Lessons from a methanol poisoning outbreak in Egypt: Six case reports

Area of Science:

• Toxicology
• Emergency Medicine
• Public Health

Background:

• Mass methanol poisonings pose significant challenges, particularly in resource-limited regions lacking preparedness and specific management guidelines.
• The availability of hazardous pharmaceuticals, such as ethanol disinfectant, from local pharmacies presents a critical public health concern.

Observation:

• Six Ukrainian patients presented with severe metabolic acidosis and visual impairments after consuming ethanol disinfectant mistaken for alcohol.
• Clinical management was empirical due to unavailable methanol-level testing and the inaccessibility of antidotes like fomepizole or safely administered ethanol.
• Two patients were comatose, one died from multiorgan failure, and another suffered permanent blindness.

Findings:

• Despite severe presentation, four patients showed rapid improvement with supportive care alone.
• The outbreak underscores the dangers of unregulated pharmaceutical sales and the critical need for accessible diagnostic tools and antidotes.

Implications:

• Highlights the urgent need for improved pharmaceutical regulation and safety monitoring in low-resource settings.
• Emphasizes the importance of staff training and resource allocation for managing poisoning emergencies.
• Demonstrates the potential for severe morbidity and mortality from methanol poisoning when critical medical interventions are unavailable.