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There are stories of Roman and Asian contact with the America's. Perhaps disease was brought over earlier then we thought.

https://en.wikipedia.org/wiki/Pre-Columbian_trans-oceanic_co...

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Is there a reason to assume disease couldn't have come into existence in this native population itself?

If a disease native to the Americas emerged and became endemic, it would have infected Europeans when they arrived. There’s a good CGP Grey video on this called Americapox.

https://m.youtube.com/watch?v=JEYh5WACqEk

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