Outbreaks Worldwide
Suspected Methanol Poisoning Incidents
It is reported that thousands of people suffer from methanol poisoning every year. If not treated, fatality rates are often reported to be 20% to 40%, depending on the concentration of toxic methanol and the amount taken. However, this is believed to be an underestimation of the real situation.
Due to the challenges in diagnosis and limited public awareness, many fatalities and ‘outbreaks’ are never identified as methanol poisonings. Statistics show that Asia has the highest prevalence of methanol poisoning worldwide with outbreaks commonly occurring in Indonesia, India, Cambodia, Vietnam, and the Philippines.
Indonesia
In the past two decades, Indonesia had the highest number of reported incidents of methanol poisoning in the world. The source of methanol poisoning in Indonesia is most often caused by bootleg liquor, known locally as “miras oplosan” or Arak – a local illegally brewed coconut flower, rice and sugarcane-based spirit which can be purchased from unlicensed “bottle-shops”. Over the years, many foreign tourists had fallen victim to methanol poisoning after consuming incorrectly distilled Arak containing methanol in Bali, Lombok and Gili Islands. Among the local population, methanol poisoning is even more prevalent due to the widespread production of illicit liquor.
India
In India, methanol poisoning is most commonly caused by the ingestion of adulterated alcohol or ‘hooch’, derived from a mixture of cane sugar and ammonium, or fermented rice. These illegal drinks are produced by unauthorised persons and sold at significantly cheaper prices. The high cost of imported or Indian-made foreign liquor is believed to be beyond the reach of 80% of locals in India. 700ml of whisky or rum costs as much as 400 rupees while ‘hooch’ is sold for a mere 25 to 30 rupees per plastic bottle. To increase profit, ‘hooch’ is commonly adulterated with methanol, a significantly cheaper ethanol substitute. In some instances, other substances like dried tobacco leaves and dry-cell batteries are added to the mixture which is prepared in a very unhygienic manner. One of the deadliest poisoning in the history of India occurred in the Golaghat and Jorhat district of Assam state in February 2019. Over 500 people who drank toxic bootleg alcohol or ‘hooch’ were affected with at least 168 fatalities reported. The incident occurred at tea plantations and most victims were plantation workers.
Cambodia
Methanol poisoning is commonly associated with the home distilling of rice wine brews which has been part of the Cambodian culture for over thousands of years. Many villagers, particularly those living in rural areas use rice wine brews to celebrate festivals and spiritual activities, for medicines and for casual drinking. Due to increasing prices of firewood, however, many rice wine producers have replaced the traditional methods of brewing rice wine with chemical means by adding methanol. Mass poisoning are common especially with the poor health and safety standards enforced in the country. One of the largest outbreak was in 2012, involving 49 deaths and 318 persons hospitalised.
Vietnam
Vietnam is the largest alcohol consumer in the ASEAN region and an estimated 85% of alcohol in the country is of homemade origins. The quality and safety of homemade alcohol alongside a lack of enforcement on the growing practices of adulterated, counterfeit spirits have led to the proliferation of methanol poisoning in the country.
Philippines
There is a colloquial term “Gin-Bulag” (blind gin) which is interpreted as getting blind from drinking too much gin. Gin mixed with methanol, commonly known as wood alcohol or Gin-Bulag is a common cause for methanol poisoning in the country. Despite this, the awareness among both healthcare professionals and the public is generally low. In many of the articles published, no mention was given to the treatment or antidote of methanol poisoning.