The Worldwide Fusarium Keratitis Epidemic of 2004-2006: What Would the Reverend Henry Whitehead and Doctor John Snow Have Done?

Public health “experts” attributed several cholera outbreaks in London in the mid-1800’s to “miasma,” polluted gases arising from the products of filth and decay. Dr. John Snow, a physician, and The Reverend Henry Whitehead, a minister, later proved epidemiologically that cholera was transmitted by contaminated water.

Between 2004-2006, a worldwide epidemic of Fusarium fungal eye infections, involving approximately 2000 victims, occurred which was attributed by the manufacturer to a “perfect storm” of events related to the contents of a specific contact lens solution and to the microbiological characteristics of the Fusarium organism. During its investigation, the manufacturer was cited by the U.S. Food and Drug Administration for inadequacies in temperature control in the production, storage, and transport of their products at/from their Greenville, SC facility. A previously published study (J Glaucoma. 2001;10(5):401-405) reported temperatures of up to 75oC/167oF in enclosed spaces in the southern U.S. during the summer months. We previously reported that heating (to 56oC/133oF) this contact lens solution, containing the antimicrobial agent, alexidine 0.00045%, in its high density polyethylene (HDPE) plastic (but not glass) container caused it to lose its anti-Fusarium properties (Arch Ophthalmol. 2011;129(2):133-136). This suggests that, during the worldwide Fusarium keratitis epidemic of 2004-2006, an irreversible chemical interaction occurred between the heated HDPE plastic bottle and the antimicrobial agent, alexidine, inactivating it. This study may be the first proven instance of human ocular disease shown to be associated with plastic containers and suggests that some plastics may have negative effects on human health in ways not previously considered.

Multiple parallels will be drawn between the London cholera outbreaks of the mid-1800’s and the worldwide Fusarium keratitis epidemic of 2004-2006 showing that scientists, intellectual curiosity, human nature, politics, business interests, greed, incompetence, and ignorance have changed little in over 150 years.