Gujarat doctors race against metabolism to save those who drank toxic liquor

On August 18, the first victim of the Bhavnagar liquor tragedy in Gujarat, a 'dry state' since the 1960s, passed away. Within six days, the death toll had risen to 13 and affected 60 people after consuming methanol-laced liquor. This incident parallels a previous 'lattha kaand' in 2022 where 42 people died across three districts of Gujarat.

Hooch tragedies in Gujarat have claimed 148 lives in Ahmedabad in 2009, 132 in Vadodara in 1989, and 101 in Ahmedabad in 1977. 'Lattha kaand' refers to loss of lives or hospitalizations due to contaminated liquor, which is often illegally marketed and sold as country liquor or moonshine. In the Bhavnagar incident, 300 bottles of 750ml each containing 38.59% methanol were sold to bootleggers.

Symptoms of methanol poisoning include nausea, vomiting, vision impairment, and breathlessness, appearing within 2-4 hours, but potentially immediately with large consumption. Patient zero, Kartik Ashwin Makwana, was admitted the day before and hospitalized retrospectively after doctors suspected hooch tragedy. He died later. Methanol breaks down into formaldehyde and formic acid in the body, causing acidosis and multi-organ failure.

Treatment includes ethanol or fomepizole to inhibit methanol metabolism, followed by folic acid or folinic acid to break down formic acid. In the Bhavnagar tragedy, many patients delayed seeking help, and hospitals have received supplies of fomepizole and procured more for distribution.