September 27, 2020

Four Americans Are Dead After Ingesting Methanol Hand Sanitizers

According to the Centers for Disease Control and PRevention’s Morbidity and Mortality Weekly Report for the week of August 5, 2020, four Americans are dead after ingesting methanol hand sanitizers. Alcohol-based hand sanitizers should only contain ethanol or isopropanol, but recently, some of them have been found to contain methanol.

Four Americans dead after ingesting methanol hand sanitizers

Methanol, or wood alcohol, is toxic when absorbed through the skin and can kill if ingested. Children can accidentally consume this product, and some adults use ethanol or isopropanol for substitutes for alcohol. Many recalls of these products have been issued in the past few months. Food Poisoning Bulletin has been reporting about this issue.

From May 1 through June 30, 2020, 15 cases of methanol poisoning were reported in Arizona and New Mexico that were associated with swallowing alcohol-based hand sanitizers. Four patients died and three had visual impairment. Six suffered seizures.

Hand sanitizers have become very important since the start of the COVID-19 pandemic. If soap and water aren’t available,e the CDC recommends the use of alcohol-based hand sanitizer that contain at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol. Cases of ethanol toxicity following ingestion of these product have been reported in people with alcohol use disorder.

But methanol, or wood alcohol, is not supposed to be used to make these products. The reports of death followed and FDA consumer alert that was issued on June 19, 2020, warning about the hand sanitizer brands that contain methanol. Close to 100 brands have been recalled.

Early symptoms of methanol and ethanol poisoning are similar. They include headache, blurred vision, nausea, vomiting, abdominal pain, and loss of coordination. People with methanol poisoning might develop severe anion-gap metabolic acidosis, seizures, and blindness. If not treated, patients can fall into a coma and die. Blindness is caused by the direct toxic effect of formate on the optic nerve.

CDC and state partners established a case-definition of alcohol-based hand sanitizer-associated methanol poisoning and reviewed 62 poison center call records during that time frame. Fifteen people met the definition, including persons who were American Indian/Alaska Native. All drank methanol-based hand sanitizer and were hospitalized. As of July 8, 2020, four patients were still hospitalized.

The investigation highlights the serious adverse health events that can occur after drinking hand sanitizer products containing methanol. In addition to adults who intentionally consume hand sanitizers, chidden can unintentionally swallow these products.

Yip L, Bixler D, Brooks DE, et al. Serious Adverse Health Events, Including Death, Associated with Ingesting Alcohol-Based Hand Sanitizers Containing Methanol — Arizona and New Mexico, May–June 2020. MMWR Morb Mortal Wkly Rep. ePub: 5 August 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6932e1

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