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Aboriginal new world epidemiolgy and medical care, and the impact of Old World disease imports.

Various workers, including T. D. Stewart, claim that the aboriginal Americas were relatively disease-free because of the bering Strait cold-screen, eliminating many pathogens, and the paucity of zoonotic infections because of few domestic animals. Evidence of varying validity suggests that precontact Americns had their own strains of treponemic infections, bacillary and amoebic dysenteries, influenza and viral penumonia and other respiratory diseases, salmonellosis and perhaps other food poisoning, various arthritides, some endoparasites such as the ascarids, and several geographically circumscribed diseases such as the rickettsial verruca (Carrion's disease) and New World leishmaniasis and trypanosomiasis. Questionably aboriginal are tuberculosis and typhus. Accordingly, virtually all the "crowd-type" ecopathogenic diseases such as smallpox, yellow fever, typhoid, malaria, measles, pertussis, polio, etc., appear to have been absent from the New World, and were only brought in by White conquerors and their Black slaves. My hypothesis is that native American medical care systems--especially in the more culturally advanced areas--were sufficiently sophisticated to deal with native disease entities with reasonable competence. But native medical systems could not cope with the "crowd-type" disease imports that struck Indian and Eskimos as "virgin-field" populations. Reanalysis of native population losses through a genocidal combination of diease, war, slavery and attendant cultural disruption by Dobyns, Cook and others strongly suggest that traditiona estimates underplayed the death toll by a factor of the general order of ten. This would make for an immediately pre-contact Indian population of some 90-111 million instead of the tradition 8-11 million. Evidence is growing that Indians may have been no more susceptible to new pathogens that are other "virgin soil" populations, and thus their immune systems need not be considered less effective than those in other people. Present-day high mortality rates in Indians of both continents from infectious disease imports may be more socioeconomic than anything else.

Delivery of Health Care↗

Tetracyclines.

Tetracyclines are relatively safe drugs with a broad antimicrobial spectrum. Doxycycline remains the preferred tetracycline agent for most indications. Doxycycline has a long half-life, which makes convenient twice-a-day dosing possible. It is well absorbed orally even in the presence of food, has excellent tissue penetration, and does not require a dose adjustment in renal insufficiency. Doxycycline is a useful agent for the treatment of atypical pneumonias, sexually transmitted diseases, traveler's diarrhea, rickettsial infections, and Lyme disease. Minocycline is the preferred drug for MRSA colonization/infection.

Bacterial Infections↗

Localization of antigen in tissue cells; antigens of rickettsiae and mumps virus.

Rickettsiae of epidemic typhus fever and Rocky Mountain spotted fever have been microscopically localized and identified in smears of exudates and tissue sections from infected cotton rats by means of homologous antibody labelled with fluorescein. Epidemic typhus has also been identified in smears from single infected human body lice. Mumps virus antigen has been microscopically localized in the parotid of the experimentally infected monkey by the same method. The antigenic material, probably active virus, was found in the cytoplasm of the acinar cells. Such infected acini were scattered irregularly throughout the gland. Some antigen could be seen in the lumens of the parotid ducts and small amounts were present in the cytoplasm of the epithelial cells lining the ducts.

Antibodies↗