Case Definition: Sodium Monofluoroacetate (Compound 1080)

Clinical description

Exposure to sodium monoflouroacetate might occur through ingestion or less likely, via inhalation. Clinical findings after ingestion of a sufficient amount of sodium monofluoroacetate to cause poisoning usually develop within 30 minutes to 2.5 hours of exposure. However, they might be delayed for as long as 20 hours. The predominant signs and symptoms of sodium monoflouroacetate poisoning are metabolic, cardiovascular, and neurologic in nature. Specific adverse health effects from acute poisoning might include metabolic acidosis, hypotension, dysrhythmias, seizures, coma, and respiratory depression (1-3).

Laboratory criteria for diagnosis

• Biologic: A case in which monoflouroacetate in urine is detected, as determined by CDC.

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• Environmental: Detection of sodium monoflouroacetate in environmental samples.

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 a sodium monofluoroacetate exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
• Confirmed: A clinically compatible case in which laboratory tests 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 the etiology of the agent is known with 100% certainty.

Additional resources

1. Barrueto Jr, F. Chapter 110 – Sodium monofluoroacetate and fluoroacetamide. In: Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum NE, eds. Goldfrank's Toxicologic Emergencies. 9th ed. New York, NY: McGraw-Hill; 2011:1437-1439.
2. Chi CH, Chen KW, Chan SH, Wu MH, Huang JJ. Clinical presentation and prognostic factors in sodium monofluoroacetate intoxication. J Toxicol Clin Toxicol 1996;34:707-12.
3. Egekeze JO, Oehme FW. Sodium monofluoroacetate (SMFA, compound 1080): a literature review. Vet Hum Toxicol 1979;21:411-6.
4. Eason C. Sodium monofluroroacetate (1080) risk assessment and risk communication. Toxicology 2002:181-2, 523-30.
5. Holstege CP, Bechtel LK, Reilly TH, Wispelwey BP, Dobmeier SG. Unusual but potential agents of terrorists. Emerg Med Clin North Am. 2007 May; 25(2):549-66.
6. Gosselin, R.E., R.P. Smith, H.C. Hodge. Clinical Toxicology of Commercial Products. 5th ed. Baltimore: Williams and Wilkins, 1984.,p. III-194.