when will someone die without treatment for thallium poisoning

Can thallium poisoning be fatal?

In humans the most characteristic sign of thallium toxicity is alopecia which usually appears in cases when death is delayed for 15-20 days. Other signs and symptoms may develop at any stage of toxicity. The current therapy for thallium poisoning is the use of …

What is the initial treatment for thallium toxicity?

The clinical symptoms of thallium poisoning are non-specific, thereby delaying admission and treatment. This study aimed to summarize the clinical features and treatment experience of patients with delayed admission who experience thallium poisoning.We conducted a retrospective descriptive analysis of patients in our hospital from 2008 to 2018 ...

How many lives have been saved by the author's thallium poisoning?

This is followed by a neurological phase 2 to 5 days or more after ingestion, although it may occur as early as 12 hours after massive ingestion. In acute toxicity, alopecia may occur 2 to 3 weeks after exposure. Death may occur in severe cases 5 to 7 days following exposure due to respiratory paralysis and failure.

How is thallium removed from the human body?

To put things in perspective, if a 62 kg person ingests a single gram, (1 gram), of thallium sulfate, he/she has a 50/50 chance of dying in three days unless treated. Now, consider how easy it is to add one gram of material to your food – it is even easier in the case of thallium sulfate since it is significantly denser than water and occupies a much smaller volume than one gram of water.

How long does it take to die from thallium?

How much thallium will cause death?

Can you recover from thallium?

What are the symptoms of death by poison?

How does the body get rid of thallium?

Can you touch thallium?

How does thallium poisoning happen?

Is thallium toxic to humans?

What are four signs a person has been poisoned?

How do you remove poison from your body?

What are the steps to take in case of poisoning?

How long does it take for thallium to kill you?

The gastrointestinal phase may occur immediately with large ingestions or may be delayed 24 to 48 hours with smaller ingestions. This is followed by a neurological phase 2 to 5 days or more after ingestion, although it may occur as early as 12 hours after massive ingestion. In acute toxicity, alopecia may occur 2 to 3 weeks after exposure. Death may occur in severe cases 5 to 7 days following exposure due to respiratory paralysis and failure.

Why can't thalium be used in water?

Water: Thallium cannot be used to contaminate water because it does not dissolve in water.

What are the characteristics of thalium?

DESCRIPTION: Thallium was discovered by Sir William Crookes in 1861. It is a soft, heavy, inelastic metal. Thallium is tasteless and odorless and has been used by murderers as a difficult to detect poison.

What is the purpose of decontamination?

INTRODUCTION: The purpose of decontamination is to make an individual and/or their equipment safe by physically removing toxic substances quickly and effectively . Care should be taken during decontamination, because absorbed agent can be released from clothing and skin as a gas. Your Incident Commander will provide you with decontaminants specific for the agent released or the agent believed to have been released.

Is thalium a rodenticide?

It also has use in some chemical reactions and medical procedures. Thallium was used historically as a rodenticide, but has since been banned in the United States due to its toxicity from accidental exposure. METHODS OF DISSEMINATION : Indoor Air: Thallium can be released into indoor air as fine particles (aerosol).

Do you have to touch a spilled agent?

Do not touch or walk through the spilled agent if at all possible. However, if you must, personnel should wear the appropriate PPE during environmental decontamination. See the PPE section of this card for detailed information.

Can thallium be released into the air?

Agricultural: If thallium is released into the air as fine particles (aerosol), it has the potential to contaminate agricultural products.

Why do people die from thallium?

People may die a very painful death, often due to heart failure. Small amounts of thallium cause loss of hair and larger doses and/or repetitive ingestion of small doses also impacts the nails and the teeth. Extended exposure to small doses affects the nervous system and the heart.

Which countries have thallium poisoning?

This issue is particularly relevant to nearby countries including Syria, Jordan, UAE, Saudi Arabia, Qatar, Yemen, Bahrain, Abu Dhabi, Oman, and even Libya and Iran. Only SYSTEMATIC, COMPREHENSIVE TESTING and RAPID TREATMENT. can adequately address the dangers of thallium poisoning.

