We are slowly being presented with a notion that all was not as idyllic as Akhenaten would have wanted us to believe, at his ’horizon of the Aten’. In 1350BC, Akhenaten and his consort Nefertiti lead a religious revolution that lasted not far beyond their demise some seventeen years later. They broke with the traditional complex Egyptian pantheon of gods and singled out the sun disc, Aten, as their primary god to worship. Moving to a ‘virgin’ site in Middle Egypt, now named Tel el-Amarna, the divinely inspired royal couple endeavoured to make a city like no other; one that was devoted to the sun disc, Aten. However, with the recent discovery of the South Tomb’s Cemetery remains at Amarna, a more sinister image of Amarna life for the general populace is slowly, but consistently, emerging.
Aten Temple, Amarnaproject.com
From the beginnings of agriculture and urbanization till well into the last century, infectious disease was the major overall cause of human mortality. Since 2005, excavations at Amarna, in what is now entitled the South Tombs Cemetery, have yielded skeletal remains year after year, with excavations still ongoing. The South Tombs Cemetery occupies a wadi within the cliffs that form the eastern boundary of Amarna, adjacent to the southern group of rock-cut tombs for high-ranking officials from Amarna. Through pathological observation of the discoveries since 2005 to present, an evident pattern of malnutrition and stress has been reported in the skeletal remains, indicating a poor condition of life for the people of Amarna. These types of deficiencies in the environment and diet are conditions conducive to the facilitation of epidemics. This blog sets about to examine the possibility that an epidemic spread throughout Amarna, possibly even being the ‘plague’ or ‘pestilence’ referred to in the Amarna letters and ‘Plague prayers’ of Mursilli II, causing widespread death that is evident from the burial assemblage in the South Tombs Cemetery. The Amarna cemetery is producing a large number of juveniles, not proportional to the usual attritional mortality associated with a typical ancient cemetery. Instead, the Amarna cemetery could be deemed as portraying a catastrophic burial assemblage. I will consider the evidence that the human flea Pulex irritans’ presence in large numbers at Amarna, as highlighted by scholars such as Panagiotakopulu (2004), is evidence that bubonic plague could have originated in Amarna. I will also propose different diseases besides bubonic plague for the aforementioned epidemic, as well as discussing why at Amarna, a one generational city, apparently built on ‘Virgin ground’ disease was capable of reaching epidemic proportion. The diseases which are discussed in this blog are those which, with certainty, can be linked to Amarna, such as through the findings of archaeoentomological matter that represents primary hosts for pathogens.
Firstly we should try to understand what is meant by plague in modern and ancient terms. Nowadays, when we talk of plague, the word can conjure images of the black death that swept through Europe in the 14th Century AD, this is traditionally associated with bubonic plague. However, to the ancient world a plague or pestilence was any disease which reached epidemic proportion, and the plague mentioned in the Amarna letters and ‘plague prayers’ could refer to any disease. In modern terms, plague is a bacterial disease of rodents and can be spread to humans and other animals by infected fleas. Plague takes three forms, bubonic plague, which is infection of the lymph glands; septicaemic plague, which is infection of the blood; and pneumonic plague, which is infection of the lungs. Bubonic plague is transmitted when a flea bites an infected rodent, from such the flea then goes on to bite a human. The plague bacterium grows in the gullet of the flea, obstructing it and not allowing the flea to eat; transmission occurs during abortive feeding with regurgitation of bacteria into the feeding site. Septicaemic plague is caused when a person has a break or cut in the skin and they come in to direct contact with body fluids or tissues of infected animals. Pneumonic plague can spread from person to person by inhalation of infectious airborne droplets of human mucus. Bubonic plague often spread to the lungs and lead to Pneumonic plague which allowed the pathogen to spread from human to human. Where the buboes split in victims of bubonic plague, there would then be the exposure of Septicaemic plague. This study will consider bubonic plague as the epidemic from Amarna, as well as proposing several other diseases.
