"In the late 1700s, when Euro-Americans began to visit the Northwest Coast, they reported the presence of vigorous, diverse cultures - among them the Tlingit, Haida, Kwakwaka'wakw (Kwakiutl), Nuu-chah-nulth (Nootka), Coast Salish, and Chinookans - with a population conservatively estimated at over 180,000. A century later only about 35,000 were left. The change was brought about by the introduction of diseases that had originated in the Eastern Hemisphere, such as smallpox, malaria, measles, and influenza." "The Coming of the Spirit of Pestilence examines the introduction of infectious diseases among the Indians of the Northwest Coast culture area (present-day western Oregon, Washington, and British Columbia, and southeast Alaska) in the first century of contact and the effects of these new diseases on Native American population size, structure, interactions, and viability. The emphasis is on epidemic diseases and specific epidemic episodes."