The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) said mushroom picking had started earlier than usual in 2023.

Rainy weather in several regions in August encouraged the growth of mushrooms. Growth varies yearly, depending on various things, including weather.

Since the start of August, intoxications reported to poison control centers (CAP) have increased. More than 250 cases have already been recorded, twice as many as in the same period in 2022.

There are several reasons for poisonings, including confusion of an edible species with a toxic variety or consumption of edible mushrooms in poor condition that were poorly preserved or insufficiently cooked.

It is not recommended to serve infants picked wild mushrooms but 74 young children were poisoned, including an 11-month-old child who required treatment in intensive care.

Not a new problem
Although ANSES issues recommendations yearly, cases are frequently reported to poison control centers.

Between July and December 2022, 1,923 poisonings were reported to CAPs. This was more than 1,269 cases in 2021. However, the number of serious cases was down slightly from 41 in 2021 to 37 in 2022. There were two deaths compared to four fatalities in 2021. The peak this past year was in October when more than 1,000 cases were recorded.

From all poisonings, 30 people had used recognition applications on smartphones. This is not advised due to the high risk of error.

Pick only specimens in good condition and take the entire mushroom to help with identification. Do not pick mushrooms near potentially polluted sites such as roadsides and landfills.

Store mushrooms in the fridge at a maximum of 4 degrees C (39.2 degrees F), avoid all contact with other foods, and consume within two days of picking. Ensure they are correctly cooked – 20 to 30 minutes in a pan or 15 minutes in boiling water – and don’t eat too many in one sitting.

ANSES recommends only collecting mushrooms they know, as some highly toxic ones are similar to edible species. Poisonous types can also grow where edible varieties had been picked in the past. If there is the slightest doubt, consult a specialist before consumption.

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A total of 1,923 intoxications were reported to poison control centers (CAP) during the surveillance period, between July and December. The amount is usually around 1,300 cases. Levels in 2022 were similar to those in 2019.

The monthly poisoning peak of 2022 occurred in October when more than 1,000 cases were recorded. Nearly 40 serious cases occurred, including one person needing a liver transplant and another who had kidney failure, and two people died. In 2021, 41 serious cases and four deaths were reported.

Mushroom growth varies from year to year depending on various things, including weather, according to an article in Vigil’Anses, a newsletter published by the French Agency for Food, Environmental and Occupational Health and Safety (ANSES).

Risk factors for poisoning are poor conservation, consumption of old mushrooms in poor condition, undercooked mushrooms or eating too many, and personal sensitivity, but the major risk is confusing an edible species with a toxic one.

Digging deeper into cases
A questionnaire to better understand the circumstances of intoxication was undertaken by poison control centers. It was offered to each person calling a poison control center for mushroom poisoning to assess the methods of obtaining and identifying mushrooms, plus knowledge of ANSES’s prevention messages.

Although recommendations are issued every year by ANSES, poisonings are frequently reported to poison control centers because of the consumption of raw mushrooms by young children or the use of identification applications for smartphones.

In 2022, 1,862 people were poisoned during a meal including mushrooms. The other cases include accidental ingestion by young children or vulnerable adults.

For 1,146 meals, information on the origin of mushrooms was available. More than 92 percent had been picked but some had been bought in supermarkets, markets or greengrocers or eaten in restaurants.

Picking had taken place mainly in forest areas and less frequently in a garden. A small percentage were from the roadside. Most mushrooms had been cooked before consumption but they were eaten raw in 94 meals.

Some people had tried to identify picked mushrooms before consuming them using various ways such as a book, a smartphone application, the internet or via the help of a third party such as a pharmacist or a mycologist from an association.

The most frequently identified toxic species were Satan’s (or Devil’s) bolete, yellow agarics, poisonous lepiota types or the fly agaric.

People mainly suffered from digestive symptoms including vomiting, nausea, diarrhea or abdominal pain. Neurological issues were observed in 17 percent of patients, including dizziness or headaches. Some people showed excessive sweating or a rash, as well as cardiovascular symptoms.

Wild mushroom advice
ANSES recommends that people only collect mushrooms they know as some highly toxic ones are very similar to edible species. Poisonous types can also grow where edible varieties had been picked in the past. If there is the slightest doubt, consult a specialist before consumption.

