POI­SON ‘DEATH CAPS’ RAISE ALARM

Mush­rooms sicken 14 peo­ple in North­ern Cal­i­for­nia; 3 re­quire liver trans­plants.

Los Angeles Times - - CALIFORNIA - By Veron­ica Rocha

The first signs of trou­ble came in Novem­ber, when a group of fun­gus hun­ters spot­ted a large bloom of wild “death cap” mush­rooms in the greater San Francisco Bay Area.

Over the fol­low­ing weeks, doc­tors treated 14 peo­ple who be­came se­verely ill af­ter eat­ing mush­rooms for­aged from rugged North­ern Cal­i­for­nia moun­tains. Three peo­ple needed liver trans­plants, in­clud­ing an 18month-old girl.

Few de­tails were known about the rare out­break un­til Fri­day, when doc­tors from across North­ern Cal­i­for­nia chron­i­cled the sick­ness in the Cen­ters for Dis­ease Con­trol and Preven­tion’s Mor­bid­ity and Mor­tal­ity Weekly Re­port.

Poi­son con­trol of­fi­cials in Cal­i­for­nia usu­ally get just a few cases of mush­room poi­son­ing each year, so the sud­den out­break alarmed med­i­cal ex­perts, ac­cord­ing to the re­port.

Con­sid­ered one of the world’s dead­li­est mush­rooms, Amanita phal­loides pro­duces a toxin that be­comes volatile once it is ab­sorbed in the gas­troin­testi­nal tract. The toxin is re­spon­si­ble for more than 90% of mush­room poi­son­ing deaths world­wide, ac­cord­ing to the re­port.

In late 1996 and early 1997, two North­ern Cal­i­for­nia men died af­ter eat­ing the wild mush­rooms.

Af­ter a mush­room cap is in­gested, its tox­ins work swiftly to kill cells. Pa­tients be­come se­verely de­hy­drated. They suf­fer from di­ar­rhea, vom­it­ing and cramp­ing. Their liver and other or­gans be­gin to fail.

But symp­toms can be de­ceiv­ing.

Some pa­tients are dis­charged from the hos­pi­tal af­ter their con­di­tion im­proves, only to re­turn again with liver fail­ure.

The poi­sonous mush­room usu­ally flour­ishes in the fall and in rainy months. That was the case in North­ern Cal­i­for­nia: Ac­cord­ing to the re­port, the mush­room sprouted af­ter a pe­riod of heavy rains and warm weather.

In Cal­i­for­nia, the fun­gus, which does not have a dis­tinct taste or smell, grows from coast live oaks and other trees.

It is eas­ily mis­taken for a non­poi­sonous mush­room.

The first case in the re­cent out­break was re­ported in De­cem­ber when a 37-yearold man picked two wild mush­rooms in Santa Rosa and cooked one of them. About 10 hours af­ter eat­ing the mush­room, he be­gan vom­it­ing and had di­ar­rhea and nau­sea. He was hos­pi­tal­ized for six days and re­ceived a bat­tery of tests and med­i­ca­tion.

Over the next two weeks, of­fi­cials from the Cal­i­for­nia Poi­son Con­trol Sys­tem saw a surge in mush­room poi­son­ing cases. In ev­ery case, the pa­tient had suf­fered from hep­a­to­tox­i­c­ity, a chem­i­cally driven in­jury that causes liver dam­age.

The mush­rooms even were re­spon­si­ble for poi­son­ing an en­tire house­hold.

Ac­cord­ing to the re­port, a 26-year-old woman re­ceived wild mush­rooms from some­one who had picked them ear­lier in the day in the moun­tains. The woman said she didn’t know the per­son.

She grilled the mush­rooms for din­ner and fed them to her hus­band, 18month-old daugh­ter, sis­ter and a fam­ily friend.

About nine hours later, they be­gan ex­pe­ri­enc­ing nau­sea, vom­it­ing and di­ar­rhea. They re­ceived in­tra­venous flu­ids.

The child de­vel­oped liver fail­ure and even­tu­ally un­der­went a liver trans­plant. She was hos­pi­tal­ized for 36 days and suf­fered per­ma­nent neu­ro­log­i­cal im­pair­ment.

The woman’s 38-year-old sis­ter also un­der­went a liver trans­plant.

Here are some of the mush­room poi­son­ing cases:

A 36-year-old man was hos­pi­tal­ized af­ter he ate mush­rooms that were picked by a friend dur­ing a hike.

A 56-year-old man un­der­went a liver trans­plant af­ter he ate for­aged mush­rooms.

Two women, 86 and 93, be­came ill af­ter they ate wild mush­rooms picked by a friend.

Four men, 19 to 22, suf­fered liver dam­age af­ter they ate what they thought were psy­che­delic mush­rooms.

The re­port sug­gests that peo­ple use cau­tion when con­sid­er­ing mush­room pick­ing.

Mush­rooms should al­ways be ex­am­ined by an ex­pe­ri­enced my­col­o­gist, a per­son who stud­ies fungi.

“In­ex­pe­ri­enced for­agers should be strongly dis­cour­aged from eat­ing any wild mush­rooms,” the re­port notes.

Health­care pro­fes­sion­als and sci­en­tists are con­duct­ing a clin­i­cal trial in the U.S. of a pos­si­ble an­ti­dote for the mush­room poi­son. The an­ti­dote, in­tra­venous sili­b­inin, is li­censed in Europe.

As­so­ci­ated Press

AMANITA PHAL­LOIDES pro­duces a toxin that be­comes volatile once ab­sorbed in the GI tract.

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