Costa Rican officials have issued a national alert after at least 19 people died after consuming alcohol that was contaminated with toxic levels of methanol.
The victims, 14 men and five women, died after consuming the adulterated liquor between June and July. They ranged in age from 32 to 72, the health ministry said.
The government has since seized around 30,000 bottles that are believed to be counterfeit. These bottles were marked with the labels of “Guaro Gran Apache,” “Red Star Brandy,” “Guaro Montano,” “Aguardiente Barón Rojo,” ” Aguardiente Timbuka,” and “Aguardiente Molotov.”
These alcohol brands are registered with the country’s Ministry of Health so it’s suspected that they are counterfeit products.
Health officials are asking the public to not consume or sell any of those products if they cannot be confirmed as authentic and coming straight from the manufacturer.
The World Health Organization, which has followed similar incidents around the world over the years, further advises the public to be suspicious of alcoholic products that are offered for sale in informal settings, at cheap prices, or in places not licensed to sell alcohol, like market stalls.
“Unregulated alcoholic drinks are generally very cheap and are therefore attractive to people with low incomes, particularly those who are alcohol dependent,” WHO stated in a release. “Consumers may choose these drinks because of their low cost compared to taxed alcohol.”
WHO also recommends avoiding products that have broken seals, that are not labeled, or that have labels that have typographical errors or that have been poorly printed.
According to health officials, methanol can form in alcohol due to incorrectly managed distillation processes. It is sometimes also deliberately added to products to make consumers feel inebriated with less actual alcohol added.
Once consumed, the body metabolizes methanol into formaldehyde and formic acid, which humans have a limited ability to detoxify, in turn, creating harmful effects, according to the WHO.
“In the first few hours the patient may become drowsy, unsteady and disinhibited; however, since poisoning often occurs in the context of drinking alcohol this may not be noticed. After a variable period of time victims start to develop headache, vomiting, abdominal pain and vertigo,” WHO stated.
Consumers can then start to hyperventilate and feel breathless, have their vision impacted, sometimes causing blindness. Coma, concussions and death from respiratory arrest can then folllow.
“Patients who survive may suffer permanent visual impairment,” WHO warned.
Back in February, at least 150 people in India died and more than 200 others were hospitalized after they consumed bootleg alcohol that was tainted with methanol, according to reports at the time.
At the time, it was the second mass outbreak of alcohol poisoning in India within weeks, NPR reported. Another incident a month earlier left more than 100 others dead.
This article originally appeared on HuffPost.