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While most people would prefer to think of tropical parasites and pathogens as inhabitants of some distant world, Desowitz, a specialist in tropical medicine and medical microbiology (The Malaria Capers, 1991), brings them perilously close to home. Malaria he calls "as American as the heart attack or apple pie," and yellow fever once killed one-tenth of Philadelphia's population. It was yellow fever, the author explains, that brought Louisiana into the US, for its high death rate convinced Napoleon that his American holdings were a "worthless, pestilential sinkhole." Of the diseases whose history Desowitz recounts, perhaps the least known is chronic hookworm anemia, a profoundly debilitating illness once epidemic in the American South. In a chapter subtitled "Kid Rockefeller and the Battling Hookworm," Desowitz describes how Rockefeller philanthropy not only transformed the South but led to global anti-hookworm programs. While Desowitz ranges over thousands of years in this chronicle, his concern is the present and the future. In a tale of medical detection reminiscent of Berton Rouché, he relates how a group of Orthodox Jews in Brooklyn—who, of course, shun any form of pig's meat—recently became infected with a pig tapeworm from Mexico. His message is clear: The threat of infectious diseases is ever present. Coming ecological-epidemiological shifts may bring some bad times—global warming creates a wonderful world for insects and the diseases they carry—and our present antibiotic agents have already begun to fail us, Desowitz concludes somberly. He urges increased support for all science, for just as threats come from unexpected sources, so do answers. (For the record, Desowitz believes that Pinta, a form of syphilis, was carried back to Europe by Columbus's crew.)
A real-life thriller.
|Introduction. Tropical Diseases - As Anglo-American as the Heart Attack||11|
|Ch. 1||Coming to the Americas: 50,000 B.C. to 1492 A.D. - The Humans||17|
|Ch. 2||Coming to the Americas: 50,000 B.C. to 1492 A.D. - The Worms and Germs||26|
|Ch. 3||Who gave Pinta to the Santa Maria? 1492 to 1635 A.D.||51|
|Ch. 4||Ten Little Indians and Then There Was One: 1492 to 1635 A.D.||63|
|Ch. 5||Coming to America 1638 to 1865: From Africa on the Slave Ship Named Desire||83|
|Ch. 6||The Germ's Warfare Discovered: 1650 to 1865||110|
|Ch. 7||Yellow Jack and the Cuban Crisis: 1885 to 1900||120|
|Ch. 8||Great Works 1900 to 1925: Kid Rockefeller and the Battling Hookworm||148|
|Ch. 9||Great Works 1915 to 1945: The Fever Is Broken||173|
|Ch. 10||Great Expectations 1900 to 1945: Malaria - Death at Our Doorstep||192|
|Ch. 11||Merrie Malarious Olde England: Before 1930||210|
|Ch. 12||Paradise Lost 1945 to 1996||220|
|Ch. 13||The Twenty-first Century||235|
Coming to the Americas: 50,000
B.C. to 1492 A.D.--The Humans
My grandparents sailed to America from Austria and Galicia in the 1880s, swept up in the wave of nineteenth-century immigration. Neglectful of family history, I can't trace my origins back more than a century. Still, even that small fragment of history pleases me. We take comfort in knowing where we come from and the historical causes that ultimately brought us here. I mention this bit of autobiography because on occasion I visit my two young grandsons in Florida and grandfathers of all societies have a ritualistic obligation to (1) bring toys and (2) pass down the mysteries and genealogy of the tribe. The problem is, my grandsons have the privilege of being part American Indian, and there is still some uncertainty as to their deepest roots. There are some clues, some speculations. And that's how it should be; grandfather stories should never precisely cleave to facts.
It might also be that my grandchildren will eventually want to know what baggage of pathogens their ancestors brought with them from the Old World and what microbial dangers they faced in the New.
A speculative look at Amerindians and their diseases prior to 1492 presents scenes of shifting complexity. Let us first consider the weather.
Actually, there are two "weathers," inside weather and outside weather. Its always summer in our insides, 37 [degrees] C (96.8 [degrees] F)--the humid tropical heat of the metabolically regulated healthy human body. Worms and germs flourish in that milieu. The problem for the worms and germs is that of going from host to host to perpetuate their species since they do not enjoy, as we mammals do, the uninterrupted heat of sex and gestation. The microbe's and the parasite's journey of perpetuation could expose them to the harsher climate and conditions of the outside world. Of course, the sexually transmitted pathogens have solved their perpetuation problem in a most rational way, and other microbes have developed other strategies such as forming resistant spore stages. But for many of the pathogens it can be bitterly cold and hostile on the outside. Thus, the weather in America at the times of successive human migrations would certainly have dominated disease epidemiology.
