MMWR Morb Mortal Wkly Rep. 2008 Sep 19;57(37):1015-8.
Thallium is an odorless, tasteless, heavy metal formerly used in rodenticides and still used in some manufacturing processes (e.g., electronics, pharmaceuticals, and glass). Thallium also has been used for intentional poisonings. Acute thallium poisoning produces gastrointestinal symptoms and signs, such as vomiting and acute abdominal pain, in the first few hours after ingestion, and initially is indistinguishable from other causes of acute gastrointestinal toxicity. However, within several days of ingestion, acute thallium poisoning often produces neurologic symptoms, such as extreme pain and acute muscle weakness ascending from the lower extremities, consistent with heavy metal toxicity. On January 22, 2008, 10 of 12 members in two families in Baghdad, Iraq, developed gastrointestinal symptoms; four of those 10 persons subsequently died from acute thallium poisoning, and five developed neurologic symptoms but survived. The Jordan Field Epidemiology Training Program investigated this cluster at the request of the World Health Organization (WHO) representative in Iraq. The preliminary investigation indicated this was an intentional poisoning, and law enforcement officials began a criminal investigation. Physicians who see the sudden onset of painful peripheral neuropathy and hair loss in patients should consider the possibility of thallium poisoning.
铊是一种无味、无臭的重金属，以前用于杀鼠剂，现在仍用于一些制造工艺（如电子、制药和玻璃行业）。铊也曾被用于故意投毒。急性铊中毒在摄入后的最初几个小时会产生胃肠道症状和体征，如呕吐和急性腹痛，最初与其他急性胃肠道毒性病因难以区分。然而，在摄入后的几天内，急性铊中毒常出现神经症状，如下肢开始出现的剧痛和急性肌无力，这与重金属中毒相符。2008年1月22日，伊拉克巴格达两个家庭的12名成员中有10人出现胃肠道症状；这10人中4人随后死于急性铊中毒，5人出现神经症状但存活下来。应世界卫生组织（WHO）驻伊拉克代表的请求，约旦现场流行病学培训项目对这起聚集性病例进行了调查。初步调查表明这是一起故意投毒事件，执法官员展开了刑事调查。医生在见到患者突然出现疼痛性周围神经病变和脱发时，应考虑铊中毒的可能性。