The evidence for an epidemic at Amarna
What is imperative to discuss now, is the evidence there is that any disease even reached epidemic proportion at Amarna. I can not assert a specific disease was prevalent at Amarna without first laying the foundations of why I believe there was some form of epidemic at Amarna. There is evidence that ancient contemporary countries, who were in contact with Egypt, had knowledge of some ‘pestilence’ stalking the land of Egypt. Critical evidence comes in the form of the Amarna letters EA 11, EA 35, and EA 96 and the ‘plague prayers’ of Mursilli II. To further support the contention that there was some form of plague epidemic at Amarna, we can look towards the newly discovered skeletal remains of the South Tombs Cemetery. The pattern which seems to be emerging is of a catastrophic burial assemblage as opposed to an attritional mortality. The identification of catastrophic as opposed to attritional mortality profiles in archaeological samples of human skeletons, should reflect the age structure of the living population because all individuals have an approximately equal probability of dying; irrespective of age or sex. Accompanying this is the simultaneity of some inhumations at the Amarna cemetery. We can surmise that they are family burials, with some individuals of the same age or adults with infants or juveniles, that have clearly been interred at the same time as one another. Although we cannot assume that an epidemic was the cause for all family or mass burials, we can postulate that the continual discovery of family or mass graves, which are already a common occurrence at Amarna, could highlight some epidemic. It would be hard to pass off these graves as coincidental, because the probability that several family members die at the same time to be inhumed together is low. We can surmise that these are double or multiple burials and not the result of post-mortem depositing by robbers in antiquity because of the size of the grave cuts, which have been made large enough for the corresponding bodies during original inhumation. This is also evident from the remaining in situ bones and textiles.What have also been found in the Amarna cemetery are the partial remains of wooden coffins which are too large to represent an individual burial. Mass burials are unprecedented in ancient Egypt so we have little to compare to in terms of identifying mass burials. Mass graves of bubonic plague victims from England are literally bodies piled in a mass pit; this is not seen at Amarna. However, with the care placed on the dead by the Egyptians it seems unlikely that the body would not be treated and buried with due respect, and so we probably would not see the kind of discarding of bodies that was seen in England. We must remember that the English bubonic plague was linked at the time to being air borne, an incorrect assumption, but nonetheless the English people considered the putrefaction of the body to spread the disease and felt that prolonged exposure to the dead would mean catching the disease themselves, thus they quickly disposed of the body. We must also reflect on what the Egyptians considered the disease to be. Did they know it was contagious? How did they think it was spread? Often, ancient civilizations linked the outbreak of a plague to the gods, believing that they had offended the gods in some way and were in turn being punished. This is almost certainly what the Amarna populace would have believed, having broken with the traditional pantheon of gods, they would have believed that they were being punished. However, whether they acknowledged that prolonged exposure to the dead would have been lethal we cannot ascertain. Despite Amarna not being host to mass burials such as those found in England as a consequence of the virulent spread of black death, what we do see throughout all of the excavation seasons at the Amarna cemetery, is a high density of burials, with the majority of 5m x 5m squares containing 4-6 graves. The graves also appear to be rather haphazardly positioned; there is no clear pattern of orientation. It has been suggested that random placement of the body within the grave was principally organised with one focus, to fill in gaps between existing graves. The diagnosis of an epidemic by analysis of bone remains, which is what we have at Amarna, is impossible, as the rapid action of the infectious pathogen does not allow time for the development of osseous lesions, except in the case of those epidemic diseases that are non-lethal in the short-term, such as leprosy, tuberculosis and syphilis.
Pulex irritans at Amarna- Could this suggest bubonic plague?
Findings of the fossilised human flea, Pulex irritans, in the Workmen’s Village at Amarna, has now brought in to question the presence of bubonic plague at Amarna. The bacillus Yersinia Pestis, which was primarily a disease of the Nile rat (Arvicanthis niloticus), could only achieve epidemic proportions when its vector, predominantly the rat flea (Xenopsylla cheopis), was able to move to a new host, potentially the black rat (Rattus rattus), on introduction from India or indirectly from Mesopotamia. It would appear that the black rat was a city dweller, and after its migration from the boats and its presumed interaction with the Nile rats, the black rat would make its way in to the city to live in household waste sites. This new opportunity for the flea to jump to humans, potentially allowed for the transference of Yersinia Pestis, allowing infection and therefore stochastic waves of pandemics such as bubonic plague. However, what has now become commonly proposed amongst bioarchaologists is that the intermingling of both the Pulex irritans and Xenopsylla cheopis flea, and the opportunity for exchanging hosts would have enabled the transmission of the bacillus Yersinia Pestis to a human host. There is also the assumption that, whilst the tropical rat ﬂea, Xenopsylla cheopis, is the best vector of the disease, in urban situations, the human ﬂea, Pulex irritans, can act as carriers. There are three types of flea, sedentary, mobile and the stick-tight. The human flea, Pulex irritans, is one of the mobile fleas, meaning it still requires a nest but can live on the host; nowadays it is cosmopolitan, and has been found on a wide range of hosts.Xenopsylla cheopis and Pulex irritans can live on a number of rodents and lagomorphs, and the black rat is not the only animal that can carry the ﬂea and disease. Carnivorous animals that eat rats may be infected or be relatively passive carriers; cats for example are likely to die of the plague, whereas dogs only die in very severe epidemics.
