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ProMED-EAFR:East Africa
Most Recent Alert
View printable version
Published Date
2009-08-25 11:14:00
Subject
PRO/EAFR> Methanol poisoning, fatal - Uganda: (Kampala), susp., RFI
Archive Number
20090825.201425
Full Text
METHANOL POISONING, FATAL - UGANDA: (KAMPALA), SUSPECTED, REQUEST FOR
INFORMATION
***********************************************
Date: Sun 23 Aug 2009
Source: Monitor Online [edited]
http://www.monitor.co.ug/artman/publish/sun_news/Strange_disease_kill_residents_90124.shtml
Residents of Kasana Sanja zone in Kulambiro, a Kampala suburb, are
panic-stricken following the deaths of several people in the area
within a month. The latest victims of a strange disease, who died on
Friday [21 Aug 2009], include 3 residents of Kasana Sanja zone.
Nakawa RDC, Mr Fred Bamwine, who has since visited the area, has
appealed to the police and Kampala City Council authorities to
investigate the cause of the deaths.
According to an uncle who was staying with one of the recently
deceased residents, the disease 1st killed their mother in July 2009.
"She woke up in the morning, and all seemed okay, but we were
surprised to be informed 2 hours later that she had died. And on
Friday [21 Aug 2009] at 2 a.m., my nephew called us from his bed
saying he could not see anything, though he could hear our voices. He
also felt a heavy chest. Moments later, he died. Victims of the
disease do not show any signs of illness. They simply go blind and
feel a sudden heaviness in the chest, which stops them from
breathing, and within a matter of hours, they die."
Kira Road Police Station DPC confirmed the deaths. "We have recorded
7 deaths in the last one month in Kasana LC1 Kulambiro village Sanja.
We are still waiting for the medical report."
[Byline: Stephen Otage]
--
Communicated by:
ProMED-EAFR
[This strange disease has claimed 9 people in 4 weeks, all residents
of a Kampala suburb. The common symptoms prior to death include
blindness and respiratory symptoms. These would suggest methanol
poisoning, in which visual effects and metabolic acidosis are the
hallmark. The same symptoms may, however, manifest in other types of
poisoning, including iron, salicylates, or diseases like diabetic
ketoacidosis and uremia.
The possibility of methanol poisoning will strengthened if history of
ingestion can be elicited, which, therefore, needs to be established
by the investigations that are currently going on.
Three months ago, there were related reports of 5 deaths in the
Western Uganda town of Kasese following consumption of liquor packed
locally in the town http://www.newvision.co.ug/PA/8/13/680686. The
investigation into those cases weren't conclusive, but it's possible
all these reports point to unregulated brewing of alcohol products in
the country, especially in the rural areas.
In 2007, 40 people with a presentation similar to the current deaths
died in Kampala and nearby districts after drinking a toxic local
gin. The investigation into those cases by the Ministry of Health
revealed that the cases had been exposed to a local gin that
contained too much methanol http://www.newvision.co.ug/PA/8/13/680686.
Methanol toxicity remains a common problem in many parts of the
developing world, where methanol is often a component of bootleg
alcohol, which is made in rural regions. Because of its low cost, it
is often consumed by those in lower socioeconomic classes. Methanol
has a relatively low toxicity, hence the adverse effects are thought
to result from the accumulation of formic acid, a metabolite of
methanol metabolism. Formic acid metabolism is very slow, hence
accumulates in the body, leading to metabolic acidosis.
Initial symptoms occur 12-24 hours after ingestion and in general
correlate with the volume of methanol ingested and the amount of
ethanol concomitantly ingested. The minimal lethal dose is believed
to be 1mg/kg body weight. Initial symptoms include dis-inhibition and
ataxia followed by headache, nausea, and vomiting or epigastric pain.
These are then followed by drowsiness, seizures and eventually coma.
Visual symptoms like flashes of light, blurring, scotomas, and
scintillations occur and may progress to complete visual loss. Prompt
medical care is hence vital to avoid complications secondary to
methanol intoxications. Supportive therapy is aimed at initiating
airway management, correcting electrolyte disturbances, and providing
adequate hydration. The metabolic acidosis may necessitate
administration of bicarbonate and assisted ventilation. Bicarbonate
potentially may reverse visual deficits. In addition, bicarbonate may
help to decrease the amount of active formic acid. A
ntidote therapy is directed towards delaying methanol metabolism
until the methanol is eliminated from the system, either naturally or
via dialysis, often accomplished in 2 ways: ethanol or fomepizole.
Ethanol is also metabolized by alcohol dehydrogenase (ADH), and the
enzyme has 10-20 times higher affinity for ethanol compared with
methanol. Fomepizole is also metabolized by ADH; however, its use is
limited because of high costs and lack of availability.
http://emedicine.medscape.com/article/1174890-overview.
