A Retrospective Statistical Analysis of the Fusarium Keratitis Epidemic of 2004–2006

Abstract

Purpose: A retrospective statistical analysis of the Fusarium keratitis epidemic of 2004–2006 was performed.

Methods: Poisson and binomial probability distributions were performed in conjunction with statistical data reported from Singapore’s Fusarium keratitis outbreak in order to identify the earliest theoretical point in time that this outbreak and its cause could have been recognized.

Results: The outbreak in Singapore could, theoretically, have been recognized after only three months (three cases), P = 0.0067. The cause of the Singapore outbreak could, theoretically, have been determined after only four months (five cases), P = 0.0024.

Conclusions: The worldwide Fusarium keratitis epidemic of 2004–2006 could, theoretically, have been recognized much earlier by the application of basic statistical methods to the outbreak in Singapore. The lessons learned from this analysis may help prevent future epidemics.

KEYWORDS::

• Binomial distribution
• Epidemic
• Epidemiology
• Fusarium Keratitis
• Poisson distribution
• ReNu with MoistureLoc
• Retrospective
• Singapore; Theoretical

ACKNOWLEDGMENTS

The investigations were performed in accordance with the Declaration of Helsinki; Institutional Review Board approval was not required.

Presented, in part, as: [1] “Lessons Learned from a Theoretical Retrospective Epidemiological Analysis of the Fusarium Keratitis Outbreak of 2005–2006 in the Republic of Singapore,” at the American Academy of Ophthalmology’s Annual Meeting, Atlanta, GA, November 8–9, 2008, and [2] “Root Cause Analysis of the Fusarium Keratitis Epidemic of 2004–2006 and Prescriptions for Preventing Future Epidemics” at the American Ophthalmological Society’s 145^th Annual Meeting, May 16, 2009, Half Moon Bay, California.

Financial Disclosures: Within the past two years (but not in the past year), Dr. Bullock has served as a consultant to two different law firms concerning this matter. The compensation was paid directly to the Wright State University Foundation and not to Dr. Bullock, who works pro bono for the Wright State University Boonshoft School of Medicine. Dr. Khamis has no financial disclosures in this matter.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.