How to reduce thallium retention?

Several materials can be used to reduce the retention of thallium in the body after exposure. The most known material is Prussian Blue. However, Prussian Blue is also toxic and should be administered only under medical supervision. About 500 mg/day is deemed safe and effective ii but doses of up to 20 grams/day were used to treat severe cases of poisoning in otherwise healthy adults. This can be highly important when administering treatment shortly after the poisoning occurs. THIS HYPOTHESIS WAS NOT TESTED HOWEVER. We recommend the use of Prussian Blue made fresh by mixing reagents that form it right before use.

How does thallium affect the nervous system?

Exposure to small doses of thallium has different toxic effects then large doses. Large doses cause severe pain in the legs and arms and affect the heart, nervous system and stomach. Vomiting, diarrhea and severe stomach aches are observed. The nerve ends are strongly affected and give a burning sensation as if walking on hot coal. Irregularities in the pulse and loss of control on urine and bowel movements may occur along with extreme pain when urinating. People may die a very painful death, often due to heart failure. Small amounts of thallium cause loss of hair and larger doses and/or repetitive ingestion of small doses also impacts the nails and the teeth. Extended exposure to small doses affects the nervous system and the heart.

What foods have thallium in them?

These detection methods have been used to detect thallium in numerous foods common in the Middle East including: hummus, baba ganoush, labna, tabouli, okra (bamia), majandra and others.

Why was thallium used in the Cold War?

It is also believed that thallium was used by the KGB and the CIA to eliminate opponents during the cold war. In January 2008, two families were poisoned in Baghdad eating cake laced with thallium sulfate, believed to be taken from residues of Saddam’s stockpile. Four people died and ten were sickened.

How many people can you kill with thalassium sulfate?

A single teaspoon of Thallium Sulfate contains approximately 33.8 grams – enough material to kill about 34 people in three days! A quantity of 15-20 kg of Thallium Sulfate is sufficient to kill 15,000-20,000 HEALTHY adults, more than 40,000 young children and between 25,000 and 35,000 elderly people with weakened health.

What was the poison used by Saddam Hussein?

Thallium was the poison of choice for Saddam Hussein to use on dissidents, which even allowed for them to emigrate before dying. In 1995, Zhu Ling was the victim of an unsolved attempted thallium poisoning in Beijing, China. In 1994, Zhu Ling was a sophomore studying physical chemistry at Tsinghua University in Beijing.

Why is thallium toxic?

Part of the reason for thallium's high toxicity is that, when present in aqueous solution as the univalent thallium (I) ion (Tl + ), it exhibits some similarities with essential alkali metal cations, particularly potassium (due to similar ionic radii ). It can thus enter the body via potassium uptake pathways.

What are the effects of thallium poisoning?

Among the distinctive effects of thallium poisoning are peripheral nerve damage (victims may experience a sensation of “walking on hot coals”) and hair loss (which led to its initial use as a depilatory, before its toxicity was properly appreciated). However, hair-loss generally only occurs with low doses; with high doses, the thallium kills before this can take effect. Thallium was once an effective murder weapon, before its effects became understood and an antidote ( Prussian blue) discovered. It has been called the "poisoner's poison" since it is colorless, odorless, and tasteless; its slow-acting, painful and wide-ranging symptoms are often suggestive of a host of other illnesses and conditions.

How to remove thallium from blood?

Up to 20 g per day of Prussian blue is fed by mouth to the person, and it passes through their digestive system and comes out in the stool. Hemodialysis and hemoperfusion are also used to remove thallium from the blood stream. At later stage of the treatment additional potassium is used to mobilize thallium from the tissue.

Why was Terje Wiik sentenced to 21 years in prison?

In 1999, Norwegian Terje Wiik was sentenced to 21 years imprisonment for poisoning his girlfriend with thallium.

What happened to Peggy Carr's mother?

Peggy Carr, the mother, died slowly and painfully from the poison.

Why was Beryl Hague tried?

In July 1953, Sydney woman Beryl Hague was tried for "maliciously administering thallium and endangering her husband's life ". Hague confessed to buying Thall-rat from a corner shop and putting it in her husband's tea, because she wanted to "give him a headache to repay the many headaches he had given me" in violent disputes.

