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July 28, 1993

Cause of Cuban Outbreak Neuropathologic Puzzle

JAMA. 1993;270(4):421-423. doi:10.1001/jama.1993.03510040021006

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VITAMINS being distributed to all 11 million Cubans may explain the waning of an outbreak of peripheral and optic neuropathy reported to affect nearly 47 000 people.

See also p 511.

Scientists are withholding final judgment on the etiology until more results are in. However, data so far seem to be ruling out a possible viral cause. After 5 weeks of laboratory investigation, virologists at the National Institutes of Health (NIH), Bethesda, Md, were not ready to give up, but still had not been able to grow any virus with samples brought back from Cuba. And cases were clearly not spread by contact, with no outbreaks in institutions like schools or army barracks.

Instead, evidence is suggesting that a lack of animal protein, and therefore B-group vitamins, in the diet has set the stage for serious damage from high but otherwise tolerable levels of cyanide in tobacco and foods like