Serious Adverse Health Events, Including Death, Associated with Ingesting Alcohol-Based Hand Sanitizers Containing Methanol — Arizona and New Mexico, May–June 2020
العنوان: | Serious Adverse Health Events, Including Death, Associated with Ingesting Alcohol-Based Hand Sanitizers Containing Methanol — Arizona and New Mexico, May–June 2020 |
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المؤلفون: | Danae Bixler, S. Deblina Datta, Michael Melgar, Arthur Chang, Farshad Shirazi, Luke Yip, Daniel E. Brooks, Steven A. Seifert, Steven Dudley, Susan C. Smolinske, Talia Pindyck, Kristine M. Schmit, Jennifer N. Lind, Annaliese Mayette, Kenneth Komatsu, Brandon J. Warrick, Kevin R. Clarke |
المصدر: | Morbidity and Mortality Weekly Report |
بيانات النشر: | Centers for Disease Control MMWR Office, 2020. |
سنة النشر: | 2020 |
مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Health (social science), Epidemiology, Hand Sanitizers, New Mexico, Health, Toxicology and Mutagenesis, media_common.quotation_subject, Poison control, Alcohol, Alcohol use disorder, Eating, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Hand sanitizer, Health Information Management, Hygiene, 030225 pediatrics, Internal medicine, medicine, Humans, Full Report, 030212 general & internal medicine, Fomepizole, Aged, media_common, business.industry, Methanol, Poisoning, Arizona, Isopropyl alcohol, General Medicine, Middle Aged, medicine.disease, chemistry, Methanol poisoning, Female, business, medicine.drug |
الوصف: | Alcohol-based hand sanitizer is a liquid, gel, or foam that contains ethanol or isopropanol used to disinfect hands. Hand hygiene is an important component of the U.S. response to the emergence of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). If soap and water are not readily available, CDC recommends the use of alcohol-based hand sanitizer products that contain at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol) in community settings (1); in health care settings, CDC recommendations specify that alcohol-based hand sanitizer products should contain 60%-95% alcohol (≥60% ethanol or ≥70% isopropanol) (2). According to the Food and Drug Administration (FDA), which regulates alcohol-based hand sanitizers as an over-the-counter drug, methanol (methyl alcohol) is not an acceptable ingredient. Cases of ethanol toxicity following ingestion of alcohol-based hand sanitizer products have been reported in persons with alcohol use disorder (3,4). On June 30, 2020, CDC received notification from public health partners in Arizona and New Mexico of cases of methanol poisoning associated with ingestion of alcohol-based hand sanitizers. The case reports followed an FDA consumer alert issued on June 19, 2020, warning about specific hand sanitizers that contain methanol. Whereas early clinical effects of methanol and ethanol poisoning are similar (e.g., headache, blurred vision, nausea, vomiting, abdominal pain, loss of coordination, and decreased level of consciousness), persons with methanol poisoning might develop severe anion-gap metabolic acidosis, seizures, and blindness. If left untreated methanol poisoning can be fatal (5). Survivors of methanol poisoning might have permanent visual impairment, including complete vision loss; data suggest that vision loss results from the direct toxic effect of formate, a toxic anion metabolite of methanol, on the optic nerve (6). CDC and state partners established a case definition of alcohol-based hand sanitizer-associated methanol poisoning and reviewed 62 poison center call records from May 1 through June 30, 2020, to characterize reported cases. Medical records were reviewed to abstract details missing from poison center call records. During this period, 15 adult patients met the case definition, including persons who were American Indian/Alaska Native (AI/AN). All had ingested an alcohol-based hand sanitizer and were subsequently admitted to a hospital. Four patients died and three were discharged with vision impairment. Persons should never ingest alcohol-based hand sanitizer, avoid use of specific imported products found to contain methanol, and continue to monitor FDA guidance (7). Clinicians should maintain a high index of suspicion for methanol poisoning when evaluating adult or pediatric patients with reported swallowing of an alcohol-based hand sanitizer product or with symptoms, signs, and laboratory findings (e.g., elevated anion-gap metabolic acidosis) compatible with methanol poisoning. Treatment of methanol poisoning includes supportive care, correction of acidosis, administration of an alcohol dehydrogenase inhibitor (e.g., fomepizole), and frequently, hemodialysis. |
تدمد: | 1545-861X 0149-2195 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::42b6eeb3c587b3b9a203027121ecba3f https://doi.org/10.15585/mmwr.mm6932e1 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....42b6eeb3c587b3b9a203027121ecba3f |
قاعدة البيانات: | OpenAIRE |
تدمد: | 1545861X 01492195 |
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