Overview

• CIEVS has logged more than 40 suspected poisonings in São Paulo and Pernambuco with one death confirmed and seven additional fatalities under investigation.
• Experts and international monitors say recent cases are consistent with adulterated or clandestinely produced alcoholic beverages that contain methanol, either by fraud or distillation errors.
• Methanol is converted in the liver to formaldehyde and then formic acid, which drives severe metabolic acidosis and selective optic nerve injury that can progress from mild early symptoms to irreversible vision loss and organ failure.
• Antidotal therapy focuses on blocking metabolism with ethanol or fomepizole, though fomepizole lacks registration in Brazil and the health minister is evaluating a PAHO-backed strategic reserve to improve access.
• Severe intoxication may require hemodialysis to rapidly clear toxins, and toxicology centers (32 CIATox nationwide, nine in São Paulo) advise immediate care since as little as 10 ml can cause blindness and about 30 ml can be lethal.