Fusarium musae infected banana fruits as potential source of human fusariosis: May occur more frequently than we might think and hypotheses about infection

Abstract

The banana fruit infecting fungus Fusarium musae was originally known as a distinct population within Fusarium verticillioides. However, recently, Fusarium musae was installed as a separate species and the first cases of human infection associated with Fusarium musae were found. In this article, we report an additional survey indicating that human pathogenic Fusarium musae infections may occur more frequently than we might think. Moreover, we evaluate the hypotheses on how infection can be acquired. A first hypothesis is that banana fruits act as carriers of Fusarium musae spores and thereby be the source of human infection with Fusarium musae. Acquisition is likely to be caused through contact with Fusarium musae contaminated banana fruits, either being imported or after traveling of the patient to a banana-producing country. An alternative hypothesis is that Fusarium musae is not only present on banana fruits, but also on other plant hosts or environmental sources.

Keywords: Fusarium musae; biogeography; clinical cases; human infection; imported banana fruits.

Figure 1.

Map indicating the banana-producing regions as well as the countries (i.e. Belgium, France and the United States of America) with reported cases of human pathogenic Fusarium musae infections.

Figure 2.

Aligned ΔFGC sequences (949 nucleotides long) of Fusarium musae strains obtained by Van Hove et al. and Triest et al. The sites showing differences between the strains are represented. The countries from which these strains originate are indicated in parentheses. A distinction can be made between the ΔFGC sequence of strains originating from banana fruits of ‘Neotropical’ countries and those of Asian origin. The clinical Fusarium musae strains found in the BCCM/IHEM fungal culture collection (Brussels, Belgium) are also indicated. ^T, type strain; NRRL, Northern Regional Research Laboratory (Peoria, Illinois, United States of America); MUCL, Mycothèque de l'Université Catholique de Louvain (Louvain-la-Neuve, Belgium); ITEM, Agri-Food Toxigenic Fungi Culture Collection (Bari, Italy).