The HealthMap/ProMED-mail map showing Kampala in Central Uganda is
available at http://healthmap.org/r/00v0.
For additional background information on methanol or alcohol
poisoning available from the general ProMED-mail list, the postings
below can be found at http://www.promedmail.org. - Mod JFW]
[see also:
2007
----
Alcohol contamination, fatal - Russia 20070123.0309
2006
----
Methanol poisoning, fatalities - Nicaragua (Leon)(02): follow up 20061227.3620
Alcohol contamination, fatal - Russia (12): Pskov, Volgograd 20061223.3588
Alcohol contamination, fatal - Russia (11) 20061214.3518
Alcohol contamination, fatal - Russia (10) 20061108.3203
Alcohol contamination, fatal - Russia (09) 20061102.3145
Alcohol contamination, fatal - Russia (08) 20061030.3111
Alcohol contamination, fatal - Russia, Latvia, Belarus 20061029.3104
Alcohol contamination, fatal - Latvia 20061027.3062
Alcohol contamination, fatal - Russia (07) 20061027.3061
Alcohol contamination, fatal - Russia (06) 20061024.3052
Alcohol contamination, fatal - Russia (05) 20061020.3010
Alcohol contamination, fatal - Russia (04) 20061019.3008
Alcohol contamination, fatal - Russia (03) 20061007.2885
Alcohol contamination, fatal - Russia (02): disinfectant 20060915.2612
Alcohol contamination, fatal - Russia: methanol suspected 20060912.2585
Methanol poisoning, fatalities - Nicaragua (Leon) 20060911.2576
2005
----
Methanol poisoning, fatal - Kenya (02) 20050627.1817
Methanol poisoning, fatal - Kenya: susp, RFI 20050626.1789
Methanol poisoning, fatal, counterfeit raki - Turkey 20050310.0708
2004
----
Alcohol poisoning, fatal - Iran (03) 20040622.1669
Alcohol poisoning, fatal - Iran 20040616.1610
Poisoning, fatal - Namibia (02) 20040521.1368
Poisoning, fatal - Namibia 20040513.1287
2003
----
Methanol contamination, vodka - UK: alert (02) 20030702.1633
Methanol contamination, vodka - UK: alert 20030701.1620
2001
----
Methanol poisoning - Estonia (02) 20010918.2254
Methanol poisoning - Estonia 20010912.2199
2000
----
Methanol poisoning, humans - Kenya 20001117.2011]
.............................................jfw/msp/be
ProMED-EAFR:East Africa
Most Recent Alert
View printable version
Published Date
2009-08-25 11:14:00
Subject
PRO/EAFR> Methanol poisoning, fatal - Uganda: (Kampala), susp., RFI
Archive Number
20090825.201425
Full Text
METHANOL POISONING, FATAL - UGANDA: (KAMPALA), SUSPECTED, REQUEST FOR
INFORMATION
***********************************************
Date: Sun 23 Aug 2009
Source: Monitor Online [edited]
http://www.monitor.co.ug/artman/publish/sun_news/Strange_disease_kill_residents_90124.shtml
Residents of Kasana Sanja zone in Kulambiro, a Kampala suburb, are
panic-stricken following the deaths of several people in the area
within a month. The latest victims of a strange disease, who died on
Friday [21 Aug 2009], include 3 residents of Kasana Sanja zone.
Nakawa RDC, Mr Fred Bamwine, who has since visited the area, has
appealed to the police and Kampala City Council authorities to
investigate the cause of the deaths.
According to an uncle who was staying with one of the recently
deceased residents, the disease 1st killed their mother in July 2009.
"She woke up in the morning, and all seemed okay, but we were
surprised to be informed 2 hours later that she had died. And on
Friday [21 Aug 2009] at 2 a.m., my nephew called us from his bed
saying he could not see anything, though he could hear our voices. He
also felt a heavy chest. Moments later, he died. Victims of the
disease do not show any signs of illness. They simply go blind and
feel a sudden heaviness in the chest, which stops them from
breathing, and within a matter of hours, they die."
Kira Road Police Station DPC confirmed the deaths. "We have recorded
7 deaths in the last one month in Kasana LC1 Kulambiro village Sanja.
We are still waiting for the medical report."
[Byline: Stephen Otage]
--
Communicated by:
ProMED-EAFR
[This strange disease has claimed 9 people in 4 weeks, all residents
of a Kampala suburb. The common symptoms prior to death include
blindness and respiratory symptoms. These would suggest methanol
poisoning, in which visual effects and metabolic acidosis are the
hallmark. The same symptoms may, however, manifest in other types of
poisoning, including iron, salicylates, or diseases like diabetic
ketoacidosis and uremia.
The possibility of methanol poisoning will strengthened if history of
ingestion can be elicited, which, therefore, needs to be established
by the investigations that are currently going on.