Pick only specimens in good condition and take the entire mushroom to help with identification. Do not pick mushrooms near potentially polluted sites such as roadsides and landfills.

Store mushrooms in the fridge at a maximum of 4 degrees C (39.2 degrees F), avoid all contact with other foods and consume within two days of picking. Make sure they are cooked properly – 20 to 30 minutes in a pan or 15 minutes in boiling water – and don’t eat too many in one sitting. Also, don’t give wild mushrooms to young children or use only mobile apps for identification, due to the high risk of error.

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Food Standards Scotland (FSS) said it was aware of two children, in Edinburgh in 2022 and Lanarkshire in 2021, who became unwell after having slush ice drinks. Both required hospitalization and had symptoms consistent with glycerol intoxication. One of the youngsters consumed three slushies in a limited time.

Glycerol is an ingredient in slush ice drinks to prevent the liquid from freezing solid. It is allowed as an additive and there are no limits. Manufacturers can add as much of it as needed to achieve the desired technological function. The level of glycerol in slush ice drinks varies depending on the manufacturer and the product.

FSS has been looking into the incident with the Food Standards Agency (FSA), Public Health Scotland, NHS Health Protection Teams, and local authorities.

Stuart McAdam, head of incidents at Food Standards Scotland, said: “Although glycerol is generally of low toxicity, there are concerns about the effect on young children when large quantities are consumed over a short period of time.

“We are working with UK trade associations that represent the soft drinks industry and a wide variety of stakeholders to better understand the levels of glycerol used across the sector.”

Unlimited refills and self-serve options
One concern is unlimited refills at theme and activity parks. The FSA said it was also aware of a growing number of self-serve options at retail shops, convenience stores, and newsagents. A particular problem is refill offers are often unmonitored. There is no legislation limiting the availability of self-service refills.

Consumption of more than one drink or large volumes in short time periods, may cause significant adverse health effects in young children, said the agency.

The advice is that children, especially those under the age of 3, should not drink more than one of these types of drinks within an hour.

Young children having one 350 mL slush ice drink could potentially suffer headaches, nausea, or vomiting. Consumption of more than one drink in a short time period could lead to more severe effects.

A European Food Safety Authority (EFSA) opinion in 2017 concluded that infants could be exposed to high enough levels to cause side effects by drinking less than one 330 mL can of a flavored drink.

Awareness of the potential risk of glycerol intoxication in children when consuming slush drinks has been raised with food businesses and local authorities. FSA has provided advice and shared a risk assessment on the additive with industry and local authorities. Work on risk management is ongoing.

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This past year, China CDC investigated 482 incidents of mushroom poisoning across 21 regions. This resulted in 1,332 patients and 28 deaths.

Incidents and patients were more than in 2019 and 2021 but fewer than in 2020, while deaths slightly increased.

Mushroom poisoning has become a serious food safety issue in China, said researchers in the journal China CDC Weekly.

Information on incidents
The number of cases per outbreak ranged from 1 to 28. Thirteen incidents involved more than 10 patients. Of these, 73 patients from 23 incidents ate poisonous mushrooms purchased from markets or given by friends; 44 patients from seven incidents were poisoned after eating dried mushrooms; and 213 patients and three deaths from 55 incidents ate mixed mushrooms.

Mushroom poisonings occurred in all months, with the most between May and November. The first death occurred in mid-February in Fujian. The top three months for deaths were June with 13 and three each in July and September. A peak occurred in June and incidents decreased in July and August, likely because of a drought in southern China. With the arrival of rain in September, poisoning levels reached a second peak.

Yunnan, Hunan, Sichuan, and Guangxi had more than 100 patients each, and Yunnan, Hunan, and Guangdong had the most deaths.

Southwest China — including Yunnan, Sichuan, Chongqing, and Guizhou — was the most severely affected region followed by Central China in Hunan, Hubei, and Henan.

A total of 98 mushrooms were identified, causing seven different clinical types of disease. Three provisional new species were recorded as poisonous mushrooms in China as well as 10 other types. In total, 62 species had already been recorded from 2019 to 2021. This raises the number of species from incidents to more than 190 in China by the end of 2022.

