The taste offered no warning. For Bethany Clarke, the free shots served at a hostel bar in Vang Vieng, Laos, seemed innocuous, perhaps even watered down. Mixed with Sprite, she detected no bitter aftertaste, no tell-tale sting. She recalls drinking about five that evening with her best friend, Simone White, laughing under the coloured lights of the open bar.
Within 24 hours, that happy hour had become a living nightmare. Both women were in hospital. Shortly after, Simone White was dead, one of six tourists killed in the 2024 Laos methanol poisoning incident.
A Hidden Global Killer
This tragic case is a high-profile example of what experts describe as a massive, hidden global crisis. Methanol, a cheap and toxic industrial alcohol, is increasingly contaminating the world's alcohol supply chain, causing thousands of deaths and severe injuries like permanent blindness.
Dr Knut Erik Hovda, an international expert on methanol poisoning from the University of Oslo, calls it a "forgotten" problem. "It's huge, and it keeps just disappearing, and then it crops up again in a different place, when you have your guard down," he stated.
Data compiled by Oslo University Hospital and Médecins Sans Frontières (MSF) reveals the staggering scale:
- Documented incidents in nearly 80 countries.
- Over 1,000 poisoning incidents.
- More than 41,000 poisoned individuals.
- At least 14,600 recorded deaths.
Dr Hovda emphasises that these figures represent "only the tip of the iceberg," with many outbreaks going unreported or misdiagnosed.
The Aftermath of a Poisoned Drink
Bethany Clarke, who is from the UK but was living in Brisbane, describes the horrific aftermath with blunt clarity. Assuming they had severe hangovers, their condition worsened on a tour bus, leading to vomiting and Clarke fainting. After a debate over the cause, they sought hospital treatment.
In the ward, the grim reality set in. Clarke watched her friend's condition deteriorate, hearing her breathing shift to short gasps. Doctors delivered the devastating news that White's brain was swelling, crushing her skull. Her life support was turned off on 21 November.
Clarke and at least six others survived the Laos incident, though one was left blinded by the toxin's attack on the optic nerve. She is now campaigning for greater awareness of the dangers.
Beyond Tourists: A Crisis for the Poor and Disenfranchised
While travel warnings now cover 38 countries, including 11 recent additions flagged by the UK government, the vast majority of victims are local populations. The poor and disenfranchised are most at risk, often consuming cheap, illicit alcohol when legitimate spirits become too expensive due to high taxation or cultural taboos.
This pattern is starkly visible around the world:
In Turkey, where taxes on spirits can make a bottle of raki cost £28 against a minimum wage of £470, a parallel illicit market is thriving. A series of poisonings there has killed more than 160 people. Gökhan Genç, an Ankara resident, lamented, "It's become normalised."
In Iran, about 10,000 people have been recorded as killed by methanol poisoning over the past two decades. In India, another 6,500 deaths have been documented, primarily affecting the rural poor.
In Brazil, Rafael dos Anjos Martins Silva, 27, died after drinking contaminated gin bought from a licensed shop. His mother, Helena, described his final moments: "His last breath was in my arms." Brazil has seen 16 confirmed deaths from methanol this year, well above its historical average.
A Treatable Tragedy
One of the greatest tragedies of methanol poisoning is that it is highly treatable if identified early. "As long as I get hold of you early enough, I can make sure you walk out of my hospital within a couple of days and be completely fine," Dr Hovda explained.
There are two effective antidotes:
- Fomepizole: The best clinical treatment, but often prohibitively expensive at over $1,000 per dose.
- Ethanol (drinking alcohol): Counterintuitively, consuming ethanol halts the body's conversion of methanol into toxic formic acid. Beer, wine, or spirits can be used as a first-aid measure until proper medical care is accessible.
Dr Hovda recalled a successful mass treatment in Kenya, where 35 men were served an alcoholic drink every two hours in the ward. "Five were blind before treatment started, but all survived," he said.
The challenge lies in the "big imitator" nature of the poisoning. Symptoms, which can include vomiting, dizziness, and vision changes, often don't manifest for 12-24 hours, leading people and medical professionals to misdiagnose the condition as a hangover, food poisoning, or a virus.
For survivors like Bethany Clarke and the families of victims like Simone White, the campaign continues—not just for awareness among travellers, but for a global recognition of a public health crisis happening largely out of the spotlight.
