HLA-DRB1*03 locus associated with a higher risk of paratyphoid fever in human remains from medieval mass burial at Heiligen-Geist-Hospital in L?beck

Medieval Europe was repeatedly affected by outbreaks of infectious diseases, some of which had a significant impact in shaping contemporary European immune response/immune gene composition. The Late Medieval mass-burial site next to the Heiligen-Geist-Hospital in L?beck contained the human remains of more than 800 individuals spread among several mass graves. The cause of death could be identified as enteric paratyphoid fever in two of the four investigated graves. Population genetic analyses revealed that the buried individuals were of northern and eastern European descent. We performed an analysis of the human leukocyte alleles (HLA) in 53 individuals from all mass grave contexts. HLA-DRB1*03, which is associated with a higher risk for typhoid fever in modern South-East Asian populations, is increased in frequency in the medieval population compared to modern Europeans.