Case Definition: Thallium
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Clinical description
Ingestion of toxic amounts of thallium might cause gastrointestinal signs and symptoms, most commonly abdominal pain. Subacute symptoms (onset of days to weeks) after a substantial, acute exposure or a chronic exposure to limited amounts of thallium might include severely painful ascending neuropathy, ataxia, seizure, alopecia, and neurocognitive deficits (1-3).
Laboratory criteria for diagnosis
- Biologic: A case in which elevated spot urine thallium levels are detected (reference level: <0.5 µg/L) (20), as determined by a commercial laboratory. - OR-
- Environmental: Detection of thallium in environmental samples, as determined by NIOSH or FDA.
Case classification
- Suspected: A case in which a potentially exposed person is being evaluated by health-care workers or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists.
- Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for thallium exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
- Confirmed: A clinically compatible case in which laboratory tests of biologic and environmental samples have confirmed exposure.
The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or a 100% certainty of the etiology of the agent is known.
Additional resources
- Ferguson TJ. Thallium. In: KR Olson, ed. Poisoning & drug overdose. 4th ed. New York , NY: McGraw-Hill; 2004:352-54.
- Mulkey JP, Oehme FW. A review of thallium toxicity. Vet Hum Toxicol 1993;35:445-53.
- Mercurio M, Hoffman R. Thallium. In: Goldfrank LR, Flomenbaum ME, Lewin NE, Howland MA, Hoffman RS, Nelson LS, eds. Goldfrank's toxicologic emergencies. 7th ed. New York, NY: McGraw-Hill, 2002:1272-80.
This document is based on CDC’s best current information. It may be updated as new information becomes available.
Page last reviewed February 22, 2006
Page last modified March 10, 2005