Selenium poisoning from consumption of contaminated wheat: a case series from rural Maharashtra, India.

INTRODUCTION

We report acute alopecia linked to selenium-contaminated wheat in rural Maharashtra, India. After local media reported sudden hair loss in 18 villages, we investigated two villages - Machindrakhed and Bhondgaon. Five individuals were evaluated.

CASE SERIES: The wheat samples distributed through the Public Distribution System were analyzed and had selenium concentrations of 13.6-14.7 mg/kg (normal: 0.1-1.9 mg/kg). All five patients had consumed Public Distribution System wheat. Symptoms began within 48 h and included vomiting, diarrhea, and fever on the 4th day, followed by scalp tingling, itching, severe hair loss, and dystrophic finger- and toenails. Hair regrew within 5-6 weeks after cessation of wheat consumption. Elevated selenium concentrations were noted in the urine (n = 5) and blood (n = 3), but other metals were not detected. Washing selenium-contaminated wheat with alkaline water reduced selenium concentrations.

DISCUSSION: Because selenium dissolves more readily in alkaline soils, we determined that alkaline washing significantly reduced selenium concentrations in contaminated wheat and may represent a low-cost, household-level mitigation strategy.

CONCLUSIONS

Selenium poisoning occurred in 18 villages in the Buldhana district in India due to contaminated wheat distributed by the Public Distribution System.