Health AI Central
Peer-Reviewed Publication
N Engl J Med2026;395(10):983-991.September 10, 2026Journal Article

Outbreak of Severe Methemoglobinemia during Maritime Migration.

Lucia Bernasconi1, Davide Lonati1, Alessandra Teresi2, Francesco D'Arca3, Nicolò Ricca4, Daniele Merli5, Martina Pes1, Antonella Rotolo1, Elena Grignani6, Cristina Agozzino7, Cristina Carolina Benussi1, Benedetta Brolli1, Eleonora Buscaglia1, Monica Carnovale1, Arianna Centonze7, Massimo Ciotta8, Francesco Di Lascio9, Gerlando Fiorica9, Tommaso Frigerio1,10, Fabio Genco11, Agostino Massimo Geraci12, Giovanni Ippati7, Vincenzo Mazzarese8, Valentina Maria Negrini1, Marco Palmeri11, Valeria Margherita Petrolini1, Francesco Petrusa13, Elisa Roda1, Giulia Scaravaggi1, Azzurra Schicchi1, Sara Scotto1, Francesca Zaffino14, Carlo Alessandro Locatelli1
1Pavia Poison Control Center, National Toxicology Information Center, Laboratory of Clinical and Experimental Toxicology, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
2Emergency Medical Services 118, Lampedusa Base, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Civico Di Cristina Benfratelli Hospital, Palermo, Italy.
3Emergency Health Care Facility (Punto Territoriale di Emergenza), Azienda Sanitaria Provinciale (ASP) di Palermo, Lampedusa, Italy.
4Italian Red Cross, Lampedusa Migrant Reception Hotspot, Lampedusa, Italy.
5Department of Chemistry, University of Pavia, Pavia, Italy.
6Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
7Anesthesia and Intensive Care Unit with Hyperbaric Chamber, Sant'Antonio Abate Hospital, ASP Trapani, Erice, Italy.
8Anesthesia and Intensive Care Unit, ARNAS Civico Di Cristina Benfratelli Hospital, Palermo, Italy.
9Anesthesia and Intensive Care Unit, San Giovanni di Dio Hospital, ASP Agrigento, Agrigento, Italy.
10Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy.
11Emergency Medical Services 118, ARNAS Civico Di Cristina Benfratelli Hospital, Palermo, Italy.
12Emergency Department, ARNAS Civico Di Cristina Benfratelli Hospital, Palermo, Italy.
13Anesthesia and Intensive Care Unit, Hyperbaric Medicine and Pain Therapy Unit, ASP Agrigento, Sciacca-Ribera Hospitals, Sciacca, Italy.
14Office of the Directorate General for Health Emergencies and National Antidote Stockpile, Department of Prevention, Research, and Health Emergencies, Ministry of Health, Rome.
PubMed DOI

Abstract

BACKGROUND: Migrants crossing the Central Mediterranean sea route travel in overcrowded vessels, where fuel may leak and contaminate seawater accumulating on the vessel floor, resulting in prolonged dermal exposure and fuel-related skin injuries. Since March 2024, clusters of cases of severe acquired methemoglobinemia with no apparent cause have been identified by clinicians in Lampedusa at disemb…

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