How long does it take for thallium to cause nausea?

In the first 48 hours after serious thallium exposure, the affected individual will usually experience nausea, vomiting, and diarrhea. Within a few days, symptoms of nervous system damage become apparent. These symptoms can include pain, loss of reflexes, convulsions, muscle wasting, headaches, numbness, dementia, psychosis, and even coma. After two to three weeks, characteristic changes are seen in the bases of hair shafts, and there is hair loss ( alopecia ). Finally, after around three weeks post-exposure, heart rhythm disturbances may occur.

How much thallium is in the body?

If a significant amount (significant poisoning is usually defined as ingesting over 1 gram of thallium, or over 8 milligrams per kilogram of body weight) of thallium enters the body, symptoms of thallium poisoning develop.

What element was used in the 2007 poisoning of a woman?

The March 2007 poisoning of an American woman and her daughter in Russia with the element thallium sparked widespread media attention. After the women became ill in Moscow, they returned to the U.S. for treatment, where the diagnosis of thallium poisoning was confirmed.

Where is thallium found?

Small amounts of thallium are normally found in the earth's crust and atmosphere. It is also present in small amounts in cigarette smoke. Thallium has multiple industrial uses, and certain isotopes of thallium are used in medical imaging studies. Thallium can be absorbed from the skin as well as be ingested or inhaled.

Is thallium toxic to rats?

Thallium is a soft, malleable gray metal that was previously widely used in rat poisons and insecticides. Thallium itself and compounds containing the element are highly toxic. It is particularly dangerous because compounds containing thallium are colorless, odorless, and tasteless.

What are the risks of thallium?

Living near hazardous waste sites containing thallium (may result in higher than normal exposures). Touching or, for children, eating soil contaminated with thallium. Breathing low levels in air and water.

How much thallium should be discharged?

The EPA requires that discharges or accidental spills into the environment of 1,000 pounds or more of thallium be reported.

What is thallium odorless?

In its pure form, thallium is odorless and tasteless. It can also be found combined with other substances such as bromine, chlorine, fluorine, and iodine. When it's combined, it appears colorless-to-white or yellow.

What element was used in the 2007 poisoning of a woman?

Medical Editor: William C. Shiel Jr., MD, FACP, FACR. The March 2007 poisoning of an American woman and her daughter in Russia with the element thalliumsparked widespread media attention. After the women became ill in Moscow, they returned to the U.S. for treatment, where the diagnosis of thallium poisoning was confirmed.

What is thalassium used for?

Thallium is used mostly in manufacturing electronic devices, switches, and closures, primarily for the semiconductor industry. It also has limited use in the manufacture of special glass and for certain medical procedures.

Where is thallium found?

Pure thallium is a bluish-white metal that is found in trace amounts in the earth's crust. In the past, thallium was obtained as a by-product from smelting other metals; however, it has not been produced in the United States since 1984. Currently, all the thallium is obtained from imports and from thallium reserves.

Can thallium cause diarrhea?

Studies in people who ingested large amounts of thallium over a short time have reported vomiting, diarrhea, temporary hair loss, and effects on the nervous system, lungs, heart, liver, and kidneys. It has caused death. It is not known what the effects are from ingesting low levels of thallium over a long time.

What is the best treatment for thallium poisoning?

