The Ministry of Health in Costa Rica issued a national alert after nineteen people died from drinking alcohol adulterated with toxic levels of methanol.

The victims were five women and fourteen men between the ages of 32 to 72 years old. They died in several Costa Rican cities from the beginning of June according to the ministry as reported by CNN.

The Costa Rican government has confiscated around 30,000 bottles of alcoholic beverage. Several brands suspected to be tainted of methanol are affected by the confiscation.

The public is warned against drinking liquor from a number of brands after samples were tested positive for methanol. The Ministry of Health claims that tainted alcohol often contains methanol that can induce intoxication when consumed. Sellers add methanol to distilled spirits in an effort to increase its amount and potency. This is according to SafeProof, an organization that lobbies against counterfeit liquor.

Symptoms of methanol poisoning include confusion, dizziness, drowsiness, headaches and the lack of muscle movement coordination. According to the World Health Organization, methanol is toxic even in small amounts and poisoning outbreaks are linked to “adulterated counterfeit or informally-produced spirit drinks.”

WHO reports that outbreaks have surfaced in countries worldwide in recent years. Victims have reportedly ranged from sizes 20 to 800 in worst cases.

A similar case was reported in India where 154 died and 200 more were left hospitalized after consuming counterfeit liquor. The liquor in question is unregulated moonshine believed to be “country-made liquor” in the northeast state of Assam.