Date Sent: 08/15/2016 05:02 PM EDT
Sender: Michigan Health Alert Network
Subject: Thallium Poisoning Health Alert
Please distribute this Health Alert widely through all of your networks, with special attention to Neurologists, primary care, and Emergency Room providers.
The Calhoun County Public Health Department, the Michigan Poison Control Center and the Michigan Department of Health and Human Services (MDHHS) are investigating a case of thallium poisoning, the second case this year in Michigan where patients have been exposed to thallium and become severely ill.
Michigan health care practitioners should be on alert for potential thallium exposures. Thallium is a heavy metal that was used as a rodenticide until 1972, used in semiconductor and optical industries, in the production of photoelectric cells and in a number of chemical process. There have also been cases nationally related to contaminated heroin, cocaine, and methamphetamine.
We are requesting that providers who are caring for complex neurological cases address whether thallium poisoning could be in the differential diagnosis. Thallium causes a prodrome consisting of abdominal pain, vomiting, and either constipation or diarrhea. Symptoms of thallium poisoning include vomiting, diarrhea, temporary hair loss, and effects on the nervous system, lungs, heart, liver, and kidneys, peripheral neuropathy progressing to motor neuropathy, encephalopathy and potentially death.
Calhoun County Public Health, MDHHS and Poison Control would like to make healthcare providers aware, including any Emergency Room, Primary care or Neurology providers within your health system that the symptoms of thallium poisoning can often be mistaken for other disorders, such as Guillain-Barre Syndrome, peripheral neuropathies, encephalopathies or other diseases. In the case of a patient with a neurologic syndrome of unclear etiology and aspects of the presentation consistent with what is mentioned above, practitioners should consider collecting a spot urine thallium or a spot blood thallium for screening and contact the Michigan Poison Control Center (1-800-222-1222) 24 hours/day.