Researchers are worried that doctors treating refugees might misdiagnose the resulting illness as pneumonia.
Last year, more than a million refugees fleeing conflicts decimating Africa and the Middle East arrived in Europe. To get there, most had to brave the Mediterranean crossing from Libya to Greece or Italy in small rubber dinghies, facing a host of natural and man-made dangers. The threats to the refugees during crossing have been well documented, but according to a new report published in the Lancet, many of these refugees may have also been exposed to a previously unrecognized danger—the ingestion of gasoline, which is most commonly abused as a sedative in poor communities.
According to the researchers, some smugglers responsible for transporting people across the Mediterranean force their passengers to inhale a mixture containing gasoline during the journey in order to sedate them. The problem is that gasoline is made of aromatic hydrocarbons, which can cause severe lung inflammation and death if left untreated.
Their report is based on the cases of three patients treated at a hospital in Munich: a 16-year old Somalian, 18-year old Ethiopian, and 21-year old Eritrean, all of whom were admitted to the hospital just weeks after their crossing. The patients arrived at the hospital with fevers and exhibited shortness of breath, which is generally symptomatic of bacterial pneumonia.
Yet when the doctors treated the patients for pneumonia, the symptoms did not go away. In fact, the condition of all three patients severely worsened to the point where they had to be transferred to intensive care and subjected to mechanical ventilation as their lungs progressively failed.
The doctors treating the patients were baffled at this pathology, until questioning of the patients and cross-examination of the patients suggested that they were suffering from pneumonitis, an inflammation of the lungs that can be caused by inhaling fuel. Pneumonitis cannot be treated in the same way as a bacterial lung infection and once the link between fuel inhalation and the symptoms was established, the doctors were able to save two of the patients although were unable to save the 18-year old Ethiopian, who died of multiple organ failure.
While it is easy to dismiss three cases as anecdotal, the researchers fear that forced fuel inhalation by refugees may be far more common. Pneumonitis can take weeks to show symptoms and until this paper, there was no awareness of fuel ingestion by refugees. This means that refugees with pneumonitis may have been misdiagnosed with bacterial pneumonia and didn't receive proper treatment. The researchers hope that their paper raises awareness among doctors treating refugees so that future cases might not go unnoticed.