Ecuador - More than 500 people injured and 48 deaths by alcohol tainted with methanol
Ecuador - More than 500 people injured and 48 deaths by alcohol tainted with methanol
<TABLE id=apex_layout_271110100662109808 class=formlayout role=presentation border=0 summary="" datatable="0"><TBODY><TR><TD noWrap align=right>
Archive Number</TD><TD noWrap align=left>20110830.2667</TD></TR><TR><TD noWrap align=right>
Published Date</TD><TD noWrap align=left>30-AUG-2011</TD></TR><TR><TD noWrap align=right>
Subject</TD><TD noWrap align=left>PRO/EDR> Alcohol contamination, fatal - Ecuador: methanol</TD></TR></TBODY></TABLE>
ALCOHOL CONTAMINATION, FATAL - ECUADOR: METHANOL
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International Society for Infectious Diseases
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Date: 29 Aug 2011
Source: Associated Press [edited]
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http://hosted.ap.org/dynamic/stories/L/LT_ECUADOR_CONTAMINATED_ALCOHOL?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT>
Ecuadorean authorities are trying to buy back half a million bottles
of contaminated alcohol, and end an outbreak of alcohol poisoning that
has killed 48 people and sickened hundreds.
The country's health minister says the liquor is tainted with
methanol, or wood alcohol, which is used for industrial purposes. The
buyback offer involves 14 brands of wine and other alcohol that stores
have been barred from selling since July [2011].
More than 500 people have been injured by the contaminated alcohol,
with some left permanently blinded.
The alcohol came from small provincial providers that didn't have the
required health permits.
Ecuador's government has set aside some USD 400 000 to buy back the
alcohol at 80 cents a bottle.
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[Methanol (wood alcohol) is produced from the destructive distillation
of wood. Epidemics of methanol toxicity have resulted from the
consumption of methanol-contaminated whiskey or other alcohol
products. The formation of 2 toxic metabolites, formaldehyde and
formic acid, causes methanol poisoning. The elimination rate depends
upon the folate pool. In primates it is generally small, and
consequently primates (including humans) are more sensitive to
methanol toxicity than other animals.
Methanol is widely available in formulations including antifreeze,
windshield washer fluid, Sterno canned heat, shellacs, various paints,
paint removers, varnishes, duplicating fluids, and gasoline
additives.
Fatalities have been reported after ingestion of 15 ml or 3 teaspoons
of a 40 per cent solution, although 30 ml is generally considered a
minimal lethal dose. With aggressive medical care it is possible to
survive the ingestion of 500-600 ml. However, consumption of as little
as 10 ml may cause blindness, depending on the amount and individual
tolerance.
Methanol is well-absorbed from the gastrointestinal tract, and peak
levels occur generally within 30-90 minutes. It is distributed into
tissues, so concentrations in the vitreous humor and optic nerve are
high. The highest concentrations are found in the kidney, liver, and
gastrointestinal tract, with smaller concentrations in the brain,
muscle, and adipose tissues.
Methanol is oxidized 10 times more slowly than ethanol. Consequently
there is a longer elimination half-life.
Onset of symptoms varies between 40 minutes and 72 hours
post-ingestion. Co-ingestion with alcohol will delay the appearance of
symptoms, but the absence of symptoms does not exclude serious
toxicity. The usual latent period is 12-24 hours.
Clinical signs may include headache, vertigo, lethargy and confusion,
which are common in mild to moderate ethanol intoxications. Coma and
convulsions appear in severe cases, probably as a result of cerebral
edema. Methanol produces little to no euphoria, unlike ethanol.
Blurred vision, decreased visual acuity, and photophobia (sensitivity
to light) are common complaints. Constricted visual fields, fixed and
dilated pupils, retinal edema and hyperemia of the optic disk are
common clinical findings. Prompt initial therapy is necessary to
reverse symptoms, though visual defects have persisted in up to 25 per
cent of severe cases.
Methanol is a mucosal irritant and may produce nausea, vomiting, and
abdominal pain, not unlike large doses of ethanol.
Early in the clinical course, gut decontamination with ipecac or
lavage may be indicated. However, if the methanol is mixed with
ethanol, these patients may not realize something is out of the
ordinary until it is too late for this type of treatment to be
helpful.
Intravenous administration of ethanol in a 10 per cent dextrose
solution may be helpful. As ethanol prolongs the elimination half-life
of methanol, the treatment may take several days and the patient
should be hospitalized. Dialysis may be necessary to prevent kidney
failure as well. Hemodialysis remains an effective treatment. -
Mod.TG
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