An acute infectious epidemic almost eliminated the St Kilda community in 1727. An epic tale of survival in adversity followed. Contemporary records reveal atypical features, suggesting a speculative alternative.
Keywords Chickenpox, Mary Wortley Montagu, Rachel Chiesley, St Kilda, smallpox
Declaration of Interests No conflict of interests declared.
The inhabitants of St Kilda are well known for their susceptibility to infection. Low herd immunity, limited genetic biodiversity, malnutrition and poor social conditions have been incriminated as the major predisposing factors, but the clinical evidence for the effect of malnutrition and the clinical relevance of the more recent discovery of heavy metal and dioxin pollution on infectious diseases have not been scrutinised from a medical perspective.
Keywords Chloracne, dioxin, infectious diseases, malnutrition, St Kilda, vitamin C
Lord Howe Island and the St Kilda archipelago have many similarities, yet their communities had totally disparate outcomes. The characteristics of the two islands are compared and contrasted, and it is hypothesised that the differences in health and diseases largely explain the success of one society and the failure of the other.
Keywords Infectious diseases, Lord Howe Island, neonatal tetanus, remote islands, St Kilda
Declarat ion of Interests No conflict of interests declared.
