At least 19 people in Costa Rica died after consuming alcohol with toxic levels of methanol, government officials say.

The National Health Ministry has issued a national alert following the deaths, saying that 14 men and five women between the ages of 32 and 72 have died from what appeared to be methanol poisoning. The deaths occurred in San José, Cartago, Limón, Guanacaste, and Heredia.

"It is important to emphasise that this information is preliminary since the investigations continue," a statement from the Ministry read. "The Ministry of Health continues to carry out operations throughout the national territory in order to reduce the exposure of consumers to adulterated products."

Meanwhile, government officials confiscated around 30,000 bottles of alcohol believed to be tainted, creating “adulterated liquor,” or liquor that has been tamped with. Often, that tampering is done with methanol, a much more toxic alcohol than ethanol.

Adding methanol to distilled liquor allows sellers to increase the drink’s volume, as well as its potential potency. Poisoning by methanol can cause dizziness, confusion, and the inability to coordinate muscle movement, as well as other dangerous symptoms. Even small traces of the substance can be toxic.

The brands Guaro Montano, Guaro Gran Apache, Aguardiente Estrella, Aguardiente Barón Rojo, Aguardiente Timbuka, and Molotov Aguardiente all had samples that tested positive for methanol adulteration, according to ABC News.

The World Health Organisation says that methanol poisoning outbreaks are often tied to “counterfeit” drinks. Vendors who have sold the adulterated liquor in Costa Rica could now face criminal sanctions.

In June, the FBI reportedly joined an investigation into whether tourist deaths across the Dominican Republic were caused by tainted alcohol. It’s unclear if these cases are similar to Costa Rica’s outbreak.

According to WHO, outbreaks of adulterated liquor have also been reported in India, Turkey, Norway, the Czech Republic, and other nations.

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