When Marcelo Lombardi, 45, complained of feeling sleepy on Friday, his family didn’t think much of it.
Ms. Lombardi often spent long hours running her family’s 17-year-old real estate business in Sao Paulo, Brazil, working alongside her two older sisters. A prominent lawyer, he was a well-loved figure in Sacoman, Southeast, where he lived for more than 35 years.
One of the sisters, Fernanda Lombardi, recalled that her life up until that day on September 26 was “perfect.” “At the beginning of the week, I came home with groceries, including a bottle of vodka,” she told CNN. “It was his favorite drink.”
On Saturday, Marcelo woke up unable to see. “He told his wife all he could see was a big bright light,” Fernanda said. When they arrived at the hospital, no one was able to tell the family about Marcelo’s condition.
“It took about five hours before they told us that my brother had been poisoned,” Fernanda said. “By then, all his organs had stopped working. He looked me in the eyes and said, ‘I’m not leaving.'” Marcelo died the next day.
Later, the family learned from health officials that a sip of the vodka cocktail they had casually enjoyed at home a few days earlier had been contaminated with industrial methanol, an invisible killer. Health officials say the colorless liquid is the cause of an ongoing health crisis that has caused nationwide panic and affected around 100 million people in six Brazilian states.
Methanol is a clear, odorless, highly flammable liquid found in antifreeze, varnishes, and fuels. Ingesting just a few milliliters can cause blindness or death.
Federal authorities are investigating several areas to determine how industrial methanol entered Brazil’s consumer alcohol supply. In Brazil, methanol trade is regulated by the government and limited to industrial uses such as biodiesel production, solvents, and laboratory applications. Its sale is legal but strictly controlled and all transactions must be registered.
One of the main investigations is that methanol, which is cheaper than ethanol, may have been used intentionally by counterfeiters to reduce the cost of producing alcoholic beverages. Federal police are investigating whether the chemicals used in the clandestine factory were purchased from gas stations and then diverted to illegal alcohol production. At least one gas station in São Paulo has been identified as a common supplier in several cases. Investigators are also investigating whether smuggled or diverted industrial methanol entered Brazil’s black market, was used to clean and sterilize bottles in underground distilleries, and contaminated drinks that were then sold illegally.
As a precautionary measure, health and industry groups are urging consumers and bars to destroy or properly dispose of empty bottles to prevent counterfeiters from reusing them to make fake liquor.
Federal agents uncovered a massive black market supply chain flooding bars, venues and homes with counterfeit alcohol. To date, authorities have confiscated hundreds of thousands of fake labels, including more than 100,000 in São Paulo alone, making it difficult to estimate how far these poisoned bottles have spread.
According to a statement from the São Paulo government, four clandestine factories were shut down and 41 people were arrested in a joint operation by civilian police and health surveillance authorities.
Lombardi is the third death recorded since authorities announced the crisis in September, with the first case dating back to late August.
As of October 8, Brazil’s Ministry of Health has recorded 259 suspected cases and five confirmed deaths nationwide, with poisoning cases also confirmed in São Paulo, Paraná and Rio Grande do Sul states. All deaths so far have occurred in São Paulo, the epicenter of the crisis. Hospitals have also reported rapid blindness, irreversible coma, and organ failure occurring within hours of ingestion.
Eduardo Capitani, a toxicologist and pulmonologist at the University of Campinas Poison Control Center, one of the country’s leading poison control and research centres, was one of the first to alert the government to the developing health emergency. From early to late September, his team identified 10 suspected cases in São Paulo and nearby cities, enough to trigger a national alert. In response to the alert, the Ministry of Justice and the Ministry of Health held a joint press conference and announced a coordinated investigation into the origin of the contaminated batch.
“We have previously seen a spike in fuel ethanol consumption among unhoused people in 2023 and 2024,” Capitani said. “In this case, the victims were drinking cocktails at a bar or party. This is not an isolated incident.”
Capitani said Brazil’s public health system responded quickly, but the crisis has exposed serious structural weaknesses. Few hospitals had labs capable of testing for methanol or its toxic byproduct, formic acid, and few had the antidotes in stock to quickly treat patients.
For Fernanda Lombardi, the race to find the antidote at the pharmacy brought emotions she’ll never forget. “It could have saved my brother’s life, but it was nowhere to be found. We felt helpless.”
“Ethanol is nature’s antidote to methanol,” Capitani explained. “In adulterated drinks, people may be ingesting both the poison and its antidote, but the proportions are unpredictable.”
Symptoms are very similar to a hangover, including headache, nausea, and dizziness. Within 24 hours, patients may lose vision and have difficulty breathing. If untreated, methanol is metabolized to formic acid, which attacks the optic nerve and nervous system, leading to blindness, organ failure, or death within 48 hours.
Treatment requires intravenous administration of ethanol or fomepizole, specific antidotes that block the toxic conversion of methanol. But most Brazilian hospitals are running out of ethanol, and fomepizole, which has been approved in the United States and Europe since the 1990s, finally arrived in Brazil this week after an emergency import of 2,500 doses.
Brazil’s Health and Environmental Surveillance Secretary Maria Angela Batista Galván Simón oversaw the first arrival of fomepizole at São Paulo’s Guarulhos International Airport. “We’re working to keep our antidote stockpile full, but it’s difficult to predict how much we’ll need,” he told CNN from the airport Thursday.
“There is no national detoxification policy,” Capitani warned. “Many hospitals didn’t have enough 100 percent ethanol. Until it arrived, sometimes hours later, that time could cost patients their eyesight and their lives.”
Brazil’s Ministry of Health addressed the issue in a statement to CNN:
“The ministry has been working since February this year to develop a national detoxification policy that will strengthen surveillance, access to medicines and training of health professionals.”
If pure ethanol is not available, your doctor may temporarily administer vodka, which is one of the purest forms of commercially available ethanol. “But now it’s become Russian roulette, because even vodka can be contaminated,” Capitani warned.
Themis Miselkowski-Torres, a rheumatologist and toxicologist who is leading the effort at São Paulo’s Poison Control Center, says the crisis is unprecedented.
“I’ve been working at this center since 2004 and I’ve never seen anything like this,” she told CNN.
“We have been advised to refrain from any alcoholic beverages for the time being.” And in the homeland of the famous caipirinha drink, made from cachaça, lime and sugar, that’s not easy.
Torres explained that wine and beer are safer because of the fermentation process and the way they are made. However, as Health Minister Alexandre Pasilla emphasized at a recent press conference, “there is currently no such thing as completely safe drinking.”
In São Paulo, bars and restaurants in wealthy neighborhoods such as Itaim Bibi, Pinheiros and Bellini have reported sharp declines in customer numbers and cancellations of reservations. Some places have completely stopped selling vodka, whiskey and cachaça.
From São Paulo to Pernambuco, fear has cast a shadow over Brazil’s vibrant bar culture. This is a sobering reminder of how a single contaminated bottle can devastate a family and test a country’s ability to contain a crisis.
Fernanda Lombardi said her brother’s death shattered her family and community.
“He was healthy, hardworking and happy,” she said. “He wouldn’t let us go out and would just stay at home and drink a little vodka. That’s what we don’t understand.”
The family handed over the bottle to police, but toxicology results have not yet been released.
“My brother was killed by greed,” she said. “Someone was thinking about money and not people’s lives. We want justice so no other family should have to go through this.”
Hundreds of mourners came to pay their respects at his funeral.
“Everyone was talking about how he helped them, but I had no idea,” Fernanda Lombardi said. “He did a good job quietly.”
