Six backpackers have died over a suspected methanol poisoning in Laos, but tainted drinks aren’t just a risk in south-east Asia.
British lawyer, Simone White, 28, has died following reports that several people had become ill in the popular Laotian town of Vang Vieng. Two Danish travellers, an American, and two Australian friends, Bianca Jones and Holly Bowles, both 19, have also died over an alleged alcohol poisoning in the south-east Asian country.
Police in Laos have detained the manager and owner of a hostel in connection with the six deaths, who has refuted claims. Duong Duc Toan, manager of the Nana Backpacker Hostel, said staff were told by other guests that Ms Bowles and Ms Jones were unwell after they failed to check out as planned on November 13, and they arranged transport to a hospital for them.
He said the women had joined more than 100 other guests for free shots of Lao vodka offered by the hostel two days earlier as he claimed to only buy alcohol from legitimate sellers. Ms White was also allegedly among the group having shots.
Thai authorities confirmed Ms Jones died earlier this week because of a “brain swelling due to high levels of methanol found in her system”. On Friday, it was confirmed that her friend, Ms Bowles, has also died after drinking tainted alcohol in Laos, her family said.
Each of the six travellers in the town are believed to have consumed drinks tainted with methanol, which is sometimes added to mixed-drinks at disreputable bars as a cheaper alternative to ethanol, but can cause severe poisoning or death. Australian Foreign Minister Penny Wong said: “Drink spiking and methanol poisoning are far too common in many parts of the world. At this time I would say to parents, to young people, please have a conversation about risks, please inform yourselves, please let’s work together to ensure this tragedy doesn’t happen again.”
Counterfeit alcohol hotspots
In countries with more relaxed regulation on liquor, methanol is sometimes illegally added to alcoholic drinks at disreputable bars as a cheaper alternative to ethanol. Parts of Indonesia with popular tourist strips have been found to sell counterfit alcohol in areas such as Bali, Lombok and Sumatra.
Essex backpacker Cheznye Emmons, 23, was fatally poisoned after drinking counterfeit gin, which she bought from a shop in a sealed bottle sporting a familiar brand, while travelling in Indonesia in 2013. But it isn’t just Laos and Indonesia tourists need to be concerned about, as according to guidance published on the UK’s Foreign, Commonwealth and Development Office (FCDO) website, Brits and expats need to be aware of the risk of methanol poisoning in Costa Rica and Vietnam.
Brits have also reported methanol poisoning in Greece, where most notably, Hannah Powell, from Middlesbough, aged just 21 at the time, suffered kidney failure and blindness after drinking a vodka cocktail with methanol whilst holidaying on the island of Zakynthos in 2016.
Year-round favourite holiday destination Turkey has also been dubbed as a hotspot to watch. Local media in Turkey have reported travellers being hospitalised after unknowingly drinking alcohol spiked with methanol.
Back in 2011, four Russian tourists died and two dozen more were ill after they consumed tainted whisky served on a yacht. Authorities arrested 22 people and seized thousands of bottles of spiked spirits after shutting down an organised group supplying the counterfeit goods. Meanwhile Australian officials have also warned travellers of Thailand and Cambodia to be aware of fake alcohol.
Methanol poisoning symptoms
Methanol is the simplest form of alcohol – it’s a highly flammable liquid but it is colourless and odourless, meaning it’s hard to spot when mixed in drinks. It is not for consumption and is instead used as an industrial product, for things like paint strippers, aerosol cans, dyes, and petrol.
Unfortunately, the signs of methanol poisoning can take up to 12 hours to appear. If ingested, it can cause blindness, kidney failure, seizures and death. Symptoms include: Headache, dizziness, vomiting, seizures, abdominal pain and impaired vision. Fatality rates are as high as 50 per cent, with just half a shot (15ml) proving to be deadly.
It appears Ms White was travelling with her friend, Bethany Clarke, a healthcare worker also from Orpington, Kent, who took to the Laos Backpacking Facebook group to warn other travellers before Simone’s passing.
She said: “Urgent — please avoid all local spirits. Our group stayed in Vang Vieng and we drank free shots offered by one of the bars. Just avoid them as so not worth it. Six of us who drank from the same place are in hospital currently with methanol poisoning.”
Ms Clarke added that she became “very fatigued and then fainted, then just felt nauseous and then my liver started to shut down”. She continued: “I got to the private hospital in time but underwent many infusions and tablets and days of recovery.”
Lethal health risks
Professor Alastair Hay, professor of environmental toxicology at Leeds University, explained how methanol can affect the body in two ways – as an acid and by attacking nerves. “The risk from methanol is twofold. Methanol breaks down in the body to formaldehyde and then formic acid. The formic acid upsets the acid/base balance in blood and the major consequence is initially the effect on someone’s breathing,” he said.
“There are effects on many other organs, the kidney being one. The disturbance of acid/base balance and disrupted breathing will eventually affect the heart and it will stop functioning. Formaldehyde attacks nerves, particularly the optic nerve and blindness is a potential risk.”
Professor Hay said ethanol is a treatment for the poisoning as it delays the methanol metabolism. He continued: “Depending on the severity of poisoning, treatment may require dialysis to remove methanol from blood whilst at the same time keeping someone mildly drunk by administering ethanol. If the poisoning is not too severe, and only blood tests will determine this, ethanol alone may suffice.
“The principle behind administering ethanol is quite simple; it delays methanol metabolism. Both alcohols are broken down by the same liver enzyme alcohol dehydrogenase. But the enzyme prefers ethanol. So ethanol acts as a competitive inhibitor largely preventing methanol breakdown, but markedly slowing it down, allowing the body to vent methanol from the lungs and some through the kidneys, and a little through sweat. Avoiding the formation of toxic levels of formaldehyde is key.”
Similarly Professor Oliver Jones, professor of chemistry at RMIT University, explained how methanol is a type of alcohol which is similar in structure to ethanol but far more toxic. He said: “While thankfully rare, methanol poisoning is very serious, and treatment should be given at a hospital. Methanol poisoning is treated by stopping the alcohol dehydrogenase enzyme from creating toxic by-products.
“This can be accomplished by either using a drug to inhibit the enzyme directly or by giving the patient ethanol. In the latter case, the alcohol dehydrogenase enzyme is essentially too busy processing the ethanol to process the methanol into the dangerous byproducts. Dialysis of the blood to remove both the methanol and toxic breakdown products can also be an option.”
Tips on staying safe
NHS Choices state the following to help you reduce your risk of methanol poisoning:
- If the price of your alcoholic drink looks too good to be true, it probably is.
- Buy alcoholic drinks from a reputable vendor and check bottle seals are intact.
- Be suspicious of alcoholic drinks offered for sale in informal settings that are not licensed to sell alcohol, such as market stalls.
- Steer clear of alcoholic drinks sold in unlabelled containers.
- Check branded products for labels that are poorly printed or with errors, or bottles with broken seals. Do not buy these.
