Over the weekend a Kiwi tourist suffered what is suspected to be methanol poisoning, with the man's partner fearing it was from tainted alcohol served at a reputable venue.
"It was touch and go on Saturday," Colin Ahearn, a well-known safe drink advocate for Bali tourists, who the couple quickly contacted looking for help, told Yahoo News Australia.
"He was convulsing on the toilet, almost having a fit. He was that messed up when he got back. He's a big bloke as well, weighing more than 100kg."
The man had been out drinking with friends before his condition rapidly deteriorated and he had trouble breathing and he became incoherent.
His partner was "terrified" by what Mr Ahearn said were tell-tale signs of methanol poisoning.
While rare, methanol poisonings have been an obscure and ugly offshoot of capitalism on the holiday island, with a small percentage of those looking to cash in on the hospitality industry cutting corners and allegedly using bootleg liquors.
Methanol is a dangerous byproduct of the distillation process and on occasion isn't properly removed when bootleg spirits are made, and in-turn poisoning unwitting patrons.
Mr Ahearn, like he has done countless times before, took the couple through a step-by-step guide what to do next, including the important process of consuming ethanol, which he says is best from duty-free spirits, which counteracts the methanol.
Thankfully, the man's condition began to improve and he appears to have avoided any long-term consequences.
Fears methanol poisoning is being mistaken for 'Bali belly'
But Mr Ahearn fears Australians' Covid-enforced break from Bali has set back efforts to educate travellers on the dangers of drinking spirits on the island, and wants tourists to be aware of the threat so they can make their own choices.
He also fears some people are wrongly self-diagnosing their symptoms as 'Bali belly' – a sickness involving gastro-inducing viruses which are on the rise in Australia.
"You wonder how many people get a dose [of methanol] and don't make that connection or keep their mouths shut... it'd be the vast majority [of cases] I'd bet," Mr Ahearn said.
Discussions around methanol poisoning resurfaced briefly earlier this year following the suspicious death of Sydney man Charlie Bradley, whose family pointed to tainted drinks as a possible explanation for his death. However Mr Ahearn, despite having no medical qualifications, said he did not suspect methanol poisoning to be the cause of death from his experiences assisting dozens of cases over the years.
Methanol poisoning can be deadly, and previous reports suggest it kills hundreds of Indonesians every year. However there are fears the cause of methanol deaths are often wrongly attributed to other causes.
Australian-Kiwi teenager Liam Davies notably died from methanol poisoning in 2013 after consuming replica vodka-based drinks on the nearby Gili Islands, while a Fiji expat in Bali died last year in what was feared to be methanol poisoning. The drink she consumed however was a homemade concoction.
What are the symptoms of methanol poisoning?
Methanol is odourless and tasteless and people can often mistake its effects with the consumption of alcohol, according to the World Health Organisation.
With its consumption alongside ethanol, there is a delay in metabolism resulting in a delay in the “onset of toxicity for many hours”.
Symptoms include drowsiness and victims may become unsteady and disinhibited.
As time passes, those affected may suffer headaches, as well as vomiting and shortness of breath.
In the worst cases, methanol poisoning can cause blindness and death from respiratory arrest.
It takes just 60ml of methanol to kill someone. Mr Ahearn's best advice to avoid methanol poisoning is to only drink pre-mixed drinks, duty-free spirits or beer and wine.
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