September 9, 2026 · The New England journal of medicine · DOI: 10.1056/NEJMoa2606487

Outbreak of Severe Methemoglobinemia during Maritime Migration

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The authors aimed to investigate the cause of severe acquired methemoglobinemia observed among migrants arriving in Lampedusa, Italy, since March 2024. Their study identified dermal absorption of the gasoline additive N-methylaniline from fuel-contaminated seawater as the likely culprit, affecting 82 patients, with significant health implications including high methemoglobin levels and delayed complications. The findings highlight the need for accessible methylene blue treatment and improved diagnostic capabilities in similar migration contexts.

Lucia Bernasconi, Davide Lonati, Alessandra Teresi, Francesco D'Arca, Nicolò Ricca, Daniele Merli, Martina Pes, Antonella Rotolo, Elena Grignani, Cristina Agozzino, Cristina Carolina Benussi, Benedetta Brolli, Eleonora Buscaglia, Monica Carnovale, Arianna Centonze, Massimo Ciotta, Francesco Di Lascio, Gerlando Fiorica, Tommaso Frigerio, Fabio Genco, Agostino Massimo Geraci, Giovanni Ippati, Vincenzo Mazzarese, Valentina Maria Negrini, Marco Palmeri, Valeria Margherita Petrolini, Francesco Petrusa, Elisa Roda, Giulia Scaravaggi, Azzurra Schicchi, Sara Scotto, Francesca Zaffino, Carlo Alessandro Locatelli

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