The article by Gilsanz et al1 in this issue provides 12-month follow-up data on victims of the toxic oil syndrome. The tragic story begins in May 1981, when an outbreak of a previously unknown syndrome began to appear in the working-class suburbs of Madrid.2 The initial clinical features of the syndrome were fever, respiratory distress, headaches, exanthem, pruritus, and myalgias.2,3 Early deaths were attributed to respiratory insufficiency. Two cases of acute respiratory distress syndrome were recently reported.4 On June 10, 1981, physicians at the Nino Jesus Children's Hospital, Madrid, determined the probable cause to be ingestion of an illegal cooking oil sold by door-to-door salesmen as an inexpensive substitute for olive oil.3 By June 30, 1981, the authorities began to seize the bottles of unlabeled cooking oil, and new cases stopped appearing. Unfortunately, in the several months the oil was available,
See also p 254.