POISON ‘DEATH CAPS’ RAISE ALARM
Mushrooms sicken 14 people in Northern California; 3 require liver transplants.
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.