Native American disease history: Past, present and future directions

Infectious disease introduction in the Americas has been approached in historical, not biological, terms. We believe that this historical focus has limited scholarly understanding of Native American disease experience, past and present. Our goal is to link disease contact and contemporary Native American biology. We review the historical debates, and argue that advances in evolutionary theory and molecular genetics should be incorporated into models and descriptions of Native American disease history. Our discussion highlights the model of infectious disease evolution and host-pathogen interactions in terms of the classic division between host, parasite and environment. We reference specific infectious diseases throughout and examine the question of New World tuberculosis in detail. We are hopeful that our discussion will result in new directions for investigation of disease history in the Americas.