On Aug 20, 2020, a 44-year-old man who was previously healthy suddenly became confused
and began to sweat heavily on a domestic flight in Russia approximately 10 min after
departure; he vomited, collapsed, and lost consciousness. After an emergency landing,
the man was admitted to the toxicology unit of a local hospital in Omsk, Russia, approximately
2 h after symptom onset. According to the discharge report, the patient presented
comatose with hypersalivation and increased diaphoresis and was diagnosed to have
respiratory failure, myoclonic status, disturbed carbohydrate metabolism, electrolyte
disorders, and metabolic encephalopathy.