Our results revealed tMRCA average values ranging from 4725 to 1175 years ago and support the estimates of Serre et al. (3000–6000 years ago) , rather than Morral et al. (52,000 years ago) , but the latter figure was challenged by Kaplan et al.  because of disagreement with assumptions used in their calculations. In addition, the tMRCA values from western European regions reported herein refine the results of Fichou et al.  from a study of Breton CF patients in which the Estiage analysis suggested that the most common recent ancestor lived 115 generations ago. That tMRCA value, however, may have underestimated the age of p.(Phe508del) in Brittany due to consideration of all the haplotypes, even those that were reconstructed with ambiguities, as well as a potential bias associated with consanguinity due to including both haplotypes in homozygous families. In the more stringent Estiage analyses reported herein, those potential biases were avoided for all populations, leading to estimates of the oldest tMCRA values corresponding to the Early Bronze Age in western Europe, which is generally agreed to begin around 3000 BCE. This finding extends our results from a direct investigation of aDNA in teeth from Iron Age burials near Vienna around 350 BCE and allow us to conclude that p.(Phe508del) was present in that region long before then. More specifically, in the Austrian families studied, the Estiage data revealed a mean tMCRA value of 3575 years ago, which converts to 1558 BCE (Middle Bronze Age) .
Perhaps most remarkably, the estimated ages of p.(Phe508del) in the three western European regions (France, Ireland, and Denmark) were similar with closely overlapping 95% CI values. This observation is also in line with previously documented spatial autocorrelograms expressing genetic and geographical distance for these populations . Such data provide more insight about the ancient origin of CF in our judgment—both when and where—and lead us to propose that CFTR p.(Phe508del) is derived from ancestors who lived in western Europe during the Bronze Age, as early as 2700 BCE, and that its relatively rapid dissemination occurred because of human migrations around the northwestern Atlantic trading routes  and then towards central and eastern Europe . Diffusion from northwestern to central Europe in approximately 1000 years is consistent with the prominent Bronze Age migrations evident in the archeological record [21, 22] and from genomic studies of aDNA . On the other hand, we are assuming a discrete origin of the principal CF-causing variant, but it is possible that p.(Phe508del) arose more than once or earlier, and then reached western Europe subsequently through Neolithic migrations.
[About Bell Beakers] (…) More specifically, their distinctive Bell Beaker pottery appeared and spread across western and central Europe beginning around 3000–2750 BCE and then disappeared between 2200 and 1800 BCE [22, 29]. Their migrations are linked to the advent of western and central European metallurgy, as they manufactured and traded metal goods, especially weapons, while traveling over long distances . Most relevant to our study is the evidence that they migrated in a direction and over a time period that fits well with the pattern of tMRCA data we found for the p.(Phe508del) variant. Olalde et al.  have shown that both migration and cultural transmission played a major role in diffusion of the “Beaker Complex” and led to a “profound demographic transformation” of Britain after 2400 BCE. Moreover, the cultural elements that unite the widely distributed Beaker folk are so obvious that some have considered them a distinct ethnicity of Bronze Age people .
From our results, we propose the novel concept that large scale, long term west-to-east migrations of the Bell Beaker Europeans [22, 28–30] during the Bronze Age, could explain the dissemination of p.(Phe508del) in Europe and its documented northwest-to-southeast gradient .In fact, our tMRCA data show a temporal gradient also.
As you can see from the references, they consulted with Barry Cunliffe (or people accepting his theory), who is obsessed with Bell Beakers expanding Celtic languages from the British Isles. He is like the British equivalent of Danish scholar Kristian Kristiansen, and his obsession with Corded Ware = Indo-European (and Germanic = CWC Denmark), immutable no matter what genetic results might show.
The funny thing is, the interpretation of the paper is probably right. From what we can see in the data, it is quite possible that the disease spread with expanding Bell Beakers…only it spread from the East group in Hungary, i.e. from east to west. The regional difference in TMRCA and apparent west—east cline would point to the different expansions of affected lineages in the corresponding regions, and not to an origin in the British Isles.
The Merovingian period in Northeast France (developing from 440/450 to 700/710 CE; Legoux et al., 2004) represents [a case of multiple burial], where a large majority of the types of deposits encountered consists of individual burials. In this context, whereas hundreds of individual burials are known, the syntheses recently conducted have enabled the inventory of only six multiple burials (Lefebvre and Lafosse, 2016). These observations naturally raised questions about the exceptional circumstances that led the members of the community to set up such unusual burials. The archaeological site of Hérange, excavated in 2014 (Lorraine, Grand Est region; Fig. S1), holds a key position in the debate surrounding the interpretation of multiple burials during the Merovingian period since it contains one of these rare multiple burials: burial 41, which was dated through archaeological material to the period 530–640 CE.
