Hassanian-Moghaddam Hossein, Nikfarjam Ali, Mirafzal Amirhossein, Saberinia Amin, Nasehi Abbas Ali, Masoumi Asl Hossein, Memaryan Nadereh
Toxicological Research Center, Loghman-Hakim Hospital, Kamali Ave, South karegar Street, Tehran 13336, Iran Department of Clinical Toxicology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ministry of Health, Mental and Social Health and Substance Abuse office, Tehran, Iran.
J Public Health (Oxf). 2015 Jun;37(2):354-9. doi: 10.1093/pubmed/fdu038. Epub 2014 Jun 18.
There are no guidelines addressing the public health aspects of methanol poisoning during larger outbreaks. The current study was done to discuss the role of active case finding and a national guideline that organizes all available resources according to a triage strategy in the successful management of a methanol mass poisoning in Rafsanjan, Iran, in May 2013.
A retrospective cross-sectional study was performed reviewing the outbreak Emergency Operation Center files. The objectives were to describe the characteristics, management and outcome of a methanol outbreak using Active Case Finding to trace the victims.
A total of 694 patients presented to emergency departments in Rafsanjan after public announcement of the outbreak between 29th May and 3rd June 2013. The announcement was mainly performed via short message service (SMS) and local radio broadcasting. A total of 361 cases were observed and managed in Rafsanjan and 333 were transferred to other cities. Seventy-five and 100 patients underwent hemodialysis (HD), retrospectively. The main indication for HD was refractory metabolic acidosis. Eight patients expired due to the intoxication. Except for the deceased cases, no serum methanol level was available.
In developing countries, where diagnostic resources are limited, use of active case finding and developing national guidelines can help in the management of large outbreaks of methanol poisonings.
在大规模甲醇中毒事件爆发期间，尚无针对公共卫生方面的指南。本研究旨在探讨主动病例发现以及根据分诊策略整合所有可用资源的国家指南在2013年5月伊朗拉夫桑贾尼成功处理一起甲醇群体中毒事件中的作用。
进行了一项回顾性横断面研究，查阅了疫情应急行动中心的档案。目的是描述使用主动病例发现追踪受害者的甲醇中毒事件的特征、处理情况及结果。
在2013年5月29日至6月3日疫情公开通报后，共有694名患者前往拉夫桑贾尼的急诊科就诊。通报主要通过短信服务（SMS）和当地广播进行。拉夫桑贾尼共观察并处理了361例病例，333例被转至其他城市。回顾性分析显示，75名和100名患者接受了血液透析（HD）。血液透析的主要指征是难治性代谢性酸中毒。8名患者因中毒死亡。除死亡病例外，没有血清甲醇水平的数据。
在诊断资源有限的发展中国家，采用主动病例发现和制定国家指南有助于处理大规模甲醇中毒事件。
