Prof. Hovda: Methanol is a silent but deadly weapon

Organized in collaboration with Istanbul Medipol University School of Medicine, University of Oslo, Emory University, and MENATOX, the “Methanol Outbreak Awareness Symposium” brought together experts in the field. The symposium, held at the South Campus Conference Hall, addressed the epidemiological map of methanol poisoning, its pathophysiology, and diagnostic and therapeutic approaches. Issues such as public awareness, legislation, antidote stock management, and the effectiveness of referral chains were also discussed in detail.

The international symposium was chaired by Istanbul Medipol University Secretary General Assoc. Prof. Semih Korkut, while the organizing committee included Istanbul Medipol University Vocational School of Health Services (VSHS) Director Prof. İlknur Keskin and International Medical School Vice-Dean Prof. Mesut Yılmaz. The event featured speakers, including University of Oslo University Department of Acute Medicine Faculty Member and Clinical Toxicologist Prof. Knut Erik Hovda, MENATOX President Dr. Badria Alhatali, and Health Sciences University Emergency Medicine Clinic Faculty Member and Medical Toxicologist Assoc. Prof. Aynur Şahin.

ASSOC. PROF. KORKUT: EMERGENCY MEDICINE MUST TRANSFORM      
The opening speech of the event was delivered by Istanbul Medipol University Secretary General Assoc. Prof. Semih Korkut, who stated that during his 27-year career he has witnessed the great transformation of first aid and emergency medical services in Türkiye. Sharing this transformation with a personal anecdote, Assoc. Prof. Korkut said: “In 1986, we called an ambulance for my mother. At that time, we were in Balıkesir; in other words, we were not in a hard-to-reach place like our eastern regions. However, the ambulance arrived exactly 24 hours later. The vehicle that arrived was a white pickup truck, and there was only one personnel in it. Today, we have one of the largest emergency health systems in the world. Of course, there are still areas that we need to improve, but the distance we have covered cannot be denied.”

Emphasizing that he has worked in the field of emergency services for many years, including the Ministry of Health/Emergency Health Services General Directorate, Assoc. Prof. Korkut said: “During this process, I took part in the teams that prepared the legislation. Together with my colleagues, we made serious efforts to prepare the regulations. These efforts have created a solid foundation for us to achieve better points in the future, but now emergency medicine needs to undergo a transformation. Our emergency physicians must go beyond being the first responders to the patient. We must also become competent in areas, such as disaster management, toxicology, crisis moments, and psychological support. Emergency medicine must become a field that not only works in the field, but also acts with disaster awareness and provides direction.”

PROF. YILMAZ: EVERY HOUR MEANS THE DIFFERENCE BETWEEN LIFE AND PERMANENT DAMAGE     
Prof. Mesut Yılmaz, Vice-Dean of the International School of Medicine, also noted that methanol poisoning has become a global public health problem. Prof. Yılmaz said: “Methanol, which is illegally produced and mixed with counterfeit alcohol, has caused devastating epidemics in many regions from Central America to Southeast Asia. Unfortunately, we are also seeing similar cases in various cities in Türkiye.” Stressing that methanol poisoning can lead to serious consequences such as optic nerve damage and multiple organ failure, Prof. Yılmaz said: “Every hour between exposure and diagnosis means the difference between life and permanent damage and indicated that early diagnosis and effective treatment protocols are of crucial. Prof. Yılmaz concluded his speech as follows: “When methanol takes a life in Nairobi, Jakarta, Izmir or Oslo, we all feel this loss. Let today be the first step to act with a common consciousness.”

PROF. HOVDA: METHANOL IS A SILENT KILLER    
One of the keynote speakers of the symposium, Clinical Toxicologist Prof. Knut Erik Hovda from the University of Oslo, said that methanol poisoning is not limited to economic poverty, but is a threat affecting the entire world. Prof. Hovda added that “Methyl alcohol is not only a problem for Türkiye, but for the entire world” by emphasizing that the deaths of tourists, which are often reported in the media, do not reflect the depth of the problem. Stating that poisoning usually occurs within 12-24 hours, and sometimes even longer, Prof. Hovda explained that symptoms include chest and abdominal pain, rapid breathing, vomiting, visual disturbances, and brain damage. Noting that late diagnosis increases the mortality rate, he said: “If the patient reaches us in time, no matter how much methanol they have taken, it is possible to restore their health with treatment.” Underlining the importance of a four-stage chain in the fight against methanol, Prof. Hovda listed these stages as “awareness”, “knowledge and rapid diagnosis”, “effective treatment”, and “emergency preparedness plans”. Prof. Hovda concluded his speech as follows: “Methanol continues to spread as a silent but deadly weapon. This is the collective responsibility of not only health professionals but also community leaders, legislators, and individuals.”

DR. ALHATALI: OUTBREAKS OF COUNTERFEIT ALCOHOL HAVE REACHED HIGH LEVELS IN THE LAST 25 YEARS   
Speaking at the symposium, Dr. Badria Alhatali, President of the Middle East and North Africa Clinical Toxicology Association (MENATOX), said that according to the World Health Organization, 56.2 percent of the alcohol consumed in the Eastern Mediterranean region is unregistered. Emphasizing that this type of alcohol is produced, distributed, and sold in an untaxed and uncontrolled manner, Dr. Alhatali noted that methanol-related deaths are increasing in MENA countries.

Noting that many people are reluctant to seek health care for cultural, religious, and legal reasons, Dr. Alhatali said that the highest methanol outbreaks in the past 25 years were in Pakistan, Iran, and Morocco, and the highest death toll was in Iran.

Stating that the false information spread during the pandemic period increased alcohol consumption, Dr. Alhatali said that methanol poisonings also increased significantly during this period. Noting that more than 2,500 cases and more than 500 deaths were reported in just four weeks, Dr. Alhatali added that people consumed alcohol to protect themselves from COVID-19, to receive treatment or to escape the stress of quarantine, but most of them were unaware that they were drinking counterfeit alcohol.

At the end of her speech, Dr. Alhatali emphasized that early awareness plays a vital role in preventing epidemics and said: “As long as society does not realize that what is happening is a public health crisis, these epidemics will continue to silently claim more lives.”

ASSOC. PROF. ŞAHİN: OUR HEALTH INFRASTRUCTURE IS STRONG, BUT OUR AWARENESS IS LACKING 
Assoc. Prof. Aynur Şahin from the Health Sciences University stated that Türkiye is among the top 10 countries in the world in terms of methanol poisoning cases. Assoc. Prof. Şahin stated that the main reasons are the tendency to smuggle alcohol for economic reasons, illegal production, and the wide accessibility of these products in society, and that lack of social awareness, social pressure, and lack of information are also among the factors that make the process difficult.

Stressing that Türkiye has a strong infrastructure in terms of emergency health services, Assoc. Prof. Şahin stated that despite the 112-emergency network and hospital system being developed, there are some deficiencies in terms of rapid diagnosis and effective treatment of methanol poisoning. The fact that toxicology tests are not widely used in emergency services and that some antidotes are not available due to high costs are among the most important problems. Noting that critical antidotes such as fomepizole are unavailable in Türkiye, Assoc. Prof. Şahin stated that encouraging the domestic production of such products and stocking them in strategic hospitals is of vital importance. Stating that “these deaths are preventable”, Assoc. Prof. Şahin emphasized that Türkiye could significantly reduce this public health problem if diagnosis, treatment, prevention, and professional training were addressed as a whole.