(…) The biological analysis of the human remains recovered in the second burial (“burial 41”) enabled the demonstration of the combined presence of a woman of approximately 40 years old (A) and three immature individuals, including a 4–5-year-old child (B), a 14–16-year-old teenager (C) and a 2,5–3-month-old infant (D) (Lefebvre and Lafosse, 2016) (Fig. 1). Since rare multiple burials described for the Merovingian period in Northeast France mainly contained two or rarely three deceased, the discovery of a burial grouping four individuals reinforced its exceptional nature. (…) Intriguingly, great care was observed in the treatment of the dead, as illustrated through a special arrangement of the deceased in the grave (Fig. 1). Indeed, the woman A occupied a central position in the grave, with her left arm covering part of the body of child D, her right arm covering the torso of child B and her right hand covering the legs of children B and C. Several arguments, such as the close contact or the imbrication of the bones of individuals A, B and C, have attested to the simultaneity of their deposits in the burial (Lefebvre and Lafosse, 2016).
Interestingly, studies have demonstrated an important chronological homogeneity for the rare multiple burials discovered for the Merovingian period in the Lorraine region (Lefebvre and Lafosse, 2016). The collected data support the existence of an epiphenomenon arisen around the middle of the Merovingian period and that may have linked the multiple burials to (i) a funerary “fashion trend” for a special group of the community, (ii) an increase in cases of violence or (iii) an epidemic crisis linked to infectious disease. In other Lorraine sites, none of the available indices permitted the specification of the cause of death for the individuals recovered in these specific burials. The deceased could well have died of natural causes, violent acts or infectious diseases that had left no visible evidence on the skeletal.
The aDNA analyses conducted on the four individuals discovered in the exceptional multiple burial 41 from Hérange (Lorraine) have demonstrated strong biological links between three individuals. Notably, we could propose that the woman A was the mother of the two immatures B and D deposited just besides her whereas she was not genetically closely related to the teenager C deposited along her legs. Consequently, we propose that the special arrangement of the deceased in the grave clearly reflected the degree of biological links between the deposited individuals. In Hérange, the bereaved were well aware of kinship among the deceased, wanted to express this close linkage through their relative location within the burial, and intentionally arranged body positions consequently. In conclusion, the collected archaeological, archaeo-anthropological and genetic data suggest that the special setup of the multiple burial 41 in the Hérange necropolis and the great care in the treatment of the dead, could be explained by the contemporaneous death of the four related individuals. Data gathered for other archaeological sites from the region or in Germany suggested an epidemic crisis (plague epidemic?) during the middle of the Merovingian period that may explain the contemporaneous death of related individuals living in close contact and easily sharing pathogens.
Reported mtDNA haplogroups include U* for samples A, B, and D, and H for sample C.
Interesting excerpts from the paper and supplementary materials (emphasis mine):
Here, we analyse material from the Mikhailovsky II burial site, which was excavated in 2015 and is one of numerous kurgan cemeteries identified in the Samara Oblast. It consists of seven kurgan burials, and is chronologically associated to the ‘Pokrovka’ phase (3,900-3,750 BP) of the ‘Srubnaya’ culture (3,850-3,150 BP) (radiocarbon dates produced in this study provided in Supplementary Table 6), also referred to as the ‘proto-Srubnaya’ that is considered the earliest phase of the LBA in the Samara Oblast. All sex and age groups were represented in this cemetery. We analysed nine individuals buried in three kurgans and identified two individuals buried in the same kurgan (see Supplementary Figure 1) to be positive for Y. pestis. According to anthropological analysis these were a 30-40 year-old male (RT5) and 35- 45 year-old female (RT6).