Sixteen edible mushrooms were identified from poisoning incidents in 2022. These incidents were likely because of the consumption of mixed mushrooms with poisonous ones, contaminated mushrooms, or some species that may be poisonous to certain people, said scientists.

Mushroom types implicated
The top three lethal species were Amanita exitialis and Amanita rimosa which caused seven deaths each and Russula subnigricans, which was behind six fatalities. Chlorophyllum molybdites caused the most poisonings.

In June, one person in Sichuan was poisoned by Paxillus orientalis, resulting in hemolysis. This was the first reported case of illness from this species in China. Researchers strongly advised against collecting and eating types of Paxillus, despite previous acceptance as edible, used in medicine, and a perception of safety.

In 2022, 51 species of gastroenteritis-causing organisms were identified. The top two were Chlorophyllum molybdites and Russula japonica.

Overall, 32 species caused psycho-neurological disorders. Lanmaoa asiatica ranked first. Scientists said the increased poisonings may be partially attributed to the rise of online shopping, which lacks face-to-face communication about the proper cooking.

“To reduce the risk of poisoning, we recommend that people set aside some fruiting bodies before eating or take a photo of the fresh mushrooms before cooking. In view of the extensive impact and harm of poisonous mushrooms on public health, it is necessary to promote prevention and improve the ability of professionals to identify, diagnose, and treat mushroom poisoning. We recommend creating more scientific, plain, and varied popularization materials and publicizing them to people at risk before and throughout the poisoning season,” said researchers.

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New South Wales (NSW) Health said there are 47 people in the state who have reported symptoms after eating baby spinach and at least 17 of them have sought medical attention.

Initial symptoms may include delirium or confusion, hallucinations, fever, dilated pupils, rapid heartbeat, a flushed face, blurred vision, and dry mouth and skin. The onset of symptoms occurred within hours of eating the affected baby spinach.

Riviera Fresh has recalled Riviera Farms brand baby spinach 350 grams and 1-kilogram. It was sold at Costco Wholesale in New South Wales, the Australian Capital Territory (ACT), and Victoria. All use-by dates from Dec. 16 to Dec. 28, 2022, are affected.

Woolworths Group has recalled Chicken Cobb Salad with a use-by date of Dec. 20 and Chickpea Falafel Salad with use-by dates of Dec. 20 and Dec. 22, which include the spinach. They were sold at Woolworths and Woolworths Metro stores in NSW, ACT, Queensland, and Victoria. Aldi has also recalled Fresh Salad Co. Fresh and Fast Stir Fry with a date of Dec. 24 sold at stores in Victoria.

Illness is believed to have been caused by accidental contamination of products with “unsafe plant material,” said Food Standards Australia New Zealand (FSANZ).

Possible symptoms
ACT Health is looking into several potential cases in the state and investigating the issue with other agencies.

The Victorian Department of Health said reports of “unusual and severe” symptoms have occurred in Victoria following consumption of the baby spinach.

Consumers have been advised not to eat the spinach and dispose of it. People who have eaten the product should seek medical advice or contact their local poisons information center.

Riviera Farms said it was working with retailers and regulators to identify, and recall, potentially contaminated spinach products from shelves. 

“It appears these products, which were grown on a farm in Victoria and shipped to stores in NSW, have been contaminated with a weed which can have health consequences if consumed. Samples have been sent to laboratories for testing,” said a company statement.

“Riviera Farms advised authorities immediately after being alerted by one of our retailers and we will continue to work closely with health and food regulators as investigations continue. Riviera Farms has been in the business of providing fresh food since the 1880s and has been saddened by this incident, which is the first in our long history of providing fresh food products.”

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Officials in Seyé, in the Mexican state of Yucatan, said the incident involves up to 500 people but no deaths have been reported. The first alert about the poisoning was made this past week.

Patients were seen by the district’s doctor and sent to a hospital in the town of Acenceh but the local town hall also had to be converted into a temporary medical facility to handle the number of people who were sick.

Preliminary analyzes suggests a high probability that people were poisoned because of the presence of Clenbuterol in meat they ate, but some test results are still pending.

Clenbuterol is used in livestock to promote growth, despite being banned, but can cause symptoms including headaches, increased sweating, insomnia, nausea, possible muscle spasms, and increased blood pressure. Symptoms usually occur shortly after consuming contaminated food, and last for two to six days.

