Illness from fuel ingestion mistaken for pneumonia in refugees

Refugees fleeing across the Mediterranean by boat face acute and sometimes fatal cases of pneumonitis after ingesting fuel, a condition that is often mistakenly diagnosed as common bacterial pneumonia, a new study has found for the first time.
The research at Technical University of Munich in Germany and Jamaica Hospital in the US is intended to raise awareness of this illness among doctors treating refugees.
Last year, more than one million people fleeing war and expulsion came to Europe. Every week the dangerous crossing of the Mediterranean claims the lives of many refugees.
The wave of migration is also changing the everyday work of medical practitioners.

Along with the inadequate medical care in most African countries and the illnesses the refugees bring with them, the flight itself harbours life-threatening risks: human smuggling and the crossing from Libya to Greece or Italy often take place under horrendous conditions.
The risks involved in crossing the sea in rubber dinghies are well known. However, another danger has so far gone unnoticed: the ingestion of fuel.

In some cases, smugglers force their passengers to take mixtures containing engine fuel in order to sedate them.
The health risks are serious: Gasoline consists of aromatic hydrocarbons and can cause severe inflammation of the lungs and other types of poisoning.

A particular source of concern is the fact that the symptoms such as fever and shortness of breath initially resemble those of a "normal" bacterial pneumonia.
Consequently, they often go unrecognised during medical treatment after the crossing. It is also impossible to recognise the cause and the severity of the illness in X-ray and CT images.
Moreover, the symptoms often do not appear until weeks later. A further aspect is the difficulty of determining causes due to language barriers between the refugees and doctors.
After careful questioning of interpreters and patients and a joint assessment of three cases, researchers succeeded for the first time in describing the suspected link between fuel mixtures and pneumonitis in refugees fleeing by boat.

One of the cases was documented by a former staff member of the hospital department working in the US. One case proved fatal.
The goal of the study is to ensure better patient care with a timely differential diagnosis to enable clinical personnel to undertake more targeted treatment efforts at an earlier stage.
The research was published in the journal Lancet.