After its divergence from Y. pseudotuberculosis, Y. pestis acquired its high pathogenicity and distinct niche mainly by chromosomal gene loss16 as well as the acquisition of two virulence-associated plasmids, pMT1 and pPCP11,17,18. Throughout this process, one of the most crucial evolutionary adaptations related to its pathogenicity was its ability to colonise arthropods, a phenotypic/functional gain mediated by a combination of chromosomal and plasmid loci19,20. These genetic changes are central to the most common “bubonic” form of the disease, where bacteria enter the body via the bite of an infected flea, travel via the lymph to the closest lymph node and replicate while evading host defences. Recent ancient genomic investigations of Y. pestis have identified its earliest known variants in Eurasia during the Late Neolithic/Bronze Age period (LNBA) that show genetic characteristics incompatible with arthropod adaptation. These strains, therefore, have been considered incapable of an efficient flea-based transmission2; however, the alternative early-phase transmission could have provided an independent means of arthropod dissemination2,3,21. To date, the earliest evidence of a Y. pestis strain with signatures associated with flea adaptation has been reported during the Iron Age through shotgun sequencing of an ~2900-year-old genome from Armenia (strain RISE397), though at a coverage too low (0.25-fold) to permit confident phylogenetic positioning2. Although the mechanism by which the LNBA lineage caused human disease is unclear, its frequency in Eurasia during the Bronze Age2,3 and its phylogeographic pattern that mimics contemporaneous human migrations are noteworthy3.
The central steppe region seems to have played a significant role as a migration corridor during the entire Bronze Age, and as such, it likely facilitated the spread of human-associated pathogens, such as Y. pestis, across Eurasia. Here, we explore additional Y. pestis diversity in that region by isolating strains from LBA Samara, in Russia. We identify a Y. pestis lineage contemporaneous to the LNBA strains with genomic variants consistent with flea adaptation. This reveals the co-circulation of two Y. pestis lineages during the Bronze Age with different properties in terms of their transmission and disease potentials.
A recent study has suggested that flea-adapted Y. pestis, along with its potential to cause bubonic plague in humans, likely originated around 3000y BP2. Contrary to such conclusions, the lineage giving rise to our Y. pestis isolates (RT5 and RT6) likely arose ~4000 years ago (Supplementary Tables 6 and 9), and possessed all vital genetic characteristics required for flea-borne transmission of plague in rodents, humans and other mammals. (…)
Moreover, our analysis of the previously published Iron Age RISE397 strain from modern-day Armenia2 revealed its close relationship to RT5 and RT6 (Supplementary Fig. 4). Note that the modern 0.PE2 and 0.PE7 lineages, which are known to possess all genomic characteristics that confer adaptation to fleas19, fall ancestral to RT5 (Fig. 2b) and RISE397 (Supplementary Fig. 4), but are more derived than the LNBA lineage. Our phylogenetic and dating results thus suggest that 0.PE2 and 0.PE7 also originated during the Bronze Age, with their mean divergence here estimated to 4474 (HPD 95%: 3936–5158) and 5237 (HPD 95%: 4248–6346) years BP, respectively, based on the Bayesian skyline model (Supplementary Table 9). While these lineages may have been confined to sylvatic rodent reservoirs during the EBA, the possibility that they co circulated among human populations contemporaneously with the LNBA lineage should be considered. Although the places of origin of 0.PE2 and 0.PE7 are not known, today, their strains are isolated from modern-day China and the Caucasus region. In terms of their disease potential, both 0.PE2 and 0.PE7 possess pMT1 plasmids with fully functional ymt genes, but 0.PE2 strains lack pPCP144, and though frequently recovered from sylvatic rodent reservoirs, their virulence in humans is not known. On the other hand, the more basal 0.PE7 contains pPCP12 and has previously been associated with human bubonic plague12. It is, therefore, tempting to hypothesise that efficient flea adaptation in Y. pestis, as well as the potential for bubonic disease, might have evolved earlier than 5000 years ago.
It seems possible that already in the Bronze Age, with the establishment of transport and trade networks, the interconnectivity between Europe and Asia that is also reflected in the ancient human genomes, likely contributed to the spread of infectious disease. Similarly, the abundant trade routes of the medieval period are considered the main conduit for plague’s movement between Asia and Europe8,12. Our current data suggest a more complex model, where at least two human-associated lineages (LNBA and RT5) with different transmission potentials were established in Eurasia during the Bronze Age (Fig. 2b, c).
The haplogroup of RT5 is R1a1a1b-Z645 (most likely Z93, only with coverage of 1-fold), mtDNA U2e2a.
