On May 4, 1993, Cuba asked the international health community and the World Health Organization (WHO) to find the cause of a mysterious epidemic of blindness that was spreading uncontrollably. Contradictory hypotheses confronted theteam of scientists on this mission. Is the epidemic the result of a plot to topple Castro, as the Cubans believe? Or exposure to radioactivity or an unidentified nerve toxin accidentally released by the Russian Army withdrawing from Cuba? Cuban Blindness: Diary of a Mysterious Epidemic Neuropathy is a firsthand account of the epidemic of blindness and the hardships of life in Cuba at the time of the "special period" that followed the collapse of the Soviet Union and the tightening of the US embargo. Dr. Román-who was at the time Chief of Neuroepidemiology at the US National Institutes of Health-was a participant in this scientific mission and describes the neurological symptoms experienced by the victims of this epidemic disease, and narrates the epidemiologists' detective work struggling to solve the mystery. This book combines neuroscience and scientific discovery with political intrigue, finally bringing the reader to the unexpected solution provided by a WWII survivor of Changi POW Camp in Singapore. Cuban Blindness: Diary of a Mysterious Epidemic Neuropathy is a description of the neuroepidemiological study undertaken to identify the cause of the epidemic neurological disease that affected Cuba in 1993-1994.
- Summarizes clinical manifestations in prototypical case reports
- Analyzes possible neurological and neuroepidemiological causes from possible viruses to toxins
- Discusses the health ramifications of political decisions surrounding the Cuban Embargo
- Describes the implementation of treatment and preventive measures
1. Pinar Del Rio, Cuba, December 12, 1991
2. An Economy in Crisis Havana, November 22, 1991
3. Ariza Prison Cienfuegos, Cuba, August 5, 1992
4. The Strange Epidemic Geneva, May 4, 1993
5. Pan American Health Organization (Paho) Washington DC, May 10, 1993
6. Federal Building: Bethesda, Maryland, May 11, 1993
7. Neuroepidemiology, NIH: Bethesda, Maryland, May 14, 1993
8. Cuba: A Dream Island, May 14, 1993
9. A Farcical Journey Miami International Airport, May 15, 1993
10. In the Eye of the Storm Cuba, May 16, 1993
11. Epidemiologists: Medical Detectives Havana, May 17, 1993
12. Eye Hospital of Havana, Cuba: 7:00 AM, Monday, May 17, 1993
13. An Unknown Virus Pedro Kourí Tropical Medicine Institute Havana, Cuba: Tuesday, May 18, 1993
14. The Virologists' Arrival: Havana
Cuba 10:00 AM, Wednesday, May 19, 1993
15. Mariel Thursday, May 20, 1993
16. Hunger Everywhere Pinar Del Río, May 20, 1993
17. Cassava and Cyanide Thursday, May 20, 1993
18. The Myelitis of Santiago De Cuba Friday, May 21, 1993
19. Tobacco Blindness Isla De La Juventud: May 23, 1993
20. Of Poisons and Warfare Toxins Havana, May 26, 1993
21. Three-Thousand-Five-Hundred Patients Every Week Havana, May 27, 1993
22. The Answer: Changi P.O.W. Camp Singapore, February 15, 1942
23. Blockade Amblyopia Cuba, 1897-1898 & 1991-1993
24. The End of the Epidemic
Gustavo Román is a clinical neurologist practicing in Houston, Texas. During his academic career he has been interested in neuroepidemiology, tropical neurology, stroke, vascular, nutritional and infectious diseases of the nervous system. Most recently, he has studied autism and Alzheimer's disease. Since 2010, he works at the Neurological Institute of Houston Methodist Hospital where he is the Jack S. Blanton Presidential Distinguished Endowed Chair for the Study of Neurological Disease and Professor of Neurology at Weill Cornell Medical College, Cornell University, New York, N.Y.