Illness has been linked to consumption of Cochinita Pibil, which is a traditional Yucatan dish that includes pork.

Officials have closed the outlet where the food that poisoned dozens of residents was believed to have been prepared and they are visiting suppliers of the business to carry out checks to try to find the source of the problem.

In 2020, more than 50 people fell sick in the Mexican state of Morelos after eating meat contaminated with Clenbuterol. 

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The 32-year-old woman from Mainz has been placed in a psychiatric hospital, according to the public prosecutor’s office in Darmstadt and police in southern Hesse. She has not yet responded to any of the accusations.

Seven people reported health problems after consuming various foods or drinks in August 2021 at the Technical University of Darmstadt. Some of them were taken to hospitals with symptoms of intoxication and blueish discoloration of the extremities. The health of a 30-year-old student was described as critical at the time.

The university later revealed that all seven employees and staff members affected were feeling better and had left hospitals. An examination of blood and urine samples taken from victims indicated harmful substances in six cases that likely resulted from contaminated food.

University President Tanja Brühl said there was relief that the case had been solved.

“We were all shocked by the poisoning cases, which put the health of members of the university in serious danger. We are glad that those affected have recovered. We would like to thank all TU members for the extensive support of the police investigations and the prudent behavior in the weeks after the crime,” she said.

Solving the puzzle
Investigators said the woman came to their attention at an early stage of the probe that involved speaking to more than 1,000 witnesses. They found she had probably been in the building on the day of the incident.

At the time, emergency services evacuated the site and blocked the immediate area. They inspected other buildings on the campus but didn’t find any more contaminated items.

The Department of Materials Science student who has been detained had been enrolled since late 2017 and is thought to have mixed various items such as water containers with harmful substances. It has not been made public what agent caused the poisoning or how the woman got hold of it.

Those affected had been mentioned in written records kept by the accused. Police said this indicates “she felt persecuted” by these people.

Officers said she had been placed in a psychiatric hospital because there is a suspicion “that the accused is not criminally responsible due to a mental illness”.

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The group said deathcap (Amanita phalloides) mushrooms are difficult to distinguish from some other wild varieties and advised people to only eat mushrooms bought from a supermarket, greengrocer or other reputable source.

People from other countries should also be cautious as the mushrooms can look like edible types that grow in their own countries.

Weather impact
Cathy Moir, council chair, said that foraging for wild food is becoming popular but gathering wild mushrooms can be life threatening.

“Deathcap mushrooms can appear any time of year but are usually more common during autumn, a week or two after good rains. However, during a wet summer like this one, fruiting has occurred much earlier with reports of them in the Australian Capital Territory (ACT) and Adelaide Hills region since Christmas,” she said.

“They have been found in the Canberra region, in and around Melbourne, in Tasmania and in the Adelaide region. They are not native to Australia and are found near oak, hazel or chestnut trees. The similar native marbled deathcap mushrooms have been found in Western Australia in eucalypt forest, although they may not be as toxic. While no cases have been reported in other states it is possible that they also grow there.”

In November 2021 in the ACT, three people went to emergency departments after ingesting wild mushrooms. The state has seen four deaths associated with Death Cap mushrooms since 2002.

Toxin in deathcap mushrooms is not destroyed by peeling, cooking or drying. Symptoms of poisoning include vomiting, diarrhea and stomach cramps and usually appear six to 24 hours after eating. They may ease for two to three days before a terminal phase of three to four days. Without early medical intervention people may go into a coma and die after two or three weeks of liver and kidney failure.

Burden for children
Most deaths from mushroom poisoning in Australia result from deathcap mushrooms. However, there are other wild mushrooms that have caused fatalities or can make people ill.

These include various Cortinarius (webcap) and Galerina species, the ghost mushroom (often mistaken for oyster mushrooms), and the yellow stainer which resembles a field mushroom and is the most commonly ingested poisonous mushroom in Victoria and New South Wales (NSW).

“The NSW Poisons Information Centre, which receives enquiries from NSW, the ACT and Tasmania as well as after-hours enquiries for all of Australia, received 549 calls during 2020 regarding exposures to mushrooms with another 133 recalls about these cases. 23 percent of calls were intentional recreational or foraging exposures in adults,” said Moir.

