The first European contact in 1492 started an influx of communicable diseases into the Caribbean. Diseases originating in the Old World (Afro-Eurasia) came to the New World (the Americas) for the first time, resulting in demographic and sociopolitical changes due to the Columbian Exchange from the late 15th century onwards. The Indigenous peoples of the Americas had little immunity to the predominantly European diseases, resulting in significant loss of life and contributing to their enslavement and exploitation perpetrated by the European colonists. Waves of enslaved Africans were brought to replace the dwindling Indigenous populations, solidifying the position of disease in triangular trade. Infectious diseases Before the first wave of European colonization, the Indigenous peoples of the Americas and the Caribbean are thought to have lived with infrequent epidemic diseases, brought about by limited contact between tribes. This left them socially and biologically unprepared when the Italian explorer Christopher Columbus and his crew introduced several infectious diseases, including typhus, smallpox, influenza, whooping cough, and measles following his 1492 voyage to the Americas. The European diseases spread from the carriers to the Indigenous populations, who had no immunity, leading to more serious cases and higher mortality. Because the Indigenous societies of the Americas were not used to the diseases as European nations were at the time, there was no system in place to care for the sick. Smallpox is among the most notable of diseases in the Columbian Exchange due to the high number of deaths and impact on life for Indigenous societies. Smallpox first broke out in the Americas on the island of Hispaniola in 1518. The disease was carried over from Europe, where it had been endemic for over seven hundred years. Like the other diseases introduced in the time period, the Europeans were familiar with the treatment of the disease and had some natural immunity, which reduced mortality and facilitated quicker recovery. The Taíno people, who inhabited Hispaniola, had no natural smallpox immunity and were unfamiliar with treating epidemic disease. In 1493, the first recorded influenza epidemic to strike the Americas occurred on the island of Hispaniola in the northern Spanish settlement of Isabela. The virus was introduced to the Isle of Santo Domingo by the Cristóbal Cólon, which docked at La Isabela on 10 December 1493, carrying about 2,000 Spanish passengers. Despite the general poor health of the colony, Columbus returned in 1494 and found that the Native