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More than 500 people in western Russia have fallen sick following 2 outbreaks of mass alcohol poisoning.In the Belgorod region, the emergency situations ministry was quoted as saying that 309 people had been diagnosed with toxic hepatitis, including 289 hospitalised in the town of Stary Oskol, 560 kilometres (348 miles) south of Moscow, ITAR-TASS news agency reported Sunday. Hospital staff said that drinks based on industrial alcohol [likely this is methanol - Mod.TG] appeared to be behind the outbreak, which had killed 7, ITAR-TASS reported. Another 212 people had fallen sick in and around the town of Rzhev, 220 kilometres (137 miles) west of Moscow, ITAR-TASS quoted the local emergency situations ministry as saying. Ten people in the Rzhev region have died since the 1st case of poisoning was registered on [21 Aug 2006]. Regional police have confiscated more than 21 tonnes of alcoholic liquid, including disinfectant, that is suspected to have been used in the poisionous drinks sold in the area, ITAR-TASS said. Official figures show that about 42 000 Russians die every year from alcohol poisoning, often after drinking homemade vodka known as "samogon," or bottles of counterfeit beverages sold in shops. A widespread habit of binge drinking is also seen as one of the main causes of the country's steep death rate and rapidly shrinking population. Men in Russia die on average at 58 -- 16 years earlier than their counterparts in the West. The overall population, currently standing at 142.4 million, shrinks on average by 700 000 every year, according to official figures. Source: MediaCorps Press
ProMED-mail[The above article mentions that part of the recall may have been related to the possibility of disinfectants mixed with the alcohol. There are some disinfectants that may contain some methanol as well. A mix of methanol and ethanol may prevent overt signs of methanol toxicity and lead rapidly to hepatitis. The below discussion is taken from the moderator's comment from posting 20040616.1610 (Alcohol poisoning, fatal - Iran):Methanol (wood alcohol) is produced from the destructive distillation of wood. Epidemics of methanol toxicity have resulted from the consumption of methanol-contaminated whiskey. The formation of 2 toxic metabolites, formaldehyde and formic acid, causes methanol poisoning. The elimination rate depends upon the folate pool. In primates it is generally small and consequently primates (including humans) are more sensitive to methanol toxicity than other animals. Methanol is widely available in formulations including antifreeze, windshield washer fluid, Sterno canned heat, shellacs, various paints, paint removers, varnishes, duplicating fluids, and gasoline additives. Fatalities have been reported after ingestion of 15 ml (or 3 teaspoons) of a 40 percent solution, although 30 ml is generally considered a minimal lethal dose. With aggressive medical care it is possible to survive the ingestion of 500-600 ml. However, consumption of as little as 10 ml may cause blindness, with the amount varying with the individual. Methanol is well absorbed from the gastrointestinal tract and peak levels occur generally within 30-90 minutes. It is distributed into tissues, so concentrations in the vitreous humor and optic nerve are high. The highest concentrations are found in the kidney, liver and gastrointestinal tract, with smaller concentrations in the brain, muscle and adipose tissues. Methanol is oxidized 10 times more slowly than ethanol. Consequently there is a longer elimination half-life. Onset of symptoms varies between 40 minutes and 72 hours post-ingestion. Co-ingestion with alcohol will delay the appearance of symptoms, but the absence of symptoms does not exclude serious toxicity. The usual latent period is 12-24 hours. Clinical signs may include headache, vertigo [головокружение, исконно русское слово с сокращением вертит головой на лат. манер], lethargy and confusion, which are common in mild to moderate ethanol intoxications. Coma and convulsions appear in severe cases, probably as a result of cerebral edema. Methanol produces little to no euphoria [это самое главное вредительство], unlike ethanol. Blurred vision, decreased visual acuity, and photophobia (sensitivity to light) are common complaints. Constricted visual fields, fixed and dilated pupils, retinal edema and hyperemia of the optic disk are common clinical findings. Prompt initial therapy is necessary to reverse symptoms, though visual defects have persisted in up to 25 per cent of severe cases. Methanol is a mucosal irritant and may produce nausea, vomiting and abdominal pain, not unlike large doses of ethanol. Early in the clinical course, gut decontamination with ipecac or lavage may be indicated. However, if the methanol is mixed with ethanol, these patients may not realize something is out of the ordinary until it is too late for this type of treatment to be helpful. Intravenous administration of ethanol in a 10 percent dextrose solution may be helpful. As ethanol prolongs the elimination half-life of methanol, the treatment may take several days and the patient should be hospitalized. Dialysis may be necessary to prevent kidney failure as well. Another treatment is Fomepizole (4-methylpyrazole, Antizol), which inhibits alcohol dehydrogenase and does not trigger delirium, fetal risks, liver injury, gastropathy, or frequent vomiting. Also, Folinic acid (leucovorin) is recommended for restoration of 1-carbon metabolism, especially for methanol exposure. - Mod.TG] see also: Methanol poisoning, fatalities
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