Patients with radiographic evidence of retained thallium in the gastrointestinal tract may benefit from whole bowel irrigation#N#5#N#with polyethylene glycol solution. Extracorporeal removal of thallium using hemodialysis or hemoperfusion should take place as early as possible during the course of poisoning. Hemodialysis is most beneficial when blood levels are high, before tissue distribution has taken place. After systemic signs develop, dialysis reveals inconsistent results. Although excretion of thallium is nominally enhanced with dialysis, this procedure may accelerate the redistribution of thallium out of tissues such as the central nervous system. Therefore, hemodialysis should be performed in most symptomatic patients with acute thallium poisoning in conjunction with other treatments. Prussian Blue, an FDA-approved antidote for cesium and thallium poisonings, is a potassium-rich oral cation exchange resin. Potassium is exchanged preferentially for thallium entering the enterohepatic circulation. As Prussian Blue sequesters thallium, a concentration gradient is established for the continued movement of thallium into the gut. Dosing of Prussian Blue is 250 mg/kg/day, divided every 6-12 hours. Constipation may complicate Prussian Blue administration, and may be attenuated by the addition of a cathartic such as mannitol. Duration of treatment with Prussian Blue is not well-studied. Case reports have suggested this therapy can be safely discontinued when spot urine thallium levels are <100 mcg/L. Patients with persistent neurological findings may require physical or occupational therapy for several weeks-to-months after acute toxicity is treated. Hair growth spontaneously returns to normal over days or weeks. Multiple-dose activated charcoal (MDAC) may enhance thallium excretion by interruption of enterohepatic circulation; however, human models of toxicity have not demonstrated clinical benefit to MDAC. Forced diuresis provides no clinical benefit in the treatment of thallium poisoning. Some proposed treatments attempt to take advantage of the similarities between cellular handling of potassium and thallium. For example, the administration of potassium blocks renal tubular reabsorption of thallium, thus enhancing excretion up to 300%; however, potassium administration also mobilizes thallium from tissue depots, thus making more thallium available to the central nervous system. Therefore, “potassium mobilization” is not advised as either a diagnostic challenge nor as a treatment modality. Sodium polystyrene sulfonate (Kayexelate®) is a proposed treatment, demonstrating excellent in vitro binding to thallium. However, polystyrene binds preferentially to potassium, not thallium, in vivo, and is not recommended because of its potential to cause hypokalemia. Thallium binds poorly to medicinal chelators, such as Ca-Na-EDTA, British anti-Lewisite (BAL), and DMPS. D-penicillamine may worsen thallium toxicity. Other proposed pharmaceutical treatments, such as N-acetylcyesteine,diphenylthiocarbazone, and dithiocarb may increase thallium excretion, but are not recommended, because they are ineffective or may worsen neurological toxicity.

How to detect thallium poisoning?

Thallium poisoning should be suspected in any patient with neurological symptoms and hair loss. Gastrointestinal findings may be mild or nonexistent, especially in chronic poisoning. Thallium blood levels may be elevated after recent exposures, but it is cleared from the blood relatively quickly. Cases of known thallium exposure may be confirmed easily by early blood testing with quantitative atomic absorption. The diagnosis of thallium poisoning may not be considered until several days after exposure – typically when hair loss begins – by which time blood levels may have decreased significantly. Measurable urine concentrations of thallium tend to persist for several days after exposure, and may be used to monitor treatment. A 24-hour urine thallium concentration is the most accurate way to assess thallium toxicity; however, a “spot” urine level provides more rapid confirmation. Acute toxicity will produce a thallium concentration many times higher than the reference range of 0-5 mcg/L. Injection of large boluses of potassium to enhance urinary thallium excretion before urine sampling, also known as “potassium mobilization” (described below) is not advised, as this practice may precipitate cardiac and neurological toxicity. Both blood and urine levels should be obtained in cases of known or suspected thallium poisoning. Hair testing for thallium may provide additional confirmation of thallium exposure in the presence of strongly positive urine and blood results; however, hair testing is a highly unreliable method of diagnosing acute or chronic thallium poisoning, and is generally not recommended. Experienced pathologists may detect a characteristic pattern of black pigmentation at the roots of scalp hair in thallium-poisoned patients. Electrocardiography may demonstrate prolongation of the QTc interval, non-specific T-wave changes, and dysrhythmias. Serum transaminases and alkaline phosphatase may be elevated. Complete blood count may reveal anemia from gastrointestinal hemorrhage. Plain abdominal radiography may show opacities due to heavy metal retention in the gastrointestinal tract; however, absence of radiographic findings may be misleading and does not exclude retained metal. Electromyelography may reveal diminished neuromuscular transmission, and electroretinography may demonstrate delayed visual evoked response. These findings may precede clinical symptoms. The differential diagnosis of thallium poisoning includes arsenic poisoning, selenium poisoning, colchicine poisoning, Guillain-Barre Syndrome (GBS), and botulism. Serum or urine determinations of arsenic, selenium, or colchicine may rule out these poisonings, but may be difficult to obtain rapidly. Hair loss following neurological symptoms is a useful clue to exclude GBS and botulism.

