The Vác mummy project: investigation of 265 eighteenth-century mummified remains from the TB Pandemic Era

Aims: This chapter aims to investigate the 265 eighteenth-century human remains interned in a sealed crypt within the Dominican Church in Vác, Hungary, between 1731 and 1838, including their lifestyle, occupation, and modes of death. In particular, this chapter aims to study the natural history of tuberculosis in the preantibiotic era related to age at death, sex, and body site and to characterize the infecting organisms. Church and civic records provided details of the individuals buried in the crypt. Methods: Bodies were examined by naked eye or radiographic examination, initially by X-ray, then via CT analysis. Several selected individuals were examined for noninfectious conditions, including a nun with a severe spinal deformity, two young men with developmental abnormalities, and an elderly woman with gout. Skeletal and naturally mummified tissues were examined for the presence of Mycobacterium tuberculosis DNA using specific molecular markers and techniques. Results: The crypt individuals included wealthy citizens and clergy. Overall, specimens from 176/265 (66.4%) individuals were positive for tuberculosis, with 36/67 (53.7%) positive aged <20 years plus140/193 of adults (72.5%). When multiple body sites were examined, 79/101 (78.2%) of individuals were positive; disseminated disease was detected in 41 (40.6%) neonates, infants, and adults. Most had pulmonary disease, but 15 (14.9%) had extrapulmonary disease only. Conclusions: These human remains tell us much about their lifestyle and occupations. Tuberculosis, caused by M. tuberculosis, was widespread in this community. Examining both mummified tissues and skeletal remains gave a better indication of the nature of tuberculosis than is possible from the examination of skeletal material alone.