II. Kuru in New Guinea: Discovery and Epidemiology

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  • Public Health Department, Port Moresby, New Guinea
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Kuru, a fatal, progressive, neurologic disease occurring in the Stone Age cannibalistic New Guineans of the Fore ethnic group, was first brought to the attention of the medical world in 1957. Our early studies on the cause, clinical course, pathogenesis, epidemiology, and therapy of the disease are reviewed. The disease was restricted to the Fore and those of their neighbors with whom they intermarried (a total population of about 30,000). Usually fatal 6 to 9 months from onset, kuru alone accounted for over half the deaths beyond infancy in the most severely affected villages, and reprisal murders of sorcerers suspected of causing the disease was the second most frequent cause of death in much of the region. The youngest patients were about 5 years of age, and among the children and adolescents both sexes were about equally affected. However, among adults, who accounted for over ⅔ of the patients, women were vastly more frequently affected than men. A genetic, endocrine, toxic, or specific deficiency cause seemed most likely, but we never abandoned the possibility that kuru was of infectious etiology, and the past decade of further field and laboratory work has borne this out. A subacute infectious neurologic disorder has thus been shown to be the dominant disease for a whole isolated population, rather than the parasitic infections and acute bacterial and virus diseases more commonly the concern of tropical medicine.