• 1.

    Anon , 1912. Discussion on heredity and disease at the Pathology Society of Manchester. BMJ 2: 13181321.

  • 2.

    McNeill WH, 1993. Plagues and Peoples. New York, NY: Monticello Editions.

  • 3.

    Crosby AW, 2016. The Columbian Exchange. Los Angeles, CA: University of California Press.

  • 4.

    Penman BS, Gupta S, Shanks GD, 2017. Rapid mortality transition of Pacific Islands in the 19th century. Epidemiol Infect 145: 111.

  • 5.

    Fenn EA, 2001. Pox Americana: The Great Smallpox Epidemic of 1775–82. New York, NY: Hill and Wang.

  • 6.

    Stark RB, 1977. Immunization saves Washington’s army. Surg Gynecol Obstet 144: 425431.

  • 7.

    Becker AM, 2004. Smallpox in Washington’s army: strategic implications of the disease during the American Revolutionary War. J Mil Hist 68: 381430.

    • Search Google Scholar
    • Export Citation
  • 8.

    Shanks GD, Hu Z, Waller M, Lee SE, Terfa D, Howard A, van Heyningen E, Brundage JF, 2014. Measles epidemics of variable lethality in the early 20th century. Am J Epidemiol 179: 413422.

    • Search Google Scholar
    • Export Citation
  • 9.

    Cliff AD, Haggett P, Smallman-Raynor M, 1993. Measles: An Historical Geography of a Major Human Viral Disease: From Global Expansion to Local Retreat, 1840–1990. Oxford, UK: Blackwell.

    • Search Google Scholar
    • Export Citation
  • 10.

    Shanks GD, Waller M, Briem H, Gottfredsson M, 2015. Age-specific measles mortality during the late 19th-early 20th centuries. Epidemiol Infect 143: 34343441.

    • Search Google Scholar
    • Export Citation
  • 11.

    Shanks GD, Wilson N, Kippen R, Brundage JF, 2018. The unusually diverse mortality patterns in the Pacific region during the 1918–21 influenza pandemic: reflections at the pandemic’s centenary. Lancet Infect Dis 18: e323e332.

    • Search Google Scholar
    • Export Citation
  • 12.

    Shanks GD, Hussell T, Brundage JF, 2012. Epidemiological isolation causing variable mortality in Island populations during the 1918–1920 influenza pandemic. Influenza Other Respir Viruses 6: 417423.

    • Search Google Scholar
    • Export Citation
  • 13.

    Wilson N, Barnard LT, Summers JA, Shanks GD, Baker MG, 2012. Differential mortality rates by ethnicity in 3 influenza pandemics over a century, New Zealand. Emerg Infect Dis 18: 7177.

    • Search Google Scholar
    • Export Citation
  • 14.

    Eyre JWH, Lowe EC, 1919. Report upon the autumn influenza epidemic (1918) as it affected the NZEF in the United Kingdom. Lancet 193: 553560.

    • Search Google Scholar
    • Export Citation
  • 15.

    Summers JA, Shanks GD, Baker MG, Wilson N, 2013. Severe impact of the 1918–19 pandemic influenza in a national military force. N Z Med J 126: 3647.

    • Search Google Scholar
    • Export Citation
  • 16.

    Benn CS, Roth A, Garly ML, Fisker AB, Schaltz‐Buchholzer F, Timmermann A, Berendsen M, Aaby P, 2020. BCG scarring and improved child survival: a combined analysis of studies of BCG scarring. J Intern Med 288: 614624.

    • Search Google Scholar
    • Export Citation
  • 17.

    Shanks GD, 2019. Epidemiological isolation as an infection mortality risk factor in U.S. soldiers from late nineteenth to early twentieth centuries. Am J Trop Med Hyg 101: 980983.

    • Search Google Scholar
    • Export Citation
  • 18.

    Arrazola J, Masiello MM, Joshi S, Dominguez AE, Poel A, Wilkie CM, Bressler JM, McLaughlin J, Kraszewski J, Komatsu KK, 2020. COVID-19 mortality among American Indian and Alaska native persons–14 states, January–June 2020. Morb Mortal Wkly Rep 69: 1853.

    • Search Google Scholar
    • Export Citation
  • 19.

    Ramírez JD, Sordillo EM, Gotuzzo E, Zavaleta C, Caplivski D, Navarro JC, Crainey JL, Bessa Luz SL, Noguera LAD, Schaub R, 2020. SARS-CoV-2 in the Amazon region: a harbinger of doom for Amerindians. PLoS Negl Trop Dis 14: e0008686.

    • Search Google Scholar
    • Export Citation
  • 20.

    Escobar LE, Molina-Cruz A, Barillas-Mury C, 2020. BCG vaccine protection from severe coronavirus disease 2019 (COVID-19). Proc Natl Acad Sci USA 117: 1772017726.

    • Search Google Scholar
    • Export Citation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Epidemiological Isolation May Explain Differences in Historical Respiratory Infectious Disease Mortality

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  • 1 Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Queensland, Australia;
  • | 2 University of Queensland, School of Public Health, Brisbane, Australia

ABSTRACT.

Indigenous and aboriginal peoples of the Americas and Pacific died at enormous rates soon after joining the global pathogen pool in the seventeenth to nineteenth centuries from respiratory infections such as smallpox, measles, and influenza. It was widely assumed that this represented a selection process against primitive societies. Darwinian selection for specific genetic resistance factors seems an unlikely hypothesis given that some populations stabilized quickly over two to three generations. European-origin populations whose childhood was marked by epidemiological isolation also suffered high infectious disease mortality from respiratory pathogens. American soldiers with smallpox, South African (Boer) children with measles, and New Zealand soldiers with influenza suggest that epidemiological isolation resulting in few previous respiratory infections during childhood may be a consistent mortality risk factor. Modern studies of innate immunity following Bacillus Calmette–Guérin (BCG) in infancy point toward rapid immune adaptation rather than evolutionary selection as an explanation for excessive first contact epidemic mortality from respiratory pathogens.

Author Notes

Address correspondence to G. Dennis Shanks, ADF Malaria and Infectious Diseases Institute, Enoggera, QLD 4051, Australia. E-mail: dennis.shanks@defence.gov.au

Disclaimer: The opinions expressed are those of the author and do not necessarily reflect those of the Australian Defence Force or the U.S. Department of Defence.

Authors’ addresses: G. Dennis Shanks, Australian Defence Force Malaria Infectious Disease Institute, Gallipoli Barracks, Enoggera, Queensland, Australia, and University of Queensland, School of Public Health, Brisbane, Herston, Queensland, Australia, E-mail: dennis.shanks@defence.gov.au.

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