Jonathan Reisman, Pneumococcal colonization in Alaska Native people

I visited two Yup'ik eskimo villages in the Bristol Bay watershed of Alaska - Manokotak and Koliganek. While there, I participated in interviewing household members to collect data on in-home running water, household crowding, and recent infections and antibiotic use. Our team performed nasopharyngeal swabs on roughly 450 residents of the two villages. I also was able to participate in a traditional steam bath, and to try local foods such as moose meat, caribou meat, and agutak ("Eskimo ice cream") made with seal oil. I also learned about mushing and dogsleds and ice fishing, and witnessed the beginning of the massive spring migration of water birds back to the soggy tundra of Alaska. Back in Anchorage, I worked with a statistician to analyze data from similar interviews and nasopharyngeal swabs from the previous 4 years. We found that this population lives in severely crowded conditions and only 52% of all households in the eight villages of our study had running water. We found that the risk of colonization of the nasopharynx with pneumococcus was significantly increased in children living in households with no in-home running water and with household crowding. Given that Alaska Native people have some of the highest rates of invasive pneumococcal disease, getting running water to every household and encouraging birth spacing may be important interventions to reduce this health disparity.