 So today I'm talking a little bit about my work on leprosy and tuberculosis in Portugal And I'm sorry I will read my presentation, so I will keep on time Leprosy and tuberculosis are mycobacterial chronic infections with relatively long incubation periods both transmitted between humans Leprosy is primarily a disease of the nerves and skin caused by the mycobacterial lepride while TB is caused by bacillus from the mycobacterium tuberculosis complex which can affect any organ or body system although 70 to 80 percent of the cases are from pulmonary TB Although leprosy and tuberculosis are curable with antibiotics, terapies, the 1940s, the World Health Organization eradication targets have been seriously compromised over the last decades due mainly to antibiotic resistance, poverty and in the case of tuberculosis HIV infection The most recent released global statistics reveals around 200,000 new cases of Leprosy and an impressive number of more than 6 million notified cases of TB worldwide This means that there is much Epidemiological, social and political work to be done in the future and we archaeologists and anthropologists may have a role on these namely by unveiling the evolution and history of these diseases and by clarifying their biological and social cultural impacts on human populations over time We know that both diseases have a long history in common with humans We behold this paleopathological evidence of leprosy found in India and of TB in Israel In Europe the most ancient cases were found respectively in Italy 2,500 years BP and Hungary 7,000 year BP So the aim of this presentation is to provide an overview of skeletal evidence of leprosy and TB in Portugal Our starting point was the Portuguese Biarcheological database recently compiled by our research group staff From published and unpublished data produced over the last 27 years in Portugal Currently this database comprises a minimal number of approximately 9,000 individuals inerted from around 200 Portuguese archaeological sites and covering a time span of around 7,000 years When data is stratified By animation type the medieval period shows the highest share of primary Animations while OSCHIWARE is predominating Neolithic and modern contexts Concerning tuberculosis We searched the database not only for the words tuberculosis But also for descriptions of skeletal changes Commonly associated to these diseases. These group of lesions are well known, but I will show Some of them namely destructive changes both on the vertebral column and on extra vertebral locations such as the hip and knee joints represented in B and A Rib and endocrinic cranial lesions represented in C and D and Finally, hypertrophic osteoarthrope T represented in the figure E As this graph shows rib and endocrinia lesions were the most prevalent ones followed by Vertical destruction However, it is important to stress out that except for tuberculosis vertebral destruction also known as POTS disease The remaining lesions are compatible with the TB diagnosis, but not exclusive of this infection And as such their differential diagnosis is fundamental The paleopathological diagnosis of TB is tricky and is always a step-by-step procedure considering parameters such as the topography and typology of lesions, their radiological appearance and clinical significance, the biological profile of the individual and The archaeological and funerary context. Unfortunately, a final diagnosis is not always possible Overall, 81 suspected cases of TB were found in our database. The temporal distributions So shows that the majority belongs to the eye and late medieval and modern periods and there is no prehistory prehistoric evidence of TB in the Portuguese territory All these suspected cases are being re-analyzed and some of them being subject to radiocarbon dating, chemical and genetic genetic analysis, sorry Despite the relatively high number of suspected TB cases, only two of these have the required set of lesions to be considered probable cases of the disease One skeleton comes from the monastery of Flor de Rosa in Crato and another one from the city of Castelbran I only have time to highlight our most representative case of TB found in 2004 in the San Miguel Church at Castelbranco city Historical sources mentioned the existence of the excretion temple since the 13th century and that the associated necropolises was used until 1818 The skeleton number 4, a known adult with 12 years old, was exhumed from grave 8 which is one of the 20 anthropomorphic rock tomes existent in the east churchyard square The pathological changes were noticed during the field work and later the laboratory all Microscopic inspection and radiological study reveal the severe kyphosis and correlated thoracic deformities The spine presented the most striking lesions, namely a gibos deformity Which is characterized by a sharply angular kyphosis as the result of vertebral collapse and fusion at multiple levels Also of note was a well-defined sinus tract for pus draining observed on the body of the 9th the thoracic vertebra Additionally, bilateral destructive and proliferative lesions were found on middle and lower ribs So a diagnosis of vertebral tuberculosis or POTS disease is the most reliable option for this case and if we consider all the above mentioned skeletal lesions From the differential diagnosis were excluded several known infectious and infectious conditions such as trauma, neoplasms or roussulosis So under the scope of an international collaborative research project on ancient DNA bone samples of these individuals were PCR screened for part of the genomic element IS-6110 And the results were unfortunately negative However, this does not mean that the individual was not infected with tuberculosis Hopefully, world genome sequencing techniques will provide positive results soon Considering leprosy, I would like to remember that the skeletal involvement includes cranial and post-cranial lesions and currently the paleophotological diagnosis is based on the presence of specific renomaxillary lesions usually characterized by destructive remodeling and or osteolithic activity The most relevant post-cranial skeletal changes for the diagnosis of leprosy are concentric atrophy and acroosteolysis of the tubular bones of the hands and feet Our database reveals the existence of eight skeletons affected by leprosy The oldest case lived during the 4th-5th centuries AD and was found in the city of Santarei Interestingly, it is the only leprosy case found in a regular cemetery The medieval leprosy of the city was only established many years later The Beja leprosarium necropolis retrieved five leprosy cases And finally, I would like to present a few details regarding the Lagos leprosarium that was excavated in 2009 by the company Drias Archeologia and I was one of the anthropologists of the team A Lagos map from the 16th century shows the leprosarium exact location outside the defensive city walls and historical sources reveal that in the end of the 15th century the residents of Lagos began to pay a tax for the leprosarium construction and this hospital was in function until the 17th century when geopolitical events motivated the renewal of the city walls imposing the demolition of several buildings Some of these buildings, including evidence of their demolition in the 17th century, were found during the excavation as well as a previously unknown cemetery related to the leprosarium Two of the skeletons found have leprosy related changes and I would like to show you some of the most striking lesions present on the individual number five An adult woman Extensive renomaxillary changes typically occurring in advanced cases of leprosy were present as well as post-cranial lesions namely on ends phalanges, the helbos with the right to show an uncommon osteolithic lesion Interestingly amongst the 11 individuals two other infectious diseases were diagnosed namely troponomatosis and brucellosis suggesting that the Lagos leprosarium was not exclusive to leprosy patients Ancient DNA analysis are in progress and we hope to present new findings in the near future regarding this material So to conclude, currently we have solid evidence that leprosy existed in the Portuguese territory before the establishment of leprosarium in the 11th century and before the first written historical evidence of the disease in Portuguese medieval documents Additionally the two probable cases of TB are from the late medieval period but under the scope of an ongoing research project we are reanalyzing skeletons from seven other sites two of them dated from the early medieval period to expand our knowledge regarding the historical path of this dreadful disease So thank you very much for your attention