Tuberculosis in Polynesia: a discussion of its occurrence before initial European contact

Abstract

Infectious diseases continue to be of great importance to human societies due to the social, economic, political, and psychological disruptions they cause. In the question of infectious disease in prehistoric populations, a bioarchaeological approach situated within a political-economic context provides a comprehensive and effective framework to assess globally significant diseases, such as tuberculosis. Important aspects of tuberculosis epidemiology can be learned from the reconstruction of past events, especially in areas where tuberculosis has been assumed to be a European introduction. The M. tuberculosis complex is capable of causing skeletal changes which are therefore indicators of this disease in archaeological human remains. In the Pacific region, there have been notably few opportunities to assess pre-European skeletal remains for tuberculosis due to the lack of archaeological remains available for study. The osteological evidence that does exist is ambiguous but suggestive of pre-European presence of tuberculosis. Archaeological data support population densities that may have been sufficient to support an infectious pathogen such as M. tuberculosis. The field of molecular genetics has been successfully applied in the recovery of tuberculosis aDNA and offers methods that can significantly reduce the margin of uncertainty about the presence of tuberculosis in the Pacific. After reviewing the available data, it is determined that the lack of conclusive evidence should not preclude the possibility of pre-European tuberculosis in this region.