A (hypothetical) wormy, malarious Asian immigrant comes to America, circa 20,000 B.C. (or earlier, depending on which evidence you accept). He arrives in Alaska and he defecates. Frozen feces. Put an egg in the refrigerator and the embryo won't develop. That's true whether the egg is chicken or parasitic worm; all eggs need warmth to develop. The migration maven paleoparasitologists have used this basic biological fact in sleuthing the human colonization of the Americas. Their train of logic begins with the fact that humans in Africa, Asia, and Europe have been massively parasitized by intestinal worms for many thousands of years. The common great triad of gut worms are the roundworm (Ascaris lumbricoides), the whipworm (Trichuris trichiura), and the hookworms (Ancylostoma duodenale, Necator americanus). All three worms are strictly parasites of humans; animals can't become infected--no humans, no worms. So where did these Old World parasites come from when they parasitized the Amerinds?
All have a life cycle in which the eggs embryonate to the infective stage (or hatch in the case of hookworm) while in the soil. They require a minimum balmy temperature of 20 [degrees] C (68 [degrees] F) to 25 [degrees] C (77 [degrees] F) for them to do so. Only after they have embryonated, that is, incubated to contain larval worms, are the eggs infective, transmittable to a new human who will ingest these ova in contaminated soil or food. The hookworm is a little different; its larva develops rapidly within the egg and under optimum conditions hatches from the egg and then dwells in the soil. Along comes our barefoot pilgrim and the hookworm larva penetrates the skin and, after a complex migration through the body, comes to its home in the small intestine where it sucks blood assiduously from the vessels of the intestinal mucosa. If our hypothetical scenario holds true, all the original Amerind migrants would have been "cold sterilized" of their intestinal parasites by the time they moved south to the more parasite equable climes. Thus any pre-Columbian worms in Amerinds would signify that there were contacts and introductions before Columbus and his wormy crew reached our shores.
Another example is the mother of fevers, malaria. This disease, exquisitely dependent on temperature for its perpetuation by transmission through the mosquito, eventually became a major scourge of North and South Americans. Human malaria is a constellation of four protozoan parasites of the genus Plasmodium, all of which have an obligatory cycle of development in Anopheline mosquitoes and only anophelines, not the little brown nuisances (Culicines) that bite you at night or the spotted ones that bite you in the shade of late afternoon (Aedines). Those transmit some nasty viral diseases that devastated the Americas, but they don't transmit the malaria parasites. The malaria parasites require a certain minimum temperature, 20 [degrees] C (68 [degrees] F) to 24 [degrees] C (75 [degrees] F) depending on the species of the malaria, to undergo their complex cycle of transformation to the infective form in the anopheline. Many mosquito species can live in temperatures below the malaria parasite's life limits. Indeed some anophelines, as well as other mosquitoes, can winter over to await spring's warmth. However, an anopheline without malaria is just another damned nuisance.
Today's climate doesn't gauge yesteryear's weather. Throughout the hundreds of millions of years that the Earth has been a planet of the living, climate has been a sometime thing. The table on the following pages illustrates how climate has bounced around these last 400 million years and how it is expected to change again during the next century. Numerous causes are responsible for these climatic changes. For one thing, our Earth is not cemented in its heaven; it wobbles. Sometimes it is closer to the sun and sometimes it is farther away. Thus solar energy increases and decreases, possibly in a cyclical fashion every 100,000 years or so. Then there are natural and cataclysmic climate-altering events, like the impact of an asteroid. Nor is the greenhouse effect novel to our time. In the very ancient past, long periods of volcanism spewed massive amounts of carbon dioxide into the atmosphere. The industrial age has led to the well-publicized discharge of carbon dioxide, fluorocarbons, and other greenhouse, or ozone-depleting, gases. Meat and milk for the millions has led to the great expansion of the cattle industry. The collective flatulence of cows brings great amounts of methane into the air--more greenhouse. And so when we speak of migrations and pathogens, the climate of the times is always an influencing presence.