“More than a third of these calls were accidental exposure in children under 5 years, so remember that small children have a natural inclination to put things in their mouths so keep an eye on them when outdoors. Parents, schools and childcare workers should regularly check outdoor areas and gardens for mushrooms and remove them to reduce the risk of accidental poisoning. This will also protect your pets.”

This past year, South Australians were warned about picking mushrooms. From January to March 2021, the poisons center handled 14 mushroom related cases with four referred to hospitals. There were 111 incidents in 2020 with 12 calls referred to hospital.

“Each year, around two-thirds of calls made to the hotline about mushroom poisonings involve children less than 5 years of age. In 2020 there were 20 percent more calls made about mushroom exposure to the Poisons Information Centre than the previous year, which may be attributed to more people being active outside when COVID-19 restrictions were in place,” said Dr. David Simon.

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In 2021, there were 327 investigations involving 923 patients and 20 deaths. Mushroom poisoning incidents and patients were more than 2019 but less than 2020 as deaths slightly decreased.

The number of patients in outbreaks ranged from one to 20 and six incidents involved more than 10 patients, according to a study published in the journal China CDC Weekly.

A total of 68 patients from 14 incidents ate poisonous mushrooms from a market or given to them by friends; 46 people from 10 incidents were poisoned after eating dried mushrooms .and 113 patients from 28 incidents ate mixed mushrooms.

Overall, 74 poisonous mushrooms species causing six different clinical syndromes were identified, 15 of which were newly recorded in China. In nine cases, it was previously unknown if the species was poisonous or not. This takes the number of mushroom species linked to intoxications past 150.

Further analysis showed that mushroom poisonings occurred every month, centered from May to November and reaching a peak in August. The first death was in early March. The top three months for deaths caused by poisonous mushrooms were September, July and November.

Types of mushrooms behind intoxications
The top three lethal mushroom species were Russula subnigricans, Galerina sulciceps, and Lepiota brunneoincarnata, which caused six, five, and three deaths, respectively. Chlorophyllum molybdites was behind the most poisonings incidents.

Eight species causing acute liver failure and three linked to acute renal failure were identified.

Mushroom poisoning resulting in acute liver failure caused by Amanita spp. dropped sharply. Researchers said this progress was mainly because of continuous science popularization and health education.

Thirty-nine species causing gastroenteritis were documented in 2021. The top three were Chlorophyllum molybdites, Russula japonica, and Entoloma omiense.

Researchers urged people to not collect or eat unfamiliar wild mushrooms.

“Mushroom poisoning is one of the most serious food safety issues in China. The low level of awareness of mushroom poisoning, in contrast to the high species diversity in China is a huge challenge for mushroom poisoning control and prevention,” they said.

“Promoting knowledge about poisonous mushrooms is essential and urgent to reduce mushroom poisonings. Timely and precise species identification after mushroom poisoning is important for appropriate diagnosis and treatment. Many deaths were linked to delayed hospitalization.”

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Seven people reported health problems after consuming various foods or beverages during Monday lunchtime at the Technical University of Darmstadt (TU Darmstadt). The first people were taken to hospital with symptoms of intoxication and blueish discoloration of the extremities. The health of a 30-year-old student was critical.

The university later reported that all seven employees and staff members affected were feeling better and the last two affected people had left hospital.

The public prosecutor’s office in Darmstadt is leading the investigation and started proceedings on the initial suspicion of attempted murder.

Professor Tanja Brühl, president of TU Darmstadt, said the university was shocked in light of the apparent criminal act.

Chemical contamination
Police asked all people who had eaten or drunk in a building called “L2|01” on Monday that felt unwell or have blueish discoloration of the extremities to seek medical help immediately. Emergency services evacuated the site and blocked the immediate area. The building is the Department of Materials and Earth Sciences.

Officers inspected all other buildings on the Lichtwiese campus with the help of TU Darmstadt and did not find any further objects relevant to the incident.

Rooms have been searched for food and drinks to trace the origin of the substance that caused the poisoning. Food and water samples were also taken for laboratory testing.

Specialists from the Hessian State Criminal Police Office detected substances, including in items seized by police at the crime scene, which could have caused the symptoms experienced by those sick but they have not yet revealed what they are.