In discussion of bubonic plague, medical papyri dating from the New Kingdom, such as the Ebers Papyrus, do refer to swelling buboes, further supporting scholars assertions that bubonic plague was possibly known to the Egyptians. The Ebers Papyrus (c.1534BCE) is the earliest to mention the symptoms of what we now recognise to be bubonic plague. The Hearst Medical Papyrus (c.1520BCE) refers to ‘ when the body is blackened with spots’ which are elaborated on in the London Medical Papyrus (1350BCE) ‘When the body is coal black with charcoal (spots) in addition to the water (urine) as red liquid (bloody).- Perhaps linked to the degradation of the internal organs. However, bubonic plague alone would not have been capable of producing the epidemic referred to in the Amarna letters and ‘plague prayers’. The ‘plague prayers’ of Mursulli II, son of King Suppiluliumas of Hatti, refer to the plague as a consequence of war with the Egyptians.
My father let his anger run away with him, he went to war against Egypt and attacked Egypt. But when they brought back to Hatti [ … ] and the prisoners which they had taken, a plague broke out among the prisoners and they began to die. When they moved the prisoners to Hatti land, the prisoners carried the plague into Hatti land. From that day on people have been dying in the Hatti land.
The nature of the epidemic is clearly contagious and spread via human contact, meaning if it was plague in the modern sense, it would be Pneumonic or even Septicaemic, as bubonic would rely on the primary hosts, the fleas’, presence. On the other hand, fleas could have been transported on slave ships, perhaps by their primary host, the rat, or on cats and dogs, maybe even furs. However, there are also several other diseases, known to the Egyptians, which could have been the cause of widespread epidemic, each will be addressed in this blog. To understand the development of plague and other pathogens at Amarna we must also look at the context the archaeoentomological remains were discovered in. The human flea Pulex irritansfor example was discovered in the lower ranking houses of the Workmen’s Village, which are often labelled as presenting ‘squalid’ living conditions. Egyptian hygiene and sanitation must then be brought in to question, as the habitation of rats in the city is encouraged by the opportunity to scavenge and live on waste disposal sites. It is interesting to observe that from an evolutionary viewpoint the pathogen has nothing to gain from generating large scale death from its host, therefore its primary host is likely to be a species it has co-evolved with in a relatively passive state. It is only once the pathogen transfers to a new host, usually the biogeographic change instituted by humans that allows the development of epidemic diseases. Amarna was an atypical site since it had large tracts of available space and was not subject to the limitations at older settlements. However, this did not prevent the rapid buildup of haphazardly placed houses which eventually lead to severely crowded suburbs. Such crowded streets facilitated the rapid spread of pathogens from host to host. The facilitation of disease at Amarna was further aided by poor standards of hygiene. The Egyptians were disinclined to dispose of the household waste that continually accumulated in the home or in the streets. When rubbish was disposed of in large pit’s the chosen areas for the waste disposal sites were often in close proximity to residential zones. In Amarna, there is a belt of rubbish piles up to 1.3m high which covered an area of 120m by 180m, found only a little over half a km from the palace and the surrounding aristocratic houses. However, the findings of the human flea, Pulex irritans is circumstantial and does not conclusively indicate bubonic plague at Amarna, simply because Pulex irritans is not a flea which is generally associated with the transmission of Yersinia Pestis. Therefore, we must be circumspect to this evidence of bubonic plague at Amarna because the theory relies on the proposed elements, the black and Nile rat, ever meeting. There is also minimal evidence of small animal bone at Amarna, although a black rat was found in the Delta site of Tell el-Dab’a dated from the Middle Kingdom, indicating that the black rat did indeed makes its way in to Egypt, even before the Amarna period. This draws the question as to why then we don’t see an epidemic in the Middle Kingdom with the introduction of the Nile rat possibly at this time and not in the New Kingdom, this is at least what is supported archaeologically. Perhaps, it can be argued that because of the movement of individuals from across the country to Amarna, both from rural and urban areas, this allowed for the cross exchange of pathogens of which both parties would have been prey to some lack of immunity. This would have happened naturally as a result of co-existence with certain types of disease or parasites over many centuries, either in cities or in rural villages. However, this evidence is potentially too conditional to rely upon.