When and where: If we throw caution to the winds of hypotheses, the first Americans arrived 50,000 years ago, give or take 5,000 years. The more accepted scenario is that sometime around 20,000 B.C. they crossed from Siberia to Alaska, island hopping or land bridging by way of the Bering Straits. They were northern mongoloids with type O blood and the identifiable bits of genetic markers that characterize the Amerind or northern mongoloid. Theirs was a cold crossing during the last glacial age when the ice extended from the Polar caps. The Amerinds rapidly fanned out to the east and south; by 16,000 B.C. they had reached our East Coast and northern South America. A few thousand years later the Indians were everywhere, from Alaska to Tierra del Fuego. The latecomers were the Eskimos, the Inuits who arrived in Alaska from the Kamchatka peninsula about 10,000 years ago. Theirs was a lateral spread across the frozen North and forest tundra to Greenland. Still later, about 4,000 to 5,000 years ago a third immigration wave flowed from the Siberian forests. The immigrants came to the American Northwest Coast and stayed there to become the Tlingit, Athapaskan, Haida, and Eyak tribes. From the evidence of linguistic and genetic homologies it appears that one group wandered from the Northwest Coast to the Southwest. These were the Navajo. That is the textbook account of how humans first came to the Americas, although from textbook to textbook there is controversy over the details.
So what were people doing in northeastern Brazil 50,000 years ago?
In a remote region of northeastern Brazil, a landscape of high sandstone cliffs and scrub bush, caves, and rock shelters are adorned with spectacular Lascaux-like paintings. It had been assumed, for many years, that this was the art of an Amerind tribe who lived there 7,000 to 8,000 years ago. In 1986 a French anthropologist, Dr. Niede Guidon, upset that applecart, and virtually every other specialist in New World prehistory, by declaring that the oldest paintings dated to 32,000 B.C. She had the laboratory evidence, carbon 14 dating of charcoal from domestic fires, to back up her claim!
In 1993 a doctoral candidate who had been "dissertation digging" at Pedra Furada since 1984 sat in Paris before his committee to defend his thesis that human habitation went back not to 32,000 B.C. but to 50,000 years B.C. or more. That committee had reviewed the monster four-volume, 15-pound thesis and sat for four hours to hear the student paleoanthropologist, Fabrio Parenti, make his defense. Parenti argued that he had found assemblages of quartz pebbles at the 50,000 years B.C. sediment stratum in front of the rock shelter that were not randomly dispersed in natural fashion but were arranged in the collected fashion of humans.
Parenti's jury accepted his thesis, but for others the jury is still out. The sceptics have a problem in accepting the pebble proof of human habitation in 50,000 years B.C. Brazil. Then too, there is the problem of discontinuity. There are no discovered signs of human habitation that early anywhere in North America. Thus, those early putative Brazilians conflict with the historical orthodoxy that the human occupation of the Americas was by a southward expansion from the Bering Strait "beachhead."
One obvious catch to all this is the implication that if there were 50,000-year-old Brazilian Amerinds who came from Bering Strait transmigrations, then there would have to be 50,000+-year-old Siberians and no one knows whether humans had colonized Siberia that early or earlier.
The first human occupation of Siberia has been thought to have been between 20,000 and 30,000 years ago--a time which didn't jibe with the Pedra Furada advocates. That notion persisted unchallenged until a Russian husband and wife team of archaeologists, Yuri A. Mochanov and Svetlana Fedoseena, found a collection of chipped rocks at a site along Siberia's Lena River. To the untutored eye they didn't look like much of anything more than broken rocks. But the Mochanovs maintained that they were of human manufacture, simple tools made by smashing one rock against another. And what's more, the Mochanovs dated them at 3,000,000 years B.C.! New dating analyses by a technique called thermoluminescence date the artifacts at 500,000 years B.C. That is still very, very old--a time when our immediate ancestor, Homo erectus, is believed to have dispersed from Africa. And if true, as Dennis Stanford of the Smithsonian Institute has noted, "... if people were dealing with the cold that far north in Siberia 500,000 years ago, then a little bitty ice age like the Wisconsin (the name given to the ice age of that period) isn't going to stop you from getting to America." Thus if we can accept the specious factor, the Mochanov assertion, then the Pedra Furadan as a Siberian descendent becomes a logical possibility.