Nigeria Mystery Outbreak Solved

On April 13, 2015 an outbreak of a mysterious disease began in Ondo, Nigeria [1-6]. By April 16, the unknown disease spread swiftly across the Ode-Irele community within Ondo, resulting in a total of 25 cases and 18 deaths [1-6]. All cases were male and between the ages of 22 and 75 years of age [1,5]. The remaining five cases are currently being treated at the University College Hospital in Ibadan, Nigeria [1]. Symptoms of this mysterious disease include the rapid onset of a severe headache and blurred vision, followed by sudden blindness, loss of speech, unconsciousness and sudden death – all happening within 48 hours of symptom onset [1-3,5].

Naturally, such an outbreak has caused a great deal of panic within the Ondo-Irele community [4]. Community members initially suspected Ebola, but this was quickly repudiated. Health officials believed the mystery disease was unlikely to be Ebola because the cases were not showing the classic Ebola symptoms of diarrhea and vomiting. This belief was confirmed when laboratory tests came back negative for Ebola [4,6].

The World Health Organization (WHO) was notified on April 15 [6]. Preliminary reports from the WHO stated that a cluster of cases with rapid symptom onset and disease evolution is suggestive of poisoning, rather than an infectious pathogen [6]. Consequently, the WHO initially speculated that this mystery outbreak was the result of pesticide poisoning [1,6]. Post-mortem test results have confirmed that the cause of deaths were not due to an infectious agent [3].

The Nigerian government has since released a statement indicating the cause of this mystery outbreak as methanol poisoning [1].

Methanol Poisoning

Post-mortem toxicology results have shown that the 18 confirmed deaths were in fact due to methanol poisoning [1-3,5]. Epidemiologists were able to link the outbreak to the consumption of a local alcoholic beverage, “Ogogoro” [1,6]. The locally brewed beverage, consisting of gin, local roots and other herbs, was contaminated with methanol [1-3,5-6]. The WHO discovered that 71% of the cases had consumed this locally brewed gin [6].

Methanol is a toxic alcohol used primarily for industrial and automotive purposes [7]. The active ingredient, methyl alcohol, is colorless, flavorless and odorless, but is extremely poisonous if ingested or inhaled by humans [7]. Methanol poisoning can occur from consuming informally made or “home-brewed” alcoholic beverages contaminated with methanol [6-7]. Improperly distilled liquor can lead to the production of Methanol. Methanol poisoning and symptoms occur as a result of methanol’s metabolic by-products [7]. These by-products cause acidosis or the accumulation of acid within the blood, which results in drowsiness, confusion, and blindness [7]. As the acid accumulates in the blood, the toxicity worsens, becoming more severe as time goes on [7]. If left untreated, methanol poisoning quickly leads to death.

On Monday, April 27, 2015 the Nigerian government stated that the poisoning cluster is currently under control [1]. Fidelis Nwankwo, Nigeria’s Minister of State for Health, stated that there have been no deaths in the past 72 hours and no new cases in 100 hours [1-2,5]. Methanol may have been present in “Ogogoro” due to the unregulated distillation process for home-brewed alcohol or because of the deliberate addition of methanol to increase the gin’s potency [6]. A similar methanol poisoning outbreak occurred in Mozambique in January 2015, resulting in over 73 deaths [6]. The government has since advised residents against consuming “Ogogoro” [1].

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Sources:

Nigeria Mystery Outbreak Solved

Methanol Poisoning

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