'Outbreak' of Optic and Peripheral Neuropathy in Cuba?

From October through December of 1991, six Cubans in the Pinar del Rio province noted decreased vision and sensory symptoms (eg, paresthesia, burning, and dysesthesia) predominantly in the feet. The disorder was first recorded by Cuban physicians in January 1992 and subsequently spread throughout Cuba. As of June 12, 1993, 43412 people were reported to be affected.1According to the Cuban Ministry of Health, the disorder first seemed to affect mostly young men who smoked tobacco and drank alcohol. Since then, however, those identified as affected have included women, nonsmokers, and nondrinkers of alcohol. The disorder mainly affects adults between the ages of 15 and 65 years. The cause of this "outbreak" is unclear. Researchers in Cuba and in the United States are investigating possible pathogenic factors, including nutritional deficiencies, toxins, and viruses. Methods Through the International Peace for Cuba Appeal (a nonprofit organization organized to abolish trade restrictions