BABBOTT 

 industry, such as mining, are available to provide employment. 



There is no doubt that cold influences disease behavior in arctic 

 populations, but as I indicated, we have little evidence that under 

 natural conditions, cold of itself directly affects agent pathogenicity 

 or host resistance. Rather, it is important because of the way it 

 modifies the social environment or the way people live. For example, 

 houses must be heated ten or eleven months of the year. Fuel is 

 expensive in terms of either the money or the effort required to 

 procure it. To conserve heat, dwellings are small with consequent 

 overcrowding, and thus conditions are ideal for transmission of 

 respiratory illness. 



Studies in other areas have shown that the incidence of enteric 

 disease is influenced more by the availability of water in adequate 

 quantities than by its purity (HoUister, 19 55; Schliessman, 19 58). 

 Because of the cold, people in arctic regions depend for many months 

 each year on melted ice or snow for their water supply, and this a- 

 gain requires the expenditure of precious fuel. It is not surprising, 

 then, that the level of sanitation is low, and fecal- oral spread of 

 intestinal organisms is easily accomplished. Yet with respect to 

 bacterial enteric illness , low environmental temperatures also serve 

 a useful purpose in that bacterial pathogens are immobilized and 

 killed off in large numbers, and spread by flies is greatly minimized. 

 Cold appears to promote survival, if not multiplication, of viral 

 agents, as Dr. Reinhard will point out. 



Another indirect effect of cold on arctic disease has been the 

 limitations it has imposed upon travel until relatively recently. 

 Half a century ago, the inhospitable environment served to protect 

 people from imported pathogens. Now, there are few, if any, com- 

 munities which experience prolonged isolation. Fortunately, im- 

 proved communications brings not only more conventional patterns 

 of disease, but also preventative and therapeutic services as well. 

 Therefore, it is highly unlikely that we will see epidemics of the 

 magnitude or severity which characterized the Eskimos' early 

 contact with the outside world. As I have mentioned, death rates 

 among Alaskan natives currently approximate those of their fellow 

 citizens elsewhere. Our problem in the future is not to lower death 



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