Another theory has been hypothesised, one that states that bubonic plague first appeared under the reign of Amenhotep III, father of Akhenaten. It is based upon the notion that the 365 seated and 365 standing statues in the temple of Mut at Karnak, of Sekhmet, ‘Lady of pestilence’, indicate Amenhotep III’s attempt to placate the goddess. The goddess Mut represented Sekhmet’s pacified alter ego, hence the placement of the statues in the temple of Mut. The statues served as a ‘double spell’, with two for each day of the year, a dedication of this magnitude creates the notion that some major epidemic had been present at the time. Many of the statues were oriented facing South, as the Egyptians evidently associated the plagues with the lands south of Egypt. In light of this hypothesis, it could be argued that Akhenaten moved to a ‘Virgin site’ not only for religious reform, but because plague was ravaging the long established cities of Egypt. Perhaps the very nature of the barren site appealed to Akhenaten as he desperately sought a place that he would presume was free of plague. This links back to the discussion of how Egyptians considered the plague to be transmitted. By looking at plagues throughout the renaissance era we are highlighted to the changes in art and religious belief which accompany the turmoil. People no longer believed in traditional religious ideas because they could not understand why such a horrific epidemic had affected them. It has therefore been assumed by some that Akhenaten’s religious reform was an effort to subdue the population and to give them something new to believe in, blaming the plague on the cult of Amun, perhaps giving Akhenaten cause to link the plague to the corruptness and greed associated with the priests of Amun. This could explain why the people seemingly move so peacefully to Amarna, with little effort at first to preserve their traditional beliefs. Perhaps this is why we see a change in the death cult. It has been proposed that the artistic style changed and that the royal tombs such as Tutankhamun were small because of the lack of laborers and skilled masons. However, the city was built with incredible speed, suggesting that the population flourished enough for builders to have been present in large numbers at least at the beginning of the reign. Royal and elite tombs continue to be built at Amarna, with a dedicated Workmen’s Village, similar to its predecessor Deir el Medina at Thebes, fully functioning. The royal and elite tombs are no less grand than those found anywhere else, only they embrace the new ideology, so do not have the traditional art. Those which are discovered unfinished we can presume were left as such as a result of the abandonment of Amarna after the death of Akhenaten. We could instead link the statues of Sekhmet to the failing health of Amenhotep III, a hopeless attempt at being spared the crippling illnesses he faced in his last few years. Amenhotep III was always extravagant with his building projects. It is seemingly difficult to date the ‘Amarna letters’ plague, even pinpointing it to the specific reign of a Pharaoh can be hazardous. The earliest development of the Egyptian-Asiatic plague in the 14thCentury BC has been linked to Amenhotep III, Akhenaten, Tutankhamun and even to his widow Ankhesanamun. It has been stated that throughout the reign of Amenhotep III there was relative international peace, perhaps due to plague in both countries, caused by the lack of available troops. This would be supported by the ‘plague prayers’ as Mursilli protests that no farmers were left to plough the fields. Amenhotep III also received a healing statue of Ishtar from the king of Mitanni, which again we could link to his failing health. The ‘plague prayers’ clearly link the transmission of plague to Hatti after the death of Zennanza not before. Zennanza was sent to Egypt to marry Ankhesenamun, after she implored the King, Suppiluliumas, to send to her a prince for marriage after the death of her former husband Tutankhamun. Therefore, this suggests the plague did not reach pandemic proportions until after the reign of Tutankhamun, and certainly not before then. This does not mean that plague in Egypt originated around this time only that it spread to Hatti then. This notion is supported in the Amarna letters, where there is mention of a pestilence stalking the land of Egypt, dating to the reign of Akhenaten, again there is no mention of it being pandemic. What is also interesting to acknowledge is the sudden death of three princesses in the royal family, their deaths being commonly associated with the outbreak of plague. Evidence of the plague in mummies is scarce, and at present only one mummy from the Ptolemaic period shows evidence of Pneumonic plague. Small animal remains at Amarna are minimal but there is evidence of a black rat at Tell el Dab’a in the Delta from the Middle Kingdom (2040-1782BCE). As this was a harbour town, the rat may have arrived by ship, which is further supported in the medical papyri, where the disease is called the Asiatic illness, suggesting a foreign origin. The London Medical Papyrus (c.1350) states that to cure the Asiatic Illness one must make an incantation in the ‘Language of the Keftiu’ (Cretans) which indicates that perhaps this was the place of origin. There seems to be an element of “blame someone else” for the cause with the Egyptian’s blaming the Asiatic’s and the Asiatic people blaming the Egyptians.
