Federal health authorities issued a formal warning on Wednesday about the dangers of drinking hand sanitizer and alerted poison control centers across the nation to be on the lookout for cases of methanol toxicity after four people died and nearly a dozen became ill.
From May 1 to June 30, 15 people in Arizona and New Mexico were treated for poisoning after they swallowed alcohol-based hand sanitizer, the Centers for Disease Control and Prevention said.
Three of the patients sustained visual impairments, according to the C.D.C., which said that drinking hand sanitizer can cause methanol poisoning. Methanol is a type of alcohol commonly found in fuel products, antifreeze, industrial solvents and in some preparations of hand sanitizer that federal health officials said is harmful and should not be used.
Hand sanitizer has become an ubiquitous and often scarce substitute for hand washing during the coronavirus pandemic. The C.D.C. has recommended the use of ethyl alcohol- or isopropyl alcohol-based hand sanitizer if soap and water are not readily available.
“Alcohol-based hand sanitizer products should never be ingested,” the C.D.C. said in the advisory on Wednesday.
It was not immediately clear if any of the people who were poisoned drank the hand sanitizer for its disinfectant properties. The C.D.C. said some adults had consumed it for its alcohol content.
Health officials warned that drinking hand sanitizer made with either methanol or ethanol could cause a headache, blurred vision, nausea, vomiting, abdominal pain, loss of coordination and decreased level of consciousness. Methanol poisoning can additionally result in metabolic acidosis, seizures, blindness and death, they said.
“Swallowing alcohol-based hand sanitizer products containing methanol can cause life-threatening methanol poisoning,” the C.D.C. said. “Young children might unintentionally swallow these products, whereas adolescents or adults with history of alcohol use disorder might intentionally swallow these products as an alcohol (ethanol) substitute.”
Last week, the Food and Drug Administration, which regulates hand sanitizers, announced that it had placed methanol-based hand sanitizers manufactured in Mexico on an import alert because of their toxicity. It also said it was working with retailers to recall that type of hand sanitizer and remove those products from marketplaces. With a round of new warnings, the agency’s list of hand sanitizers that consumers should avoid grew to 115 products. Some were cautioned against because of methanol content, others because of manufacturing processes or low levels of ethyl alcohol.
“Consumers must also be vigilant about which hand sanitizers they use, and for their health and safety we urge consumers to immediately stop using all hand sanitizers on the FDA’s list of dangerous hand sanitizer products,” Dr. Stephen M. Hahn, the agency’s commissioner, said in a statement on July 27.
In June, the New Mexico Department of Health announced that three people had died, three were in critical condition and one was permanently blind after ingesting hand sanitizer that contained methanol.
A spokesman from the health department said at the time that the cases were related to alcoholism, noting that hand sanitizer was sometimes consumed for its high alcohol content.
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In 2016, a former Wells Fargo employee drew widespread attention after she told The New York Times that she had been under so much stress at her job during a banking scandal that she drank hand sanitizer and became addicted to it.
The rise in poisoning cases of people who drank hand sanitizer drew the attention of public health researchers, who wrote about it in a 2012 report.
Dr. Anthony F. Suffredini, a senior investigator at the National Institutes of Health and an author of the report, described the case of a 17-year-old hospital patient who became acutely ill after putting hand sanitizer into his feeding tube while being treated for other medical problems. The boy required mechanical ventilation to assist with his breathing and dialysis to rid his blood of the alcohol.
“This young man, who was from the South, mentioned that among his circle of friends, who were all underage, if they couldn’t find alcohol any other way, this was one of the ways they tried to get high,” Dr. Suffredini said at the time.