Born in Bogotá, Colombia, he received his medical degree from the National University of Colombia and began his specialization in neurology at the famous Hôpital de La Salpêtrière in Paris. He obtained the Diplôme d'Assistant Étranger (Neurologie et Neuropathologie) from the University of Paris, Faculty of Medicine Pitié-Salpêtrière, with a dissertation on lacunar strokes. He completed his neurology training at the University of Vermont and returned to Colombia where he served as neurology faculty in his Alma Mater. During this period he wrote two textbooks that had ample influence in Latin America: Practical Neurology (1982) and Tropical Neurology (1983)-the latter with Gabriel Toro and Lydia Navarro-Román, as coauthors.
In collaboration with Dr. Bruce Schoenberg, then Director of Neuroepidemiology at the National Institutes of Health, NIH (Bethesda, Maryland) and Dr. Peter Spencer, neurotoxicologist at Albert Einstein College of Medicine (Bronx, New York), he conducted research on tropical spastic paraparesis (TSP) sponsored by the Colombian National Institute of Health. The Román husband-and-wife team described the natural history of a geographic cluster of TSP in Colombia and published comprehensive reviews on tropical myeloneuropathies.
After receiving his board certification, Román joined the neurology faculty at Texas Tech University (Lubbock, Texas, USA) where he eventually became Professor and Interim Chair of the Department of Medical and Surgical Neurology. He resumed work with Schoenberg and Spencer on another outbreak of TSP, this time in the Seychelles Islands of the Indian Ocean. The retroviral origin of this new disease was eventually confirmed. Román edited the first book dedicated to the topic of HTLV-1 and the Nervous System (1989), with Jean-Claude Vernant (Martinique, France) and Mitsuhiro Osame (Kagoshima, Japan).
In 1990, Román succeeded Dr. Schoenberg as Chief of Neuroepidemiology at the NIH and became one of the first Hispanics to reach the Branch Chief executive rank at this institution. He also served as Clinical Professor of Neurology at Georgetown University School of Medicine in Washington DC. At the NIH, Román continued research on HTLV-1-associated TSP in Japan, the Caribbean, South America, and the Seychelles; he organized a workshop that proposed the research criteria for vascular dementia (known as the Román criteria) used worldwide; he worked with the International League Against Epilepsy (ILAE) on Guidelines for Epidemiologic Studies on Epilepsy, particularly in tropical countries. With Oscar del Brutto (Ecuador) y Julio Sotelo (Mexico) wrote a book on neurocysticercosis and proposed measures for eradication of this infection, a leading cause of epilepsy in the tropics. He organized and conducted teaching courses on neuroepidemiology, a discipline that became a useful tool for Public Health research. His disciples and collaborators around the world formed a virtual neuroepidemiology network that continues to produce epidemiological data, particularly in the fields of dementia and Parkinson disease. One of his most challenging research activities at the NIH was the study of an epidemic of optic and peripheral neuropathy in Cuba (1991-1993).
In 2000, Román returned to Texas and joined the School of Medicine of the University of Texas at San Antonio where he was eventually promoted to Professor of Neurology, Internal Medicine (Geriatrics), and Psychiatry (Geriatric Psychiatry). He established the Alzheimer Disease Memory Clinic in San Antonio, a member of the Texas Alzheimer Research Consortium (TARP). He participated in the Sleep Disorders Clinic at the Veterans Hospital, and was part of the research team of a large study (SPS3) funded by the NIH on control of hypertension for prevention of lacunar strokes and cognitive loss. In 2010, he was invited to organize from the ground-up a new Alzheimer & Dementia Center at the Houston Methodist Neurological Institute.
Gustavo Román has received numerous awards and honors including the Commendation Medal of the U.S. Public Health Service (1992), the Doctorate Honoris Causa from the National University of Colombia (2014), and honorary membership in the neurological societies of France, Spain, Colombia, Cuba, Dominican Republic, Panama, and Venezuela. He has published more than 350 scientific papers.