Malaria is a tropical disease that is still a prevalent killer in many developing countries. Whilst searching for Tutankhamun’s ancestry, archaeologists uncovered Plasmodium falciparum, the bacillus associated with Malaria tropica, in four mummies, including that of Tutankhamun. Tutankhamun also has a patchy area of skin on his cheek and neck of uncertain anamnesis. The archaeological team determined it to be the result of either an Aleppo boil, a plague spot, an inflamed mosquito bite, or merely the result of mummification. It is unknown whether this virulent strain of malaria was lethal to the ancient Egyptians, who would likely have developed some genetic immunity after co-existing in areas where the mosquito, of the genus Anopheles, bred.We can assume that many people were exposed to the mosquito and therefore to the risk of malaria, and if lethal, it would have easily killed hundreds. However, we do not know if malaria is as we know it now. We must also acknowledge that the migration of people from across the country to Amarna, both rural and urban, allowed the mutation and cross exchange of pathogens, as the two types of dwellers would have built up immunities to different pathogens but not to each other’s. However, we currently cannot trace the evidence of Plasmodium falciparum in the South Tomb Cemetery skeletal remains because the research undertaken on Tutankhamun and the other mummies relied on soft tissue and the presence of DNA, something which is missing from the Amarna remains. It is however interesting to acknowledge the presence of malaria, particularly as Tutankhamun was born and raised in Amarna. We can however rule out malaria as the pestilence or plague mentioned in the Amarna letters and ‘plague prayers’; but it is not being ruled out as a potential killer at Amarna. Malaria cannot be the plague or pestilence which spread from Egyptian prisoners of war to the Hittite kingdom as stipulated in the Amarna letters and ‘plague prayers’, purely because it is not contagious; it can only be transmitted by the primary host, the mosquito.
Musca domestica, the common housefly, have been found in large numbers in samples from pharaonic Amarna. With their habit of flitting from rubbish to food, flies disseminated intestinal infections; notably amoebic dysentery, typhoid and paratyphoid fevers. Dysentery or Shigellosis is caused by an infection of Shigella, instigated primarily by flies landing on contaminated human faeces and then landing on food for human consumption. A particular side effect of dysentery is dehydration which could account for some of the evident episodes of illness witnessed in the Amarna skeletal remains. We witness Cribra Orbitalia in a vast proportion of adults and juveniles at Amarna, indicating prolonged periods of time where individuals had deficiencies of vitamins. Cribra Orbitalia is a skeletal lesion associated with the lack of vitamins, such as iron, B12 or Vitamin C and D, which leave very specific markers in the form of porosities on the skull. One of the predominant symptoms of Shigellosis is severe diarrhoea. Prolonged bouts of diarrhoea would cause the lack of nutrients, as food is not retained in the digestive system long enough for nutrients to be absorbed. Therefore, Shigellosis would cause malnourishment and hence cause skeletal lesions such as Cribra Orbitalia. Shigellosis had the potential to reach epidemic proportions at Amarna as it can be both water borne and as previously mentioned transmitted by flies, which were common throughout Egypt. It is possible that Shigellosis could have been the epidemic referred to in the Amarna letters because we often see cases of dysentery where people are tightly compacted, such as in the army.
We can rule out leprosy as the epidemic mentioned in the Amarna letters, at least it does not seem to have been the death of any of the individuals discovered at the South Tombs Cemetery at Amarna. Leprosy, caused by the organism Mycobacterium leprae, is not very contagious as it is difficult to transmit, it also has a long incubation period, and the symptoms that do occur such as disfiguring skin sores and nerve damage are progressively debilitating. Leprosy is not lethal in the short term and consequently it leaves skeletal lesions which could be detected on the remains from Amarna; nothing of the like has been reported.
