Did Malaria, Bone Disease Kill King Tut?

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DNA Analysis of Mummy Yields New Clues to Pharaoh's Death

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

Feb. 16, 2010 -- Malaria and bone disease may have contributed to the death of King Tut more than 3,300 years ago, a new DNA analysis and other scientific methods indicate.

Many theories have been raised about the death of Tutankhamun, or King Tut, one of Egypt's most famous pharaohs, since his mummy was discovered in 1922. The theories include suggestions that he was murdered or died from an infection after breaking a leg in a fall.

But scientists who used a number of modern methods, including DNA analysis and radiological scans of mummies of Tut and probable close relatives, now report a variety of possible causes of death of Tutankhamun and others, including his grandparents, father, and siblings.

The study, led by Zahi Hawass, PhD, head of Egypt's Supreme Council of Antiquities, includes these points:

• King Tut suffered from avascular bone necrosis, a condition in which poor blood supply to the bone leads to weakening or destruction of an area of bone. This may have been from a rare condition called Kohler's disease that affects the foot.
• He was also found to have a club foot.
• Along with three mummies identified as Tutankhamun's close relatives, Tutankhamun had suffered at some time from malaria, possibly before death, but also perhaps at the time of his demise.
• The researchers write that the bone condition alone would not cause death but in addition to a malaria infection would be a likely cause. "These results suggest avascular bone necrosis in conjunction with the malarial infection as the most likely cause of death of Tutankhamun."

The researchers write that the discovery of several canes and sticks in Tut's tomb, some appearing to have been worn down by use, supports the idea that he had walking problems.

Tutankhamun died in the ninth year of his reign, about 1324 BC, at the age of 19, the researchers say. His mummy was discovered in 1922, and artifacts in the tomb have provided many clues about his life and his family's.

Searching for the Cause of King Tut's Death

Hawass and colleagues studied 11 royal mummies to search for pathological features attributable to inherited disorders, infectious diseases, and blood relationships. They also looked for evidence about what caused King Tut's death. Their research appears in the Feb. 15 issue of The Journal of the American Medical Association.

Some researchers have speculated that he died from complications from an injury, blood poisoning, or an embolism caused by a leg fracture or blow to the head. Others have said the young king may have been murdered because previous research has suggested death from a blow to the back of the head or possibly a fall from a chariot.

Between September 2007 and October 2009, royal mummies underwent detailed genetic, radiological, and anthropological studies. DNA also was extracted from the mummies.

Tutankhamun and 10 other mummies that researchers say were those of people possibly or definitely related to him were studied. In addition to King Tut and the 10 suspected relatives, five other royals who lived in an earlier period known as the early New Kingdom were examined.

Genetic study allowed the scientists to develop a five-generation pedigree of King Tut's immediate lineage, the researchers write. A number of the anonymous mummies, including one believed to be that of Tut's mother, were identified. They also identified mummies believed to be that of Tut's father, Akhenaten, and his grandmother, Tiye.

The researchers say no evidence was found of genetic conditions such as Marfan's syndrome affecting connective tissue or Kleinfelter's syndrome (having an extra X chromosome) that may have explained the androgynous appearance seen in ancient art depictions of Tutankhamun and his family.

A sudden leg fracture from a fall might have led to a life-threatening condition when a malaria infection occurred, the researchers suggest.

In an accompanying editorial, Howard Markel, MD, PhD, of the University of Michigan, writes that studying the remains of the dead raises ethical questions.

"What will the rules be for exhuming bodies to solve vexing pathological puzzles?" he asks. "Are major historical figures entitled to the same privacy rules that private citizens enjoy even after death? Most pragmatically, what is actually gained from such studies? Will they change current thinking about and prevent threatening diseases such as influenza? Will they change the understanding of the past?"

He writes that all historians are "guilty of enjoying reading the mail and personal materials of others," but that "before disturbing the dead" with 21st century technologies, questions ought to be raised "to avoid opening a historical Pandora's box."

SOURCES: Hawass, Z. The Journal of the American Medical Association, Feb. 17, 2010; vol 303.

News release, Journal of the American Medical Association.

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