In Malaysia, there exists a black market for counterfeit alcohol which was sold to foreign workers for a cheaper price. This compound has been illegally used in the production of cheap and counterfeit ethanol. It is a volatile, colourless, flammable poisonous fluid, produced from distillation of destructed wood particles. Methanol is also referred to as methyl alcohol, wood alcohol or wood spirit. It consists of carbon monoxide and hydrogen ions (CH 3OH). Methanol, or commonly known as methyl alcohol, is a colourless fluid compound. Management of methanol toxicity outbreak in resource-limited area will benefit from a well-designed guideline that is adaptable to the locality. Laboratory parameters showed difference in median between group that survived and succumbed for pH, serum bicarbonate, lactate, potassium and osmolar and anion gap. Patient was managed based on clinical presentation. Language barrier, severity of illness, late presentation, unavailability of intravenous ethanol and fomipezole and delayed dialysis may have been the contributing factors. The mortality rate was higher, and the morbidity includes permanent visual impairment and severe neurological sequelae.
Post-mortem findings of the brain were unremarkable. Serum pH, bicarbonate, lactate, potassium, anion gap, osmolar gap and measured serum osmolarity between the alive and dead patients were significant. Osmolar gap and lactate had strong correlations with patient’s mortality. The rest of the survivors did not have any long-term complications. Out of the 12 patients who survived, two patients had toxic optic neuropathy, and one patient had uveitis. From the 31 patients, 19.3% were dead on arrival, 3.2% died in the emergency department and 38.7% survived and discharged. Thirty of them were males with a mean age of 32 years old. ResultĪ total of 31 patients were received over the period of 9 days. MethodologyĪ retrospective analysis of a methanol poisoning outbreak in September 2018 was performed, describing patients who presented to a major tertiary referral centre.
This paper describes a methanol poisoning outbreak and difficulties in managing a large number of patients with limited resources.
Mortality is high without immediate interventions. Methanol poisoning usually occurs in a cluster and initial diagnosis can be challenging.
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