Influenza cannot be archaeologically attested at Amarna because it does not present any pathological scarring, as, if it is fatal, then the incubation period is not long enough to cause any visible markings on bone. Also, influenza is transmitted by inhalation of mucus droplets usually directly from the previous human host. Therefore, it has no vector which could be detected archaeologically. However, we should consider influenza as a possible cause of the Egyptian-Asiatic plague based upon the fact that it is contagious between human contact, such as is suggested by the words of Mursulli II’s ‘plague prayers’. We do not need to rely upon this subjective evidence alone, colds and influenza are thought to have been known to the Egyptians based upon medicine describing cures for diseases which seem to suggest colds. General immunity to influenza is widespread nowadays and presumably this would have been the same for ancient populations. It is the exposure to subtypes of influenza which can cause a pandemic strain with even the young dying within 24-48 hours of the onset of symptoms. One of the greatest pandemics of the 20th Century was linked to influenza, namely the ‘Spanish Flu’ during the First World War. This virulent strain of influenza was unprecedented and appears to have been capable of becoming pandemic because of the assembly of previously different geographically based groups; each host to individual immunities and lack of immunities, who fought side by side in unsanitary war camps. This is the idea we are presented with at Amarna, a mixture of people from different geographical backgrounds migrating to this new capital city. We must also remember the conditions the prisoners of war taken back to Hatti would have been in. It is also stated in the ‘plague prayers’ that plague ravaged the lands of Hatti ever since the introduction of the prisoners of war, suggesting at the contagious nature of the plague. It is said that the Spanish Flu epidemic spread to civilians as soldiers after the war rushed home, taking back the pathogens with them and thus exposing more people to the influenza virus.
A table displaying the devastating effects of disease due to biogeographical movement. (Image taken from Marcus, B. 2009. Deadly Diseases and Epidemics: Malaria. New York: Infobase Publishing. Page 9)
Opportunities for further study
Certain areas of research are yet to be assumed due to current restrictions imposed by the Supreme Council of Antiquities that means that the skeletons cannot be moved to a laboratory where further more specialised research could be undertaken. There are several skeletons perfect for examination, these include those with skin adhering to bone, abundant hair samples and even brain tissue. Since the remains cannot be studied as extensively as mummified remains, and the tissue samples are comparatively smaller it is vital to understand what can be done with skeletonized samples, such as this assemblage from Amarna.
In the first chapter of this study the potential hazards of the schistosoma haematobium at Amarna were briefly mentioned. Calcified ova of the schistosoma have been discovered in the vital organs of mummified remains through methods such as CT scans. However, as the Amarna assemblage is made up of completely skeletonized remains we must find alternative means in identifying the presence of schistosomiasis. From the few samples of skin still adhering to certain skeletons from the South Tombs Cemetery, we could potentially test them for the presence of the schistosome circulating anodic antigen. The process of identifying the presence of specific antigens is called enzyme-linked immunosorbent assay (ELISA), and was first employed at the Manchester KNH centre to detect antigens related to schistosomiasis. However, the skin samples from Amarna are small and are only present on a few individuals, so we may never gather any conclusive evidence from Amarna. It is however, interesting to note the possibility for this avenue of research. Immunocytochemistry could also be employed for the detection of Plasmodium falciparum, the bacillus responsible for malaria. As malaria is still prevalent and lethal today in developing countries, and has been detected in association with the Amarna period, it would be interesting to discover whether the Amarna population were plagued by malaria. Perhaps we could also begin to understand whether malaria was lethal to the ancient Egyptians and learn more about genetic resistance to the disease, perhaps aiding the efforts against malaria nowadays.
A recent breakthrough in plague identification in European mass graves dated to the 14th Century AD could provide hope for detection of bubonic plague in the Amarna skeletal sample. Ancient DNA (aDNA) analyses identified sequences specific for Yersinia Pestis in the teeth of the European plague victims, and moreover the Yersinia Pestis F1 protein capsule antigen has been detected in ancient skeletons by immunochromatography. aDNA analyses were performed with dental pulp or bone samples from 76 human skeletons excavated from putative plague pits from across Europe in a specialized aDNA laboratory. There are ample supplies of intact teeth from Amarna which could allow for PCR amplification. The team working on some of the European samples yielded negative results from PCR amplification, but stated that this was due to small sample size sometimes working with only one tooth from an individual.
Studies of isotopic ratios in bone, skin and hair can indicate major dietary components, and thus predict deficiencies such as those responsible for the skeletal lesion cribra orbitalia found in several individuals at Amarna. If this avenue were someday explored we could once and for all determine whether diet was inducing malnutrition in the population at Amarna or whether another factor such as disease was to blame.
I could go on, but will end here today.