Three months ago, there were related reports of 5 deaths in the
Western Uganda town of Kasese following consumption of liquor packed
locally in the town http://www.newvision.co.ug/PA/8/13/680686. The
investigation into those cases weren't conclusive, but it's possible
all these reports point to unregulated brewing of alcohol products in
the country, especially in the rural areas.
In 2007, 40 people with a presentation similar to the current deaths
died in Kampala and nearby districts after drinking a toxic local
gin. The investigation into those cases by the Ministry of Health
revealed that the cases had been exposed to a local gin that
contained too much methanol http://www.newvision.co.ug/PA/8/13/680686.
Methanol toxicity remains a common problem in many parts of the
developing world, where methanol is often a component of bootleg
alcohol, which is made in rural regions. Because of its low cost, it
is often consumed by those in lower socioeconomic classes. Methanol
has a relatively low toxicity, hence the adverse effects are thought
to result from the accumulation of formic acid, a metabolite of
methanol metabolism. Formic acid metabolism is very slow, hence
accumulates in the body, leading to metabolic acidosis.
Initial symptoms occur 12-24 hours after ingestion and in general
correlate with the volume of methanol ingested and the amount of
ethanol concomitantly ingested. The minimal lethal dose is believed
to be 1mg/kg body weight. Initial symptoms include dis-inhibition and
ataxia followed by headache, nausea, and vomiting or epigastric pain.
These are then followed by drowsiness, seizures and eventually coma.
Visual symptoms like flashes of light, blurring, scotomas, and
scintillations occur and may progress to complete visual loss. Prompt
medical care is hence vital to avoid complications secondary to
methanol intoxications. Supportive therapy is aimed at initiating
airway management, correcting electrolyte disturbances, and providing
adequate hydration. The metabolic acidosis may necessitate
administration of bicarbonate and assisted ventilation. Bicarbonate
potentially may reverse visual deficits. In addition, bicarbonate may
help to decrease the amount of active formic acid. A
ntidote therapy is directed towards delaying methanol metabolism
until the methanol is eliminated from the system, either naturally or
via dialysis, often accomplished in 2 ways: ethanol or fomepizole.
Ethanol is also metabolized by alcohol dehydrogenase (ADH), and the
enzyme has 10-20 times higher affinity for ethanol compared with
methanol. Fomepizole is also metabolized by ADH; however, its use is
limited because of high costs and lack of availability.
http://emedicine.medscape.com/article/1174890-overview.
The HealthMap/ProMED-mail map showing Kampala in Central Uganda is
available at http://healthmap.org/r/00v0.
For additional background information on methanol or alcohol
poisoning available from the general ProMED-mail list, the postings
below can be found at http://www.promedmail.org. - Mod JFW]
[see also:
2007
----
Alcohol contamination, fatal - Russia 20070123.0309
2006
----
Methanol poisoning, fatalities - Nicaragua (Leon)(02): follow up 20061227.3620
Alcohol contamination, fatal - Russia (12): Pskov, Volgograd 20061223.3588
Alcohol contamination, fatal - Russia (11) 20061214.3518
Alcohol contamination, fatal - Russia (10) 20061108.3203
Alcohol contamination, fatal - Russia (09) 20061102.3145
Alcohol contamination, fatal - Russia (08) 20061030.3111
Alcohol contamination, fatal - Russia, Latvia, Belarus 20061029.3104
Alcohol contamination, fatal - Latvia 20061027.3062
Alcohol contamination, fatal - Russia (07) 20061027.3061
Alcohol contamination, fatal - Russia (06) 20061024.3052
Alcohol contamination, fatal - Russia (05) 20061020.3010
Alcohol contamination, fatal - Russia (04) 20061019.3008
Alcohol contamination, fatal - Russia (03) 20061007.2885
Alcohol contamination, fatal - Russia (02): disinfectant 20060915.2612
Alcohol contamination, fatal - Russia: methanol suspected 20060912.2585
Methanol poisoning, fatalities - Nicaragua (Leon) 20060911.2576
2005
----
Methanol poisoning, fatal - Kenya (02) 20050627.1817
Methanol poisoning, fatal - Kenya: susp, RFI 20050626.1789
Methanol poisoning, fatal, counterfeit raki - Turkey 20050310.0708
2004
----
Alcohol poisoning, fatal - Iran (03) 20040622.1669
Alcohol poisoning, fatal - Iran 20040616.1610
Poisoning, fatal - Namibia (02) 20040521.1368
Poisoning, fatal - Namibia 20040513.1287
2003
----
Methanol contamination, vodka - UK: alert (02) 20030702.1633
Methanol contamination, vodka - UK: alert 20030701.1620
2001
----
Methanol poisoning - Estonia (02) 20010918.2254
Methanol poisoning - Estonia 20010912.2199
2000
----
Methanol poisoning, humans - Kenya 20001117.2011]
.............................................jfw/msp/be