Some have argued that such staffs were common symbols of power and that the damage to Tutankhamun's foot may have occurred during the mummification process. But our analysis showed that new bone growth had occurred in response to the necrosis, proving the condition was present during his lifetime. And of all the pharaohs, only Tutankhamun is shown seated while performing activities such as shooting an arrow from a bow or using a throw stick. This was not a king who held a staff just as a symbol of power. This was a young man who needed a cane to walk.
Tutankhamun's bone disease was crippling, but on its own would not have been fatal. To look further into possible causes of his death, we tested his mummy for genetic traces of various infectious diseases. I was skeptical that the geneticists would be able to find such evidence—and I was delighted to be proved wrong. Based on the presence of DNA from several strains of a parasite called Plasmodium falciparum, it was evident that Tutankhamun was infected with malaria—indeed, he had contracted the most severe form of the disease multiple times.
Did malaria kill the king? Perhaps. The disease can trigger a fatal immune response in the body, cause circulatory shock, and lead to hemorrhaging, convulsions, coma, and death. As other scientists have pointed out, however, malaria was probably common in the region at the time, and Tutankhamun may have acquired partial immunity to the disease. On the other hand, it may well have weakened his immune system, leaving him more vulnerable to complications that might have followed the unhealed fracture of his leg we evaluated in 2005.
In my view, however, Tutankhamun's health was compromised from the moment he was conceived. His mother and father were full brother and sister. Pharaonic Egypt was not the only society in history to institutionalize royal incest, which can have political advantages. (See "The Risks and Rewards of Royal Incest.") But there can be a dangerous consequence. Married siblings are more likely to pass on twin copies of harmful genes, leaving their children vulnerable to a variety of genetic defects. Tutankhamun's malformed foot may have been one such flaw. We suspect he also had a partially cleft palate, another congenital defect. Perhaps he struggled against others until a severe bout of malaria or a leg broken in an accident added one strain too many to a body that could no longer carry the load.