{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T06:35:41Z","timestamp":1756190141222},"reference-count":58,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,3]]},"abstract":"<jats:p>Infectious diseases depopulated many isolated Pacific islands when they were first exposed to global pathogen circulation from the 18th century. Although the mortality was great, the lack of medical observers makes determination of what happened during these historical epidemics largely speculative. Bacillary dysentery caused by <jats:italic>Shigella<\/jats:italic> is the most likely infection causing some of the most lethal island epidemics. The fragmentary historical record is reviewed to gain insight into the possible causes of the extreme lethality that was observed during first-contact epidemics in the Pacific. Immune aspects of the early dysentery epidemics and postmeasles infection resulting in subacute inflammatory enteric disease suggest that epidemiologic isolation was the major lethality risk factor on Pacific islands in the 19th century. Other possible risk factors include human leukocyte antigen homogeneity from a founder effect and pathogen-induced derangement of immune tolerance to gut flora. If this analysis is correct, then Pacific islands are currently at no greater risk of emerging disease epidemics than other developing countries despite their dark history.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0169","type":"journal-article","created":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T02:49:28Z","timestamp":1463453368000},"page":"273-277","source":"Crossref","is-referenced-by-count":12,"title":["Lethality of First Contact Dysentery Epidemics on Pacific Islands"],"prefix":"10.4269","volume":"95","author":[{"given":"G. Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"1Australian Army Malaria Institute, Enoggera, Queensland, Australia."},{"name":"2School of Population Health, University of Queensland, Brisbane, Australia."},{"name":"3Department of Zoology, University of Oxford, Oxford, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"year":"1842","series-title":"History of the Hawaiian or Sandwich Islands","author":"Jarves","key":"ref1"},{"key":"ref2","series-title":"Trans R Soc Trop Med Hyg","first-page":"420","article-title":"The depopulation of the New Hebrides and other parts of Melanesia","volume":"19","author":"Buxton","year":"1926"},{"year":"1967","series-title":"Island Populations of the Pacific","author":"McArthur","key":"ref3"},{"key":"ref4","series-title":"The Growth and Collapse of Pacific Island Societies: Archaeological and Demographic Perspectives","first-page":"278","article-title":"Population in a vegetable 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