{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:54:29Z","timestamp":1793058869295,"version":"4.5.0"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The key to evolution is reproduction. Pathogens can either kill the human host or can invade the host without causing death, thus ensuring their own survival, reproduction and spread. Tuberculosis, treponematoses and leprosy are widespread chronic infectious diseases whereby the host is not immediately killed. These diseases are examples of the co-evolution of host and pathogen. They can be well studied as the paleopathological record is extensive, spanning over 200 human generations. The paleopathology of each disease has been well documented in the form of published synthetic analyses recording each known case and case frequencies in the samples they were derived from. Here the data from these synthetic analyses were re-analysed to show changes in the prevalence of each disease over time. A total of 69,379 skeletons are included in this study. There was ultimately a decline in the prevalence of each disease over time, this decline was statistically significant (Chi-squared, p&lt;0.001). A trend may start with the increase in the disease\u2019s prevalence before the prevalence declines, in tuberculosis the decline is monotonic. Increase in skeletal changes resulting from the respective diseases appears in the initial period of host-disease contact, followed by a decline resulting from co-adaptation that is mutually beneficial for the disease (spread and maintenance of pathogen) and host (less pathological reactions to the infection). Eventually either the host may become immune or tolerant, or the pathogen tends to be commensalic rather than parasitic.<\/jats:p>","DOI":"10.1371\/journal.pone.0243687","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T13:31:51Z","timestamp":1614259911000},"page":"e0243687","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Human major infections: Tuberculosis, treponematoses, leprosy\u2014A paleopathological perspective of their evolution"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1941-2286","authenticated-orcid":true,"given":"Maciej","family":"Henneberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Holloway-Kew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teghan","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"key":"pone.0243687.ref001","volume-title":"Evolution of Infectious Disease","author":"P Ewald","year":"1996"},{"key":"pone.0243687.ref002","doi-asserted-by":"crossref","DOI":"10.1515\/9780691220161","volume-title":"Immunology and evolution of infectious disease","author":"S Frank","year":"2002"},{"key":"pone.0243687.ref003","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/B978-0-12-799942-5.00006-8","volume-title":"Genetics and evolution of infectious diseases","author":"AD Morgan","year":"2017"},{"key":"pone.0243687.ref004","volume-title":"Invisible invaders: smallpox and other diseases in aboriginal Australia, 1780\u20131880","author":"J Campbell","year":"2007"},{"key":"pone.0243687.ref005","volume-title":"The black death, 1346\u20131353: The complete history","author":"OJ Benedictow","year":"2004"},{"key":"pone.0243687.ref006","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/B978-0-12-799942-5.00023-8","volume-title":"Genetics and evolution of infectious diseases","author":"E Broset","year":"2017"},{"issue":"2004","key":"pone.0243687.ref007","first-page":"49","article-title":"The rate of human morphological human evolution and taxanomic diversity of hominids","volume":"4","author":"M Henneberg","year":"2006","journal-title":"Studies in Historical Anthropology"},{"key":"pone.0243687.ref008","first-page":"263","volume-title":"On Human Nature, biology, psychology, ethics, politics and religion","author":"F R\u00fchli","year":"2016"},{"issue":"1","key":"pone.0243687.ref009","doi-asserted-by":"crossref","first-page":"e000161","DOI":"10.1136\/bmjdrc-2015-000161","article-title":"Type 1 diabetes prevalence increasing globally and regionally: the role of natural selection and life expectancy at birth","volume":"4","author":"WP You","year":"2016","journal-title":"BMJ Open Diabetes Research & Care"},{"issue":"2","key":"pone.0243687.ref010","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/eva.12523","article-title":"Cancer incidence increasing globally: The role of relaxed natural selection","volume":"11","author":"W You","year":"2018","journal-title":"Evolutionary Applications"},{"key":"pone.0243687.ref011","volume-title":"Identification of pathological conditions in human skeletal remains","author":"DJ Ortner","year":"2003"},{"issue":"1","key":"pone.0243687.ref012","doi-asserted-by":"crossref","first-page":"S122","DOI":"10.1016\/j.tube.2015.02.021","article-title":"Tuberculosis origin: the Neolithic scenario","volume":"95","author":"I Hershkovitz","year":"2015","journal-title":"Tuberculosis"},{"issue":"3","key":"pone.0243687.ref013","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1162\/jinh_a_01301","article-title":"The Origin and Spread of Leprosy: Historical, Skeletal, and Molecular Data","volume":"49","author":"S Mark","year":"2018","journal-title":"The Journal of Interdisciplinary History"},{"issue":"5","key":"pone.0243687.ref014","doi-asserted-by":"crossref","first-page":"e1006997","DOI":"10.1371\/journal.ppat.1006997","article-title":"Ancient genomes reveal a high diversity of Mycobacterium leprae in medieval Europe","volume":"14","author":"VJ Schuenemann","year":"2018","journal-title":"PLoS Pathogens"},{"issue":"1","key":"pone.0243687.ref015","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.tube.2015.02.022","article-title":"Evolutionary changes in the genome of Mycobacterium tuberculosis and the human genome from 9000 years BP until modern times","volume":"95","author":"M Spigelman","year":"2015","journal-title":"Tuberculosis (Edinb)"},{"key":"pone.0243687.ref016","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1038\/nrmicro.2018.8","article-title":"Ecology and evolution of Mycobacterium tuberculosis","volume":"16","author":"S. 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