In 1932, a team of experts exploring the Subalyuk Cave in Northern Hungary discovered the skeletal remains of two Neanderthal individuals near the entrance. The individuals were identified as a young adult female and a child around 3 to 4 years old at the time of death. Although the fossils underwent anthropological examinations after their discovery, methodological progress encouraged the re-examination of the skeletons.

35,000-Year-Old Fossils From Central Europe Reveals First Known Tuberculosis Case in Neanderthals
(Photo: Wikimedia Commons/ Emőke Dénes)


Ancient Bacterial Infection

In a recent DNA analysis, the researchers discovered a combination of Neanderthal and human features on the skeletons, suggesting they could be some of the last Neanderthals in Central Europe. Carbon dating of the fossils in early 2023 confirmed that the child died around 33,000 to 34,000 years ago, while the adult female died earlier at about 37,000 to 38,000 years ago.

The fossils gained the attention of scientists due to their comparatively recent dates of death, as Neanderthals went extinct around this time. Additionally, the remains of the Subalyuk individuals provide additional clues about their lives and possibly the cause of their deaths. The study's findings are discussed in the paper "Re-examination of the Subalyuk Neanderthal Remains Uncovers Signs of Probable TB Infection (Subalyuk Cave, Hungary)."

Researchers found distinct evidence of skeletal infection in both individuals. This includes bony lesions along the spine of the female adult and on the interior of the child's skull. These skeletal changes, known as lytic lesions, indicate bone loss, resulting in holes filled with new bone.

Lytic lesions can happen due to several diseases, like cancer. However, their location and patterns within the bodies of the Subalyuk Neanderthals strongly suggest a diagnosis of tuberculosis, according to György Pálfi of the University of Szeged in Hungary.

To test their hypothesis, Oona Lee of the University of Birmingham in the UK took bone samples and analyzed them for the presence of M. tuberculosis DNA. Both samples were positive. Another method called spoligotyping supported the diagnosis for the child, while lipid biomarker analysis also revealed that both individuals had tuberculosis. The researchers conclude that tuberculosis was present in Central Europe during the Late Pleistocene Period based on morphological observations and their biomolecular support.

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Paleopathology of Tuberculosis

This discovery raises the question of how Neanderthals got the bacterial infection. The research team assumed the answer could be obtained from evidence of tuberculosis in large animals across ancient Europe, specifically bison. Neanderthals who hunted and ate these animals probably contracted tuberculosis from them. It suggests that the disease posed a danger through direct health risks and decimating prey animal populations.

The study of tuberculosis is one of the wealthiest subfields of the science of diseases since its existence can be demonstrated based on ancient human remains. Although there are still challenges in discovering the exact evolutionary past of this bacterial infection, human paleopathology offers abundant scientific information related to past occurrences of this infectious disease.

This is partly because some skeletal lesions are relatively specific to tuberculosis. It is one of the few infectious diseases that can leave behind pronounced and specific bone alterations.

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