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Chemical Health Hazard – Mass Methanol Poisoning (Alert): Irkutsk, Russia

2016/12/20

METHANOL POISONING – RUSSIA: (IRKUTSK) BATH LOTION, FATAL, ALERT
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Published Date: 2016-12-20 16:08:34
Subject: PRO/EDR> Methanol poisoning – Russia: (IK) bath lotion, fatal, alert
Archive Number: 20161220.4710121

[1]
Date: Mon 19 Dec 2016 03:37 EST
Source: Daily Mail [edited]

A total of 41 Russians have died from poisoning after drinking a bath lotion. Another 16 are in hospital, most gravely ill, in the Siberian city of Irkutsk.

The dead include both men and women, and they were all from the same area. A state of emergency has been declared, and more deaths are expected.

“Almost all of them are in a serious condition and are in intensive care,” said a source from the Health Ministry. “We know of 57 people who consumed the poisonous liquid, and 41 of them have died,” said Stanislav Zubovsky, the prosecutor of Irkutsk’ Leninsky district.

The fatal victims suffered rapid and agonizing deaths from methanol poisoning, said medical sources. Methanol when drunk metabolizes to formaldehyde then formic acid or formate salts. These are poisonous to the human central nervous system, leading to blindness, coma, and death.

A chief doctor, Yevgeny Vygovsky, caring for the victims said: “They have heavy chemical poisoning. All of those who were brought to us were unconscious. Their central nervous system and internal organs were struck, and toxic shock developed rapidly.”

The victims were poisoned after consuming a bath lotion called Boyaryshnik — made from hawthorn — which contains alcohol.

The bath lotion contains methanol or methyl alcohol. It is unknown whether the victims consumed the drink knowing it was a bath lotion. It was sold in street kiosks and other outlets in an Irkutsk suburb, say relatives of the victims. The drink was manufactured at an illegal production facility at a dacha — country house — close to Irkutsk. Other fake vodkas were also made there.

Senior policeman German Bratchikov said: “Not only Boyaryshnik liquid, but also Tsarskaya Okhota (‘tsar’s hunt’) and Finlyandia Serebristaya (‘silver Finland’) vodkas, and a few other brands, were discovered there.” The 2 owners of the premises have been detained. 5 more people related to retail sales of the liquid that caused poisoning were also held. A state of emergency was declared in the region over the deaths.

A neighbour of [one of the victims, a 53 year old], who was killed by the poisonous alcohol, said: “They sell it in every kiosk here for 70 roubles [about USD 1.14] a small bottle. Of course, people drink it. Those who are stronger, drink it as it is, some mix it. It’s not the 1st case. People drink it and go crazy. It’s mainly older people drinking it, 40-45 and older.”

[The fatality’s] stepdaughter said: “He wasn’t feeling well in the morning. I asked him what was happening. He said nothing. I left, went to the city centre with friends, returned home, and he was already lying there all black. I called the ambulance. His daughter and I went to the hospital; they said he wasn’t doing well. We got home, and 40 minutes later received a phone call. They said he died.” She said that “he always bought this Boyaryshnik in a shop nearby. We persuaded him to choose vodka, but he insisted that it was more tasty and no headache in the morning.”

The Siberian city of Irkutsk has a population of just under 600 000, and the winter temperatures can drop to -21 C [- 6 F]

“He said the shop was checked by the authorities. He always bought there. And this Saturday morning [17 Dec 2-16] he bought it again, then on Sunday, and at 5 pm we called the ambulance.”

His widow [a 50 year old woman], said: “They used to sell this in transparent glass bottles; now it’s purplish. Investigators say all the victims were residents of one neighbourhood, Novo-Lenino,” reported The Siberian Times.

“A criminal case has been opened into the sale of goods failing to meet safety requirements.”

The bath lotion was strictly for external use. It is not clear whether the victims knowingly drank the product or were fooled into thinking it was something else. 1st reports of deaths came on Sunday, with more announced on Monday [18-19 Dec 2016].

Poisonings caused by surrogate alcohol are common in Russia, but this case has been described as the deadliest in years.

Methyl alcohol, a light, colorless, flammable liquid, has been detected in the composition of bath lotion, health officials told the Russian News Agency, TASS.

[Byline: Will Stewart]

Communicated by:
ProMED-mail
<promed@promedmail.org>

[A photo of the bath lotion can be seen at the source URL above.

Maps of Russia and Irkutsk Oblast can be seen at http://map.rin.ru/index_e.html and http://healthmap.org/promed/p/469
– Sr.Tech.Ed.MJ]

******
[2]
Date: Mon 19 Dec 2016
Source: MSN.com, The Washington Post report [edited]

Authorities have declared a state of emergency in a Siberian city after at least 41 people died of alcohol poisoning after drinking a bath oil they hoped would give them the same buzz as booze.