Variation at the FADS1/FADS2 gene cluster is functionally associated with differences in lipid metabolism and is often hypothesized to reflect adaptation to an agricultural diet. Here, we test the evidence for this relationship using both modern and ancient DNA data. We document pre-out-of-Africa selection for both the derived and ancestral FADS1 alleles and show that almost all the inhabitants of Europe carried the ancestral allele until the derived allele was introduced approximately 8,500 years ago by Early Neolithic farming populations. However, we also show that it was not under strong selection in these populations. Further, we find that this allele, and other proposed agricultural adaptations including variants at LCT/MCM6, SLC22A4 and NAT2, were not strongly selected until the Bronze Age, 2,000-4,000 years ago. Similarly, increased copy number variation at the salivary amylase gene AMY1 is not linked to the development of agriculture although in this case, the putative adaptation precedes the agricultural transition. Our analysis shows that selection at the FADS locus was not tightly linked to the development of agriculture. Further, it suggests that the strongest signals of recent human adaptation may not have been driven by the agricultural transition but by more recent changes in environment or by increased efficiency of selection due to increases in effective population size.
Interesting excerpt for the steppe-related expansion:
In the case of FADS1 and all the other examples we investigated, the proposed agricultural adaption was either not temporally linked with agriculture or showed no evidence of selection in agricultural populations. Instead, most of the variants with any evidence of selection were only strongly selected at some point between the Bronze Age and the present day, that is, in a period starting 2000-4000 BP and continuing until the present. This time period is one in which there is relatively limited ancient DNA data, and so we are unable to determine the timing of selection any more accurately. Future research should address the question of why this recent time period saw the most rapid changes in apparently diet associated genes. One plausible hypothesis is that the change in environment at this time was actually more dramatic than the earlier change associated with agriculture. Another is that effective population sizes were so small before this time that selection did not operate efficiently on variants with small selection coefficients. For example, analysis of present-day genomes from the United Kingdom suggests that effective population size increased by a factor of 100-1000 in the past 4500 years (Browning and Browning 2015). Ancient effective population sizes less that 104 would suggest that those populations would not be able to efficiently select for variants with selection coefficients on the order of 10-4 or smaller. Larger ancient DNA datasets from the past 4,000 years will likely resolve this question.
This complexity of the reasons for selection reminded me of the comment by Narasimhan on lactase persistence expanding with steppe populations into Central Asia (based on data of the paper where he is the first author):
I always thought that to argue for natural selection in humans (viz. skin color, lactase persistence, etc.) was possible for archaic groups over tens of thousands of years, but that more recent selections would be very difficult to prove, in so far as historical population expansions involve more ‘artificial’ (i.e. man-made or man-caused) societal changes.
NOTE. I am probably more inclined to think about regional outbreaks (especially of new diseases) as one of the few potential short-term selection mechanisms in historical societies, because of their potential to create sudden bottlenecks of better fitted survivors.
I think recent works like these are showing a mixed situation, where maybe some traits were strongly selected for environmental reasons; but most of the time they were probably – like, say, Y-DNA haplogroup bottlenecks in Europe after the steppe-related expansions – due mostly to chance.
I’ve been disappointed that three recent exceptional studies of one of the world’s most historically important diseases, leprosy, have gotten so little notice from the science communication. It will take me a few hours to lay out their significance. But I think it’s important to do so.
So, here are the new studies on historical distribution and evolutionary development of Mycobacterium leprae, one of two organisms that causes leprosy (fourth study dropped yesterday!).
Leprosy is a chronic human disease caused by the yet-uncultured pathogen Mycobacterium leprae. Although readily curable with multidrug therapy (MDT), over 200,000 new cases are still reported annually. Here, we obtain M. leprae genome sequences from DNA extracted directly from patients’ skin biopsies using a customized protocol. Comparative and phylogenetic analysis of 154 genomes from 25 countries provides insight into evolution and antimicrobial resistance, uncovering lineages and phylogeographic trends, with the most ancestral strains linked to the Far East. In addition to known MDT-resistance mutations, we detect other mutations associated with antibiotic resistance, and retrace a potential stepwise emergence of extensive drug resistance in the pre-MDT era. Some of the previously undescribed mutations occur in genes that are apparently subject to positive selection, and two of these (ribD, fadD9) are restricted to drug-resistant strains. Finally, nonsense mutations in the nth excision repair gene are associated with greater sequence diversity and drug resistance.
