Uganda Public Health Fellowship Program, Kampala, Uganda.
US Centers for Diseases Control and Prevention, Kampala, Uganda.
J Environ Public Health. 2020 Apr 28;2020:5816162. doi: 10.1155/2020/5816162. eCollection 2020.
Methanol, an industrial solvent, can cause illness and death if ingested. In June 2017, the Uganda Ministry of Health was notified of a cluster of deaths which occurred after drinking alcohol. We investigated to determine the cause of outbreak, identify risk factors, and recommend evidence-based control measures.
We defined a probable case as acute loss of eyesight and ≥1 of the following symptoms: profuse sweating, vomiting, dizziness, or loss of consciousness in a resident of either Nabweru or Nangabo Subcounty from 1 to 30 June 2017. In a case-control study, we compared exposures of case-patients and controls selected among asymptomatic neighbors who drank alcohol and matched by age and sex. We collected alcohol samples from implicated bars and wholesaler for testing.
We identified 15 cases; 12 (80%) died. Among case-patients, 12 (80%) were men; the median age was 43 (range: 23-66) years. Thirteen (87%) of 15 case-patients and 15 (25%) of 60 controls last drank a locally distilled alcohol at one of the three bars supplied by wholesaler (OR = 15; 95% CI: 2.3-106). We found that alcohol sellers sometimes added methanol to drinking alcohol to increase their profit margin. Among the 10 alcohol samples from wholesaler , the mean methanol content (1200 mg/L, range: 77-2711 mg/L) was 24 times higher than the safe level.
This outbreak was caused by drinking a locally distilled alcohol adulterated with methanol from wholesaler . We recommended enforcing existing laws governing alcohol manufacture and sale. We recommended timely intravenous administration of ethanol to methanol poisoning victims.
甲醇是一种工业溶剂,如果摄入会导致疾病和死亡。2017 年 6 月,乌干达卫生部接到通知,称有一群人在饮用酒精后死亡。我们进行了调查,以确定疫情的原因、确定危险因素,并提出基于证据的控制措施。
我们将以下症状定义为疑似病例:2017 年 6 月 1 日至 30 日期间,纳布韦鲁或南加博县的居民突然失明,且出现以下症状中的至少一种:大量出汗、呕吐、头晕或意识丧失。在病例对照研究中,我们比较了来自无症状邻居的病例患者和对照患者的暴露情况,这些邻居是在喝了与病例患者相同的酒,并按照年龄和性别进行了匹配。我们从涉嫌酒吧和批发商那里收集了酒精样本进行检测。
我们确定了 15 例病例,其中 12 例(80%)死亡。在病例患者中,有 12 例(80%)为男性,中位年龄为 43 岁(范围:23-66 岁)。13 例(87%)的 15 例病例患者和 60 例对照患者中的 15 例(25%)最后一次在由批发商供应的三家酒吧之一喝了当地蒸馏的酒(OR=15;95%CI:2.3-106)。我们发现,酒类销售商有时会在饮用酒中添加甲醇以增加利润。在批发商的 10 个酒精样本中,甲醇含量平均值(1200mg/L,范围:77-2711mg/L)比安全水平高 24 倍。
本次疫情是由批发商供应的当地蒸馏酒中添加甲醇导致的。我们建议加强有关酒精制造和销售的现有法律。我们建议对甲醇中毒的受害者及时静脉注射乙醇。