An additional 15 people were in critical condition in hospitals in Irkutsk, Russia’s 6th-largest city, with a population of 1.1 million. Mayor Dmitry Berdnikov called for the state of emergency after meeting with local authorities, the Interfax news agency reported. Interfax said the death toll had risen to at least 41.

The bath oil bottles were labeled as containing ethyl alcohol, the state-run news agency TASS reported, and were clearly marked with warnings that they were not meant to be consumed internally. The products in fact contained methyl alcohol and antifreeze, said Alexei Krupin, the head of the alcohol regulating agency for Siberia.

Russia’s top investigative agency has opened a criminal investigation of the deaths and the sale of goods not meeting safety requirements. Investigators said in a statement that they had detained 2 people suspected of distributing the bath oil, and had confiscated more than 2000 liters of spirits, the Reuters news agency reported.

Many of the victims are the residents of one neighborhood, Novo-Lenino, investigators said. Cheap perfume and facial toner containing alcohol are sold in the region without the trading restrictions on alcoholic drinks, Agence France-Presse reported, and those who buy them for drinking are often the most socially disadvantaged.

Dmitry Peskov, a spokesman for Russian President Vladimir Putin, said that the president has yet to draw any conclusions on whether the poisoning is connected to the economic well-being of this population, Interfax said.

“Undoubtedly, this is a terrible tragedy,” Peskov said. “Undoubtedly, this is a well-known set of problems. The president has been informed, and without a doubt, this requires the closest attention and adoption of measures.”

Prime Minister Dmitry Medvedev said in a government meeting that he hopes to consider banning products leading to such high death tolls, and added that the country’s criminal code is being amended to toughen the punishment for people caught selling them, Reuters reported.

Poisonings with surrogate alcohol are a regular occurrence in Russia, the Associated Press reported, but the Irkutsk case was one of the deadliest such incidents in years. Homemade spirits and household products containing alcohol are popular throughout Russia as a cheap alternative to the standard brands. They are also blamed for a large number of alcohol-related deaths, according to recent studies.

Dangerous drinking patterns in Russia have led to high levels of alcohol mortality for centuries. But the alcohol-related deaths seem to have reached new extremes in post-Soviet years, according to a 2013 study published in the journal Alcohol and Alcoholism. This probably is caused by a growing use of non-beverage alcohol containing high levels of ethanol and other toxic elements.

Higher levels of poverty are pushing people to drink more and to drink cheaper, poorer-quality alcohol that can often prove dangerous for health, according to the study.

A later study, published in the Lancet in 2014, asked 150 000 Russian how much vodka they drank, then followed them for up to a decade, during which 8000 died. The study found that men who drank 3 or more bottles of vodka per week were about twice as likely to die prematurely than men who drank less than a bottle per week. According to the British researchers behind the study, 25 percent of all Russian men die before age 55, compared with only 7 percent of men in the United Kingdom. Alcohol and tobacco account for most of this difference.

“Russian death rates have fluctuated wildly over the past 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin and Putin, and the main thing driving these wild fluctuations in death was vodka,” said the study’s co-author, Sir Richard Peto of the University of Oxford in Britain.

[Byline: David Filipov, Samantha Schmidt]

Communicated by:
ProMED-mail
<promed@promedmail.org>

[How someone could drink bath lotion believing it was alcohol is difficult to imagine. What is more difficult to believe is that, as one of the victims said, the bath lotion had a better flavor. This prompts the question: if the man had imbibed the formula before without ill effects, was the formula changed? Was the change a known change? Or is this some misunderstanding of someone thinking methanol (wood alcohol) was the same as ethanol (for drinking)? It is quite possible that all the vodkas at that shop are methanol, not ethanol.

The next question is how much and how widely were the bath lotion and the vodka distributed? Should other regions be alerted?

Methanol (wood alcohol) is produced from the destructive distillation of wood. Epidemics of methanol toxicity have resulted from the consumption of methanol-contaminated whiskey or other alcohol products. 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 per cent 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, depending on the amount and individual tolerance.

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 after 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, 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, 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 per cent 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. Hemodialysis remains an effective treatment. – Mod.TG]

See Also

2015
—-
Methanol poisoning, fatal – India: (UP) 20150113.3088258
2013
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Methanol poisoning – Cuba: fatal 20130804.1862677
2012
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Alcohol poisoning – Cambodia: methanol susp 20120216.1043285
Alcohol poisoning – India: (AP, WB) methanol susp. 20120103.0014
2011
—-
Methanol poisoning, fatal – India 20111215.3600
Methanol poisoning, fatal – Indonesia: (BA) susp 20111103.3272
Alcohol contamination, fatal – Ecuador: methanol 20110830.2667
2010
—-
Methanol poisoning, fatal – Uganda 20100521.1682
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Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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