeletal lesions. Twelve hand and foot bones (Table S1) from the largest furrier pit from Staple Gardens were sampled for ancient DNA (aDNA) extraction. These remains were randomly numbered, and all elements were photographed prior to sampling. More information on this site and the squirrel remains are in the STAR Methods and Table S1.

Which creationist is going to be brave enough to go against cult dogma and say this is an example of the M. leprae bacterium evolving and not an example of intelligent design, where a designer intentionally designed the bacterium so it could pass back and forth between humans and red squirrels, in full and perfect knowledge that this would ensure it continued to infect people?

And which creationist is going explain how this doesn't illustrate malevolent intent in the mind of the creator, or show how it can be presented as evidence of 'genetic entropy' and 'devolution', whilst improving the ability of M. leprae to survive and reproduce in Medieval England?

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