title: Methanol mass poisoning in Iran: role of case finding in outbreak management.
abstract: BACKGROUND
  There are no guidelines addressing the public health aspects of methanol poisoning during larger outbreaks. The current study was done to discuss the role of active case finding and a national guideline that organizes all available resources according to a triage strategy in the successful management of a methanol mass poisoning in Rafsanjan, Iran, in May 2013.
  
  
  METHODS
  A retrospective cross-sectional study was performed reviewing the outbreak Emergency Operation Center files. The objectives were to describe the characteristics, management and outcome of a methanol outbreak using Active Case Finding to trace the victims.
  
  
  RESULTS
  A total of 694 patients presented to emergency departments in Rafsanjan after public announcement of the outbreak between 29th May and 3rd June 2013. The announcement was mainly performed via short message service (SMS) and local radio broadcasting. A total of 361 cases were observed and managed in Rafsanjan and 333 were transferred to other cities. Seventy-five and 100 patients underwent hemodialysis (HD), retrospectively. The main indication for HD was refractory metabolic acidosis. Eight patients expired due to the intoxication. Except for the deceased cases, no serum methanol level was available.
  
  
  CONCLUSIONS
  In developing countries, where diagnostic resources are limited, use of active case finding and developing national guidelines can help in the management of large outbreaks of methanol poisonings.
authors.affiliation: Toxicological Research Center, Loghman-Hakim Hospital, Kamali Ave, South karegar Street, Tehran 13336, Iran Department of Clinical Toxicology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hassanian-Moghaddam
authors.affiliation: Ministry of Health, Mental and Social Health and Substance Abuse office, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Nikfarjam
authors.affiliation: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Mirafzal
authors.affiliation: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Saberinia
authors.affiliation: Iran-Helal Institute of Applied Sciences and Technology, Tehran, Iran.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Nasehi
authors.affiliation: Department of Pediatric Infectious Disease, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Masoumi Asl
authors.affiliation: Ministry of Health, Mental and Social Health and Substance Abuse office, Tehran, Iran.
authors.forename: Nadereh
authors.initials: N
authors.lastname: Memaryan
mesh_terms: D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D000432:Methanol / Q000506:poisoning*; D011041:Poisoning / Q000453:epidemiology* / Q000401:mortality; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D000432:Methanol
keywords: epidemics; intoxication; methanol; mortality; outbreak; poisoning