Investigation of an Outbreak of Acute Methanol Poisoning in a Southwest State of Nigeria
Dayo Adeyanju
Ministry of Health, Akure, Ondo State, Nigeria.
Akinola Ayoola Fatiregun *
World Health Organization, Nigeria.
Olubowale Ekundare-Famiyesin
World Health Organization, Nigeria.
Pascal Mkanda
World Health Organization, Nigeria.
Rui Miguel Vaz
World Health Organization, Nigeria.
Elvis Isere
World Health Organization, Nigeria.
Elizabeth Adedire
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Adefisoye Adewole
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Oluwapelumi Fadahunsi
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Michael Oguntoye
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Kayode Ojo
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Akinyode Akinfemi
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Maureen Anyanwu
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
Patrick Nguku
Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aims: An outbreak of sudden deaths with clinical features suggestive of acute methanol poisoning was reported. An epidemiological investigation was conducted to verify the diagnosis and identify risk factors.
Methodology: A joint team of officials of the Ondo State Ministry of Health, the World Health Organization, and the Nigerian Field Epidemiology and Laboratory Training Programme residents investigated the outbreak which was limited to two Local Government Areas of Ondo State, in Southwest Nigeria. An incident management coordination approach, modelled after the emergency operation centre for the elimination of polio virus and ebola virus disease in Nigeria was used. Field survey involving active case searches of health facilities, households and neighbourhoods using an operational case definition was carried out. Blood and urine specimen, including remnant of home-made alcoholic beverages were collected for analysis of viral antigens, heavy metals and methanol. A case-control study was also carried to identify potential risk factors.
Results: A total of 37 cases were found with 27 deaths inclusive (case fatality rate; 73%), most (76%) of whom were in the age group ≤ 49 years. The odd of being a case was 17 fold higher among those who consumed a locally brewed gin. Laboratory reports from samples from remnants of gin consumed as well as human samples; urine and blood, were consistent with acute methanol poisoning.
Conclusion: There is a need for enforcement of regulatory measures to address the consumption of illicitly produced alcoholic beverages to forestall future outbreaks.
Keywords: Disease outbreaks, sudden death, methanol, Nigeria.