The Methanol Poisoning Outbreaks in Libya 2013 and Kenya 2014.

Authors:
Morten Rostrup
Morten Rostrup
Ullevaal University Hospital
Norway
Jeffrey K Edwards
Jeffrey K Edwards
Médecins Sans Frontières
New York | United States
Mohamed Abukalish
Mohamed Abukalish
Tripoli Medical Center
Tajoura | Libya
David Some
David Some
Médecins Sans Frontières
New York | United States
Helga Ritter
Helga Ritter
Médecins Sans Frontières
Tom Menge
Tom Menge
Kenyatta National Hospital
Nairobi | Kenya
Ahmed Abdelrahman
Ahmed Abdelrahman
University of Toronto
Canada

PLoS One 2016 31;11(3):e0152676. Epub 2016 Mar 31.

Médecins Sans Frontières, Oslo, Norway.

Background: Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise.

Methods: Retrospective study of three major methanol outbreaks in Libya (2013) and Kenya (May and July 2014). Data were collected from MSF field personnel, local health personnel, hospital files, and media reports.

Findings: In Tripoli, Libya, over 1,000 patients were poisoned with a reported case fatality rate of 10% (101/1,066). In Kenya, two outbreaks resulted in approximately 341 and 126 patients, with case fatality rates of 29% (100/341) and 21% (26/126), respectively. MSF launched an emergency team with international experts, medications and equipment, however, the outbreaks were resolving by the time of arrival.

Interpretation: Recognition of an outbreak of methanol poisoning and diagnosis seem to be the most challenging tasks, with significant delay from time of first presentations to public health warnings being issued. In spite of the rapid response from an emergency team, the outbreaks were nearly concluded by the time of arrival. A major impact on the outcome was not seen, but large educational trainings were conducted to increase awareness and knowledge about methanol poisoning. Based on this training, MSF was able to send a local emergency team during the second outbreak, supporting that such an approach could improve outcomes. Basic training, simplified treatment protocols, point-of-care diagnostic tools, and early support when needed, are likely the most important components to impact the consequences of methanol poisoning outbreaks in these challenging contexts.

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152676PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816302PMC
August 2016
16 Reads

Publication Analysis

Top Keywords

methanol poisoning
24
emergency team
12
outbreaks
9
methanol
8
2013 kenya
8
outbreaks methanol
8
case fatality
8
local health
8
libya 2013
8
poisoning outbreaks
8
knowledge methanol
8
outbreaks libya
8
poisoning
5
medications equipment
4
equipment outbreaks
4
experts medications
4
launched emergency
4
26/126 msf
4
msf launched
4
outbreaks resolving
4

References

(Supplied by CrossRef)
Methanol-laced moonshine kills 140 in Kenya
K Ahmad et al.
The Lancet 2000
Methanol contamination of Romanian home-distilled alcohol
P Levy et al.
J Toxicol Clin Toxicol 2003
Methanol mass poisoning in Iran: role of case finding in outbreak management
H Hassanian-Moghaddam et al.
J Public Health (Oxf) 2015
Substance abuse and homeless: mass methanol poisoning in Khartoum
FAA AbdulRahim et al.
Sudan Med J 2012
Methyl alcohol poisoning. (Experience of an outbreak in Bombay)
R Ravichandran et al.
J Postgrad Med 1984
Methanol mass poisoning in Estonia: outbreak in 154 patients
R Paasma et al.
Clinical toxicology (Philadelphia, Pa) 2007
Czech mass methanol outbreak 2012: epidemiology, challenges and clinical features
S Zakharov et al.
Clinical toxicology (Philadelphia, Pa) 2014

Similar Publications