Studying ancient DNA allows us to retrace the evolutionary history of human pathogens, such as Mycobacterium leprae, the main causative agent of leprosy. Leprosy is one of the oldest recorded and most stigmatizing diseases in human history. The disease was prevalent in Europe until the 16th century and is still endemic in many countries with over 200,000 new cases reported annually. Previous worldwide studies on modern and European medieval M. leprae genomes revealed that they cluster into several distinct branches of which two were present in medieval Northwestern Europe. In this study, we analyzed 10 new medieval M. leprae genomes including the so far oldest M. leprae genome from one of the earliest known cases of leprosy in the United Kingdom—a skeleton from the Great Chesterford cemetery with a calibrated age of 415–545 C.E. This dataset provides a genetic time transect of M. leprae diversity in Europe over the past 1500 years. We find M. leprae strains from four distinct branches to be present in the Early Medieval Period, and strains from three different branches were detected within a single cemetery from the High Medieval Period. Altogether these findings suggest a higher genetic diversity of M. leprae strains in medieval Europe at various time points than previously assumed. The resulting more complex picture of the past phylogeography of leprosy in Europe impacts current phylogeographical models of M. leprae dissemination. It suggests alternative models for the past spread of leprosy such as a wide spread prevalence of strains from different branches in Eurasia already in Antiquity or maybe even an origin in Western Eurasia. Furthermore, these results highlight how studying ancient M. leprae strains improves understanding the history of leprosy worldwide.
We report on a Mycobacterium leprae genome isolated from the remains of an individual with lepromatous leprosy that were excavated from a seventh‐century Hungarian cemetery. We determined that the genome was from a single nucleotide polymorphism (SNP) type 3K0 M. leprae strain, a lineage that diverged early from other M. leprae lineages. This is one of the earliest 3K0 M. leprae genomes to be sequenced to date. A number of novel SNPs as well as SNPs characteristic of the 3K0 lineage were confirmed by conventional polymerase chain reaction and Sanger sequencing. Recovery of accompanying human DNA from the burial was poor, particularly when compared with that of the pathogen. Modern 3K0 M. leprae strains have only been isolated from East Asia and the Pacific, and so these findings require new scenarios to describe the origins and routes of dissemination of leprosy during antiquity that have resulted in the modern phylogeographical distribution of M. leprae.
Leprosy is caused by the bacterial pathogens Mycobacterium leprae and Mycobacterium lepromatosis. Apart from humans, animals such as nine-banded armadillos in the Americas and red squirrels in the British Isles are naturally infected with M. leprae. Natural leprosy has also been reported in certain nonhuman primates, but it is not known whether these occurrences are due to incidental infections by human M. leprae strains or by M. leprae strains specific to nonhuman primates. In this study, complete M. leprae genomes from three naturally infected nonhuman primates (a chimpanzee from Sierra Leone, a sooty mangabey from West Africa, and a cynomolgus macaque from The Philippines) were sequenced. Phylogenetic analyses showed that the cynomolgus macaque M. leprae strain is most closely related to a human M. leprae strain from New Caledonia, whereas the chimpanzee and sooty mangabey M. leprae strains belong to a human M. leprae lineage commonly found in West Africa. Additionally, samples from ring-tailed lemurs from the Bezà Mahafaly Special Reserve, Madagascar, and chimpanzees from Ngogo, Kibale National Park, Uganda, were screened using quantitative PCR assays, to assess the prevalence of M. leprae in wild nonhuman primates. However, these samples did not show evidence of M. leprae infection. Overall, this study adds genomic data for nonhuman primate M. leprae strains to the existing M. leprae literature and finds that this pathogen can be transmitted from humans to nonhuman primates as well as between nonhuman primate species. While the prevalence of natural leprosy in nonhuman primates is likely low, nevertheless, future studies should continue to explore the prevalence of leprosy-causing pathogens in the wild.
These five studies are doing whole-genome sequencing on either modern isolates of M. leprae, or genomic fragments retrieved from buried remains (aDNA). The main objective of all the studies is to understand the diversity of M. leprae, both in terms of its history and in terms of its present-day distribution. (Benjak et al. 2018 are especially concerned to study possible reasons for variance in multiple drug resistance).
The following comments are concerned only to discuss leprosy’s history.
The answer, actually, is no. There’s two reasons for this, one having to do with chronology, the other with geography.
For chronology, these studies cumulatively suggest we are looking at a bottleneck. The current Time to Most Recent Common Ancestor (TMRCA) suggested for the divergence of M. leprae from its closest known “cousin,” M. lepromatosis (which also causes leprosy in humans) is estimated to be ca. 13.9 million years. There were no humans around 13.9M ya. So we cannot have been M. leprae‘s original host. All studies being discussed here agree on a consensus phylogeny, which puts the origin of all known strains of M. leprae at about 4-5K ya. So when we talk about the “origin” of M. leprae, we only talking about those lineages formed after this bottleneck.
