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The family of a British backpacker who died after drinking gin which had been mixed with methanol have launched a campaign to warn travellers of the dangers of fake alcohol.
Cheznye Emmons, 23, was fatally poisoned after drinking the counterfeit gin, which she bought from a shop in a sealed bottle sporting a familiar brand while travelling in Indonesia in 2013.
Methanol (also known as methyl alcohol) is a colourless liquid with a mild alcohol odour. When ingested, it is extremely poisonous and is known to cause blindness, kidney failure, seizures and death.
The chemical is deliberately added to strengthen or stretch illegal alcoholic drinks, especially spirits, some of which are being sold in bars, shops and hotels in popular tourist areas such as Bali, Lombok and Sumatra.
The practice is common in many parts of the world. However, Indonesia has recently been singled out following a number of deaths and cases of serious illness of locals and foreigners.
Some fake alcohol on sale in Indonesia has been found to contain concentrations of methanol 44,000 times above safe levels.
Figures suggest 280 people have died from illicit alcohol poisoning since 2011 in Indonesia. Three Brits have died from methanol poisoning in the country in the last five years.
The Foreign and Commonwealth Office (FCO) advises tourists to “take extreme care when purchasing spirit-based drinks, as bottles may appear to be genuine when they are not.”
The FCO reports that there have also been cases of methanol poisoning from drinking adulterated “arak” or “arrack” - a local rice or palm liquor.
The Emmons family set up the Save a Life Campaign soon after Cheznye's death and have created a poster for GP surgeries warning people travelling to Indonesia, including Bali, of the dangers of counterfeit alcohol.
Measha Emmons, Cheznye's sister, says: "The bottle may be sealed and it may look genuine but it may still have been contaminated with methanol. You won't be able to taste the difference.”
Cheznye, who was travelling with her boyfriend, first showed signs of methanol poisoning when she woke up a day after drinking the fake gin unable to see. She died five days later in hospital.
The first signs of methanol poisoning include drowsiness, feeling unsteady and loss of inhibition, but these are often confused with the effects of drinking alcohol and may not be noticed.
It can be several hours before the major symptoms of methanol poisoning appear including:
Without prompt treatment, the poison will continue to build up and can lead to convulsions, coma and death. Patients who survive may suffer permanent visual impairment.
Methanol poisoning can be treated by giving the patient fomepizole or ethanol through an intravenous drip to try to reduce the level of poisoning and dialysis to remove toxic substances from the kidneys.
Here's a checklist to help you reduce your risk of methanol poisoning:
As you get older, it’s natural for your breasts to lose their firmness, change shape, shrink in size and become more prone to certain abnormal lumps.
In most cases, breast lumps are harmless but, whatever your age, it’s important that you report any new lumps to your doctor.
From around the age of 40, you can expect your breasts to change in size and shape. It’s normal for breast tissue to become less glandular and more fatty as you get older, which makes them feel less firm and full.
With age, there’s also an increasing risk of abnormal growths in the breast. These are often harmless breast lumps, like cysts, but they can also be a sign of serious conditions like breast cancer.
As the years go by, you might also notice a wider space between your breasts and that your breasts shrink in size, sometimes by a cup size or more (unless you put on weight, in which case your breasts may get bigger). The area around the nipple (the areola) tends to become smaller and may nearly disappear, and the nipple may turn in slightly.
Many of the breast changes that happen as you get older are caused by hormonal changes.
Declining oestrogen levels at the menopause make breast tissue dehydrated and less elastic, so that your breasts lose their once rounded shape and begin to sag.
On the plus side, you may stop having any of the premenstrual lumps, pain or nipple discharge that you used to have.
Screening for breast cancer is currently offered on the NHS to women aged 50-70 in England. However, it’s in the process of being extended as a trial to some women aged 47-73.
Breast screening uses an X-ray test called a mammogram that can spot cancers when they are too small to see or feel.
It’s your choice whether to have breast screening, but bear in mind that most experts believe it’s beneficial in picking up breast cancer early.
If you’re over 70, you’ll stop receiving screening invitations through the post, but you can still carry on with screening if you want to. To arrange an appointment, contact your local breast screening unit.
Read more about breast cancer screening.
Young women who have not yet gone through the menopause often have what’s known as dense breasts.
Dense breasts contain more glandular and less fat tissue than usual. It’s not the same as having firm breasts and it has nothing to do with how big or what shape your breasts are.
Having dense breasts isn’t abnormal and it’s not something that you can change, but a potential drawback is that dense breasts can make breast cancer screening more difficult, because the dense tissue can mask potential tumours on a mammogram.
Breast tissue tends to become less dense as you get older, especially after the menopause, so it becomes easier to detect breast cancers on a mammogram.
Breast lumps are common around the menopause. They’re usually cysts, which are harmless lumps filled with fluid. But if you notice a lump, don’t wait to be offered screening – see your GP, to rule out breast cancer.
Breast cancer is most common in women over 50. Other warning signs of breast cancer include:
Read more about breast lumps.
Women over 70 are particularly at risk of breast cancer, because a woman’s risk of getting breast cancer increases with age. Don’t assume that because you’re in your 70s or older that you’re in the clear. Always report any unusual breast symptoms to your doctor.
