By Kathleen Ferraro
Ancient Rome was famous for its sanitation: latrines, sewer systems, piped water and public baths believed to improve public health. But a University of Cambridge researcher found just the opposite in his research published in the January issue of the journal Parasitology.
Piers Mitchell, a paleopathologist, or specialist in ancient human diseases, found that Roman hygiene proved insufficient to protect the population from parasites.
It turns out Roman times weren’t necessarily the glory days we watched in the 2000 epic “Gladiator.”
“This research should give people a more realistic understanding of what it was like to live in the past and what diseases they had,” Mitchell said, “rather than the glamorous view they might get from watching movies about the Romans.”
Experts on ancient Rome have touted the empire for its sanitation technologies and laws. Modern research and theoretical modeling show that sanitation should have improved Roman health compared with populations without sanitation measures, Mitchell said.
“The popular and scholarly perception has long been that the Romans were skilled sanitarians, especially taking precautions via their remarkable bathing technology, sewer apparatus and innovative ways of accessing drinking water,” said Clark Larsen, an anthropology professor at Ohio State University in Columbus. “[Mitchell’s] thorough review of the archaeological record reveals, however, that widespread presence of parasites remained a huge public health problem, despite this impressive technology.”
Conducting fieldwork at Roman sites spanning ten countries, from Britain to the Mediterranean, and covering evidence from 509 B.C. to 543 A.D., Mitchell studied the geographical distribution of parasites eggs in human stool.
The search for ancient poop takes many forms. Mitchell conducted skeletal analysis and recovered fecal samples from latrine soil, burial sites, sewer drains, rubbish pits and coprolites, or fossilized waste, from sites across Europe and the Mediterranean region. The researcher identified 12 endoparasites, organisms that live inside the body, and five ectoparasites, organisms that live outside the host.
Soil and coprolites were analyzed to detect parasite eggs. By measuring their geographic distribution, Mitchell was able to evaluate the change in parasitic infections over time.
Mitchell used the enzyme-linked immunosorbent assay (ELISA) technique to detect intestinal parasites. With ELISA, antibodies react to proteins unique to these organisms, thus revealing endoparasites.
Human whipworms, a parasite that causes intestinal disease, seem to have been the most widespread parasite in the empire, with evidence recovered in eight countries, including Austria, Britain, France, the Netherlands and Israel. A fecal-oral transmitted parasite, whipworms pass from one host and enter another through the mouth—by unwashed hands during food preparation, for instance.
Human roundworm, also transmitted via the fecal-oral route, was the second most widespread parasite at Roman sites, identified in six countries. Fish tapeworms were likewise found in six countries, spread by eating certain types uncooked fish.
Whipworm, roundworm, tapeworm and other Roman era parasites were also present in the Neolithic period (4000-2800 B.C.), Bronze Age (2800-500 B.C.) and Iron Age (700-100 B.C.). The Bronze and Iron Age saw a departure from the Neolithic period’s characteristic zoonotic—animal to people—parasites. Instead, parasites caused by poor sanitation grew, said Mitchell.
Nonetheless, after the dawn of the Roman Empire and its sanitation advances, parasites gradually increased.
“Some cultural advances or technologies, for instance, may have decreased parasites during the Roman Period, whereas other practices may have actually increased parasite-load risk,” said Elizabeth Weiss, an anthropology professor at San Jose State University. “Thus, even with sanitation, the net outcome of parasite risk may be higher.”
Anne Grauer, an anthropology professor at Loyola University in Chicago, agreed.
“Technology, such as advancements in sanitation, alone does not always impact or ameliorate the host-pathogen relationship, and that human behavior (beliefs, customs, personal preferences) often plays a pivotal and much-overlooked role in the presence of human disease,” she said.
Ironically, sanitation may have been to blame. Warm, infrequently changed water in bathhouses may have spread roundworm and whipworm eggs, according to the research. An unfortunate consequence of sanitation laws, fresh human waste removed from towns to fertilize crops spread parasite eggs onto plants soon to be eaten.
Fish tapeworms, surprisingly widespread in Roman times, indicate an apparent zest for uncooked fish. Garum sauce, a fermented fish sauce used for cooking and medicinal purposes, is a possible culprit. Romans traded garum across conquered lands, likely spreading fish tapeworms as a result of their increasingly globalized empire, according to Mitchell.
Romans also had to worry about lice, fleas and bedbugs. Mitchell recovered evidence on ancient combs, textiles, in soil and via skeletal analysis to measure the distribution of these ectoparasites.
Given the fact that the concentration of ectoparasites are similar to those in Viking and medieval sediment layers, the Romans’ habit of frequent bathing and hand washing didn’t do much more than make them a remarkably clean population.
Nonetheless, Della Cook, director of the Osteology and Paleopathology Lab at Indiana University in Bloomington, hesitated to label Roman hygiene as useless.
“It seems likely that communities with clean water supplies and flushing latrines would have had lower worm burdens, even if they had a similar variety of parasites,” Cook said.
Likewise, Weiss didn’t take increasing parasite levels at face value.
“It may be that the types of parasites increased, but that the number of people infected or the severity of the infections decreased,” Weiss said.
Now knowing that Roman sanitation measures were insufficient to keep parasites at bay, Mitchell wants to set the record straight.
“I hope it will stimulate a major rethink about how we view sanitation technologies in the Roman Empire,” Mitchell said.
He plans to take it a step further to see if the findings hold up in other societies.
“I plan to undertake similar research looking at infectious diseases in different ancient civilizations around the world to see how their technological inventions may have affected the health of their populations,” Mitchell said.