Methylmercury poisoning in Iraqi children: clinical observations over two years.

doi:10.1136/bmj.1.6113.613

Br Med J 1978;1:613-616 (11 March), doi:10.1136/bmj.1.6113.613

Methylmercury poisoning in Iraqi children: clinical observations over two years.

L Amin-zaki, M A Majeed, T W Clarkson, M R Greenwood

The clinical features of 49 children who had eaten bread contaminatedwith methylmercury in rural Iraq were reviewed. Symptoms andsigns relating to the nervous system--varying degrees of ataxia,weakness, and visual and sensory changes--dominated the clinicalpicture. The severity of poisoning was related to the bloodmercury concentration, as was the degree of recovery. Follow-upover two years showed that children who had had mild or moderatepoisoning slowly but steadily improved, some of them recoveringnormal function, though all had a residual generalized hyperreflexia.In some patients ataxia and motor weakness disappeared. Visualchanges also improved, though less completely, and of 17 blindchildren, only five had recovered partial sight by the end oftwo years. Seven of the 18 children who suffered very severepoisoning were left physically and mentally incapacitated. Thedegree of clinical progress shown by these children was betterthan that shown by some other groups of patients, possibly becausethe poisoning was relatively acute and mercury consumption wasstopped immediately after its effects had become obvious.

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