Next we have to look at geography. Let’s start with this statement from the most recent study, Mendum et al. 2018, which is discussing a genome sequenced from an individual in Hungary from the 7th c. CE: “Modern 3K0 M. leprae strains have only been isolated from East Asia and the Pacific and so these findings require new scenarios to describe the origins and routes of dissemination of leprosy during antiquity that have resulted in the modern phylogeographical distribution of M. leprae.”
Okay, so stop and consider the implications of this. We have someone from 7th c. Hungary with leprosy. The strain of M. leprae that he has is not most closely related to strains sequenced earlier in Denmark or Sweden or England (see Schuenemann et al. 2018, refs. 9, 20, & 21). Rather, the strain he has (3K0) is most closely related to modern strains currently documented on the Pacific Rim, a very, very long way from Hungary. Here are the summary reflections of Mendum et al. 2018:
The global distribution of 3K0 and 3K1 strains is today restricted to regions of the Western Pacific such as Japan (except Okinawa), Korea, China, The Philippines, New Caledonia and Indonesia amongst others (Kai et al, 2013; Avanzi et al, 2015; Monot el al, 2009; Weng et al, 2013; Honap et al, 2018). This could indicate that the 3K lineage originated in Northern or Eastern Asia. The presence of two type 3K cases (KD271 and 222) in early medieval Hungary would then suggest a route of dissemination from Asia to central Europe, perhaps via trade links or migrations. This would be consistent with what is known of the origins of the Pannonian Avars, who are believed to have reached the Hungarian plain from the Eurasian steppe in the late 6th to early 9th centuries (Curta, 2006). The other possibility is that Europe was a centre of dissemination of the ancestral 3K0 and related strains, some of which later became less common or even absent from Europe but persisted in East Asia and the Pacific. Determining the likelihood of each of these scenarios will require more sampling and characterisation of both ancient and modern strains.
Two things bear stressing:
The lineage in which the Hungarian sample has been placed, Lineage 0, has now been documented in historical remains from Denmark, too. (Schuenemann et al. 2018) So whatever transmission routes are postulated to connect the Pacific Rim to Hungary, we will also need to postulate routes to connect the Pacific Rim to Denmark.
Schuenemann et al. 2018 document four of the five known M. leprae lineages in medieval western Europe. (Mendum et al. 2018 now declare the existence of 6 lineages; see tree.)
Now, remember that we also need to keep chronology in mind: Lineage 0 is thought to have diverged from the common ancestor of Lineages 1-4 at least 3.5K ya. (Here’s the phylogenetic tree from Benjak et al. 2018, which I have marked with time divisions for emphasis.)
So what we need to explain is how a strain (Lineage 0, or 3K0 as Mendum et al. 2018 call it) can be found all the way from Denmark to New Caledonia. An “Out of Europe” narrative isn’t really helpful, any more than the earlier “Out of Africa” narrative worked.
Given the extreme amount of suffering leprosy has caused, and continues to cause around the world, and given the extraordinary investigative power that paleogenetics has now developed, it’s really time that we did a better job pulling these global narratives together.
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I've been disappointed that 3 recent exceptional studies of one of the world's most historically important diseases, #leprosy, have gotten so little notice from #scicomm. It will take me a few hours to lay out their significance. But I think it's important to do so. 1/n
Plague outbreaks in the past are mainly known from written sources; in particular, the Justinianic Plague of the Early Middle Ages and the Black Death of the Late Middle Ages have been described in vivid detail. Yet prior to the introduction of aDNA analysis, it was often quite difficult to associate burials with plague beyond doubt – especially in areas where written evidence of the plague is scarce. As analysis of ancient DNA now allows the detection of plague victims in the archaeological record, new ways are being developed for combining archaeological, historical and ancient DNA research. In this paper we would like to present and compare known examples of plague graves from the Early Middle Ages, the Late Middle Ages and the Thirty Years’ War in Germany that have also been confirmed by ancient DNA analyses. We would like to argue for a differentiated view of the burial customs, especially when more than one plague victim shared a grave, and would like to show possible conclusions, drawn from the aDNA-confirmed plague burials, that can indicate the different strategies adopted by ancient societies to deal with catastrophic events like a pandemic disease.