How is thallium absorbed?

Although ingestion is the most common route of exposure thallium may also be absorbed by inhalation or skin penetration. Thallium and its salts are corrosive to the gastrointestinal mucosa, leading to abdominal pain, intestinal fluid secretion, diarrhea, and vomiting. After absorption, thallium distributes widely to multiple organs with a distribution pattern similar to that of potassium ions, which have a similar atomic radius to thallium. Thallium deposition therefore occurs primarily in tissues with high potassium concentrations such as neuronal, myocardial, hepatic, renal, and dermal tissues. In contrast to more common heavy metal exposures such as lead, mercury, or arsenic, long-term, low-level exposure to thallium does not typically lead to accumulation in body tissues for an extended duration. Thallium replaces potassium in numerous potassium-dependent enzyme systems usually with superior affinity over potassium. Affected enzyme systems include pyruvate kinase, succinic dehydrogenase, sodium-potassium-ATPase, hemoserine dehydrogenase, vitamin B12-dependent diol dehydrogenase, guanine deamiase, L-threonine dehydrogenase, monoamine oxidase, acid phosphatase, and cathepsin. In addition, thallium damages the 60s subunit of ribosomes, resulting in impaired protein synthesis. The combined effect of these acute cellular dysfunctions is the failure of aerobic respiration and poor cellular energy production. In the peripheral nervous system, thallium causes a “dying-back” or Wallerian degenerative sensory neuropathy due to acute myelin fragmentation and axonal degeneration. This process is mediated by mitochondrial dysfunction, swelling, and vacuolization from inhibition of pyruvate kinase and succinicdehydrogenase and subsequent decrease in ATP production. Motor neuropathy may occur with severe acute exposures, as high thallium concentrations impair depolarization of muscle fibers. Central nervous system findings are mediated by multi-focal edematous changes and chromatolysis, particularly in the frontal lobe, motor cortex, basal ganglia, and pyramidal cells. Similar changes are noted in the ganglia of the spinal cord in chronic poisoning. Inhaled or ingested thallium induces pulmonary inflammation and hyaline membrane formation. High doses of thallium directly damage the myocardium with myocardial thinning, lipid droplet infiltration, necrosis, and inflammatory changes. Thallium damages kidney tissue, most likely via infarction. Hepatic findings in severe cases may include centrilobular necrosis with fatty infiltration; however, most cases of thallium poisoning result in mild hepatic inflammation. Hair loss is caused by stunted mitosis of hair follicle epithelial cells, and by destruction of hair shaft cells.

What is thallium used for?

Today, medicinal use is limited to trace amounts of radioactive thallium for nuclear imaging. Thallium is a tasteless, odorless, and extremely potent poison – acute ingestions of as little as one gram of thallium salt may kill an adult. Thallium is a well-known poison cited in numerous works of fictional literature, but is also a popular real-life agent of murder with worldwide homicidal usage documented since the 1800s.

What is the differential diagnosis of thallium poisoning?

The differential diagnosis of thallium poisoning includes arsenic poisoning, selenium poisoning, colchicine poiso ning, Guillain-Barre Syndrome (GBS), and botulism. Serum or urine determinations of arsenic, selenium, or colchicine may rule out these poisonings, but may be difficult to obtain rapidly.

What is the effect of thallium on the nervous system?

The combined effect of these acute cellular dysfunctions is the failure of aerobic respiration and poor cellular energy production. In the peripheral nervous system, thallium causes a “dying-back” or Wallerian degenerative sensory neuropathy due to acute myelin fragmentation and axonal degeneration.

What causes hair loss in thallium poisoning?

Hair loss is caused by stunted mitosis of hair follicle epithelial cells, and by destruction of hair shaft cells.