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Small “epidemic” may have killed Mozart

Aug. 17, 2009
Courtesy American College of Physicians
and World Science staff

A minor ep­i­dem­ic of strep­to­coc­cal in­fec­tion may have killed Wolf­gang Amadeus Mo­zart, the tow­er­ing com­pos­er who died mys­te­ri­ously in 1791, re­search­ers say.

Specula­t­ion on causes of Mo­zart’s rath­er sud­den death at age 35 have ranged from poi­son­ing to rheu­mat­ic fe­ver. But there has been no con­sen­sus on what really hap­pened, al­though most ex­perts call the mur­der sce­nar­i­o un­like­ly.

Mozart as por­trayed in a con­tem­por­ary etch­ing by K. Dos­tal.
The Aus­tri­an com­pos­er suc­cumbed af­ter a short ill­ness, for which oth­er re­cent di­ag­noses have in­clud­ed kid­ney fail­ure, He­noch-Schon­lein pur­pu­ra, and le­thal trich­i­no­sis. 

Ac­cord­ing to wit­nesses, Mo­zart’s body be­came badly swol­len in his fi­nal days. He died on Dec. 5, 1791, iron­ic­ally in the midst of writ­ing of his famed Req­ui­em or fu­ner­al mass, which had been anon­y­mously com­mis­sioned. Up­on sens­ing his end was near, wit­ness ac­counts say, Mo­zart took to bit­terly re­mark­ing that the piece must have been meant for him­self.

The new study pro­pos­ing an out­break of strep­to­coc­cus bac­te­ria as the cause of Mo­zart’s de­mise ap­pears in the Aug. 17 is­sue of the re­search jour­nal An­nals of In­ter­nal Med­i­cine.

Richard Zeger of the Aca­de­mic Med­ical Cen­ter in Am­ster­dam and col­leagues ex­am­ined the of­fi­cial daily reg­is­ter of deaths in Mo­zart’s Vi­en­na for the pe­ri­od be­tween No­vem­ber and De­cem­ber 1791 and Jan­u­ary 1792. These records were an­a­lyzed with the cor­re­spond­ing pe­ri­ods in 1790/1 and 1792/3. 

The deaths of 3,442 adult men and 1,569 adult wom­en were recorded over these pe­ri­ods. Tu­ber­cu­losis and re­lat­ed con­di­tions were found to ac­count for the high­est num­ber of deaths. Ca­chex­ia and mal­nu­tri­tion ac­counted for the sec­ond high­est num­ber of deaths, and ede­ma, or body tis­sue swell­ing, was the third most com­mon cause of death, the in­ves­ti­ga­tors re­ported.

In the weeks sur­round­ing Mo­zart’s death, there was a marked in­crease in deaths from ede­ma among young­er men. This mi­nor ep­i­dem­ic may have orig­i­nat­ed in a nearby mil­i­tary hos­pi­tal, ac­cord­ing to the re­search­ers. 

Their anal­y­sis sug­gests Moz­art may have died from acute ne­phrit­ic syn­drome, a com­plica­t­ion that could stem from strep­to­coc­cal in­fec­tion. Ne­phrit­ic syn­drome is a dis­or­der of clus­ters of mi­cro­scop­ic blood ves­sels in the kid­neys, and is char­ac­ter­ized by body swell­ing, high blood pres­sure, and red blood cells in the urine.

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A small epidemic of streptococcal infection may have killed Wolfgang Amadeus Mozart, the towering composer whose died mysteriously in 1791, researchers say. Speculation on causes of Mozart’s rather sudden death at age 35 have ranged from poisoning to rheumatic fever. But there has been no consensus on what really happened, although most experts call the murder scenario unlikely. The Austrian composer succumbed after a short illness, for which other recent “diagnoses” have included kidney failure, Henoch-Schonlein purpura, and lethal trichinosis. According to witnesses to Mozart’s final days, his body had become severely swollen. Mozart died on Dec. 5, 1791, ironically in the midst of writing of his famed Requiem or funeral mass, which had been anonymously commissioned. Upon sensing his end was near, witness accounts say, Mozart took to bitterly remarking that the piece must have been meant for himself. The new study proposing an epidemic streptococcus bacteria as the cause of Mozart’s demise appears in the Aug. 17 issue of the research journal Annals of Internal Medicine. Scientists examined the official daily register of deaths in Mozart’s Vienna for the period between November and December 1791 and January 1792. These records were analyzed with the corresponding periods in 1790/1 and 1792/3. The deaths of 3,442 adult men and 1,569 adult women were recorded over these periods. Tuberculosis and related conditions accounted for the highest number of deaths. Cachexia and malnutrition accounted for the second highest number of deaths, and edema was the third most common cause of death, the investigators reported. In the weeks surrounding Mozart’s death, there was a marked increase in deaths from edema, or body tissue swelling, among younger men. This minor epidemic may have originated in the military hospital, according to the researchers. The researchers’ analysis suggests that Mozzart may have died from acute nephritic syndrome, a complication that could stem from streptococcal infection. Nephritic syndrome is a disorder of clusters of microscopic blood vessels in the kidneys, and is characterized by body swelling, high blood pressure, and red blood cells in the urine.