Find out how to spot breast lumps.
Gas safety is just as important in the summer as it is in the winter. Poorly maintained appliances and boilers can cause carbon monoxide poisoning, which can be fatal. Find out how you can keep safe.
Gas central heating may be turned off in the summer, but your boiler is still being used for hot water and, perhaps, you use a gas cooker.
Remember the barbecue, too, which is often gas. More than 40% of us own a gas barbecue and 30% of us use it weekly to produce simple meals to enjoy outdoors.
Carbon monoxide (CO) is a poisonous gas produced when fuel such as gas (or charcoal or petrol) burns incompletely. Inadequately installed or poorly maintained appliances and boilers increase the risk of carbon monoxide being produced.
You can’t see, taste or smell carbon monoxide. The Health and Safety Executive (HSE) reported that last year 319 people were killed or injured due to carbon monoxide poisoning.
It is important to look out for the warning signs of carbon monoxide poisoning and to seek urgent medical attention from your GP or accident and emergency department.
It is not always possible to check gas appliances for signs they are not working properly, such as lazy yellow flames instead of crisp blue ones. It is better to ensure that all gas appliances are checked annually by a Gas Safe engineer.
If you are going on holiday in the UK or abroad, follow these tips to protect yourself and your family:
Screening is a way of finding out if people are at higher risk of a health problem so that early treatment can be offered or information given to help them make informed decisions.
This page gives an overview of screening, with links to the different types of screening offered by the NHS in England.
Screening is a way of identifying apparently healthy people who may have an increased risk of a particular condition. The NHS offers a range of screening tests to different sections of the population.
The aim is to offer screening to the people who are most likely to benefit from it. For example, some screening tests are only offered to newborn babies, others such as breast screening and abdominal aortic aneurysm screening are only offered to older people.
If you get a normal result (a screen negative result) after a screening test, this means you are at low risk of having the condition you were screened for. This does not mean that you will never develop the condition in the future, just that you are low risk at the moment.
If you have a higher risk result (a screen positive result), it means you may have the condition that you’ve been tested for. At this point, you will be offered further tests (called diagnostic tests) to confirm if you have the condition. You can then be offered treatment, advice and support.
Finding out about a problem early can mean that treatment is more effective. However, screening tests are not perfect and they can lead to difficult decisions about having further tests or treatment.
Read on to find out about the benefits, risks and limitations of screening.
An independent expert group called the UK National Screening Committee (UK NSC) advises the NHS, in all four UK countries, on which screening programmes to offer. NHS screening programmes currently offered in England are listed below. For more detailed information on each type of screening, follow the links.
You can also view screening timelines.
Pregnant women are offered the following types of screening:
Newborn babies are offered:
From the age of 12, all people with diabetes are offered an annual diabetic eye test to check for early signs of diabetic retinopathy.
Cervical screening is offered to women aged 25 to 64 to check the health of cells in the cervix. It is offered every three years between the ages of 26 and 49, and every five years between the ages of 50 and 64.
Breast screening is offered to women aged 50 to 70 to detect early signs of breast cancer. Women aged 70 and over can self-refer.
There are two types of screening for bowel cancer.
A home testing kit is offered to men and women aged 60 to 74.
Bowel scope screening uses a thin flexible tube with a tiny camera on the end to look at the large bowel. It is offered to men and women at the age of 55 in some parts of England.
AAA screening is offered to men in their 65th year to detect abdominal aortic aneurysms (a dangerous swelling in the aorta). Men over 65 can self-refer.
Before having any screening test, it’s worth finding out more about the test itself and what would happen next if you found out you have a higher risk of a particular condition.
Deciding whether or not to have a screening test is a personal choice and one which only you can make. When you are invited for screening, you will receive an information leaflet about the screening test. You can discuss any aspect of the screening test with your health professional and decide whether or not it’s right for you.
Different types of screening have different benefits and risks. Some of these are listed below.
An expert group called the UK National Screening Committee (UK NSC) advises the NHS on which screening programmes to offer.
When considering whom to screen and for which conditions, the benefits of offering a screening programme are weighed up against the harms. The UK NSC only recommends screening when they believe the benefits to the group offered screening outweigh the harms.
The UK NSC regularly reviews its recommendations on screening for different conditions as new research becomes available. This is usually done every three years.
All screening tests provided by the NHS are free. Private companies offer a range of screening tests that you have to pay for. Some of the tests on offer are not recommended by the UK NSC because it is not clear that the benefits outweigh the harms.
The UK NSC has produced a downloadable leaflet on private screening.
By law, everyone working in, or on behalf of, the NHS must respect your privacy and keep all information about you safe. The NHS Constitution sets out how the NHS should handle your records to protect your privacy. In addition, there are laws in place to ensure confidentiality is maintained.
Screening records are only shared with staff who need to see them, such as technicians carrying out screening, your GP and any clinicians involved in follow-up tests and treatment. Sometimes anonymised data is used for research purposes to improve screening outcomes and the quality of services provided by the NHS.
Read more about screening data and confidentiality.
The best way to contact the UK National Screening Committee or the NHS screening programmes is to email their helpdesk.
You can also phone the helpdesk on 020 3682 0890.
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