Police believe that between Aug. 20 and 23 several milk cartons and water vessels were mixed with a harmful substance that had a pungent smell. Beverages and water containers had been contaminated with chemical substances at various locations.

Law enforcement officials said there is no longer any acute risk but advised people to only consume food on the Lichtwiese campus that they have with them and that has been kept under supervision at all times.

Investigations are ongoing and police are trying to identify those behind the product tampering.

Angela Dorn, Minister of State for Higher Education, Research, Science and the Arts, said her thoughts are with those affected and their loved ones and wished them a speedy recovery.

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In 2020, the number of investigations reached 676, involving 102 species of poisonous mushrooms, 24 of which were newly recorded in China.

Mushroom poisoning incidents from 24 provincial-level administrative divisions involved 1,719 patients and 25 deaths. In 2019, 276 incidents involved 769 patients and 22 deaths.

In 2020, the number of cases ranged from one to 27, and 14 outbreaks involved more than 10 patients. Most incidents were reported in Hunan, Yunnan, Guizhou, Zhejiang and Sichuan. Of these, 93 patients from 24 incidents had eaten poisonous mushrooms purchased from a market or given by friends; 51 people from 12 outbreaks had been poisoned after eating dried mushrooms; and 404 patients from 131 incidents with seven deaths ate mixed mushrooms. Experts in the China CDC Weekly journal strongly advised people to avoid having mixed wild mushrooms and alcohol.

Main types behind intoxication
There were also more occasions when patients consumed a combination of poisonous mushrooms, which increases difficulty and risk for diagnosis and treatment because of the different symptoms.

Like in 2019, mushroom poisonings occurred in every month but mainly from June to October. There were two peaks in June and September involving 428 and 412 patients, and eight and three deaths, respectively.

The most lethal species of those identified were Lepiota brunneoincarnata with five deaths and Russula subnigricans, and Amanita subpallidorosea with four deaths each. Chlorophyllum molybdites caused the most poisonings, being mentioned in 154 incidents with 304 patients.

Lepiota brunneoincarnata, the most dangerous species in 2020, was responsible for 15 incidents, 29 patients, and five deaths as the lone cause or in combination with other species.

A total of 56 species causing gastroenteritis were identified from intoxications in 2020. Among them, Baorangia major, Chlorophyllum demangei, Entoloma caespitosum, Gymnopus densilamellatus, Lactarius atromarginatus, Lactifluus deceptivus, Micropsalliota furfuracea, Neonothopanus nambi, Pulveroboletus subrufus, Russula rufobasalis, and Tricholoma stans were newly discovered as lethal and were added to the poisonous mushroom list.

Controlling the problem
Another 28 species causing psycho-neurological disorders were linked to incidents including Clitocybe subditopoda, Gyromitra venenata, Mallocybe fulvipes, and Pseudosperma yunnanense, which were new species added to the poisonous mushrooms list.

Gyromitra venenata was discovered in incidents in the Yunnan and Guizhou provinces and were the first reported poisonings because of gyromitrins in China since 2000. The rare poisoning Shiitake mushroom dermatitis was also reported. Hemolysis poisoning caused by Paxillus involutus was recorded for the second time since the beginning of this century, resulting in one death in Inner Mongolia.

Epidemiological investigations, timely and accurate species identification, toxin detection, and appropriate diagnosis and treatment are key to control mushroom poisoning, said researchers.

“The growing number of poisonous mushroom identifications suggests that what we know only a portion of the variety of poisonous mushrooms. Many species need to be formally described and their edibility is not clear,” they said.

“Promoting knowledge about safe consumption of mushrooms is essential to reduce mushroom poisonings. It is not wise to collect and eat wild mushrooms.”

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The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) seasonal message focused on holly, mistletoe and poinsettia blooms, berries and leaves that can be used to decorate cakes, homes and gardens. Ingestion of berries or leaves, particularly by children or pets, can cause symptoms of varying severity depending on the quantity consumed.

Poison control centers in France receive between 60 to 80 calls about children under the age of 15 who have accidentally put holly berries in their mouth. Almost 40 percent of cases occur during the winter holiday season between December and January.

In most cases, children put one or two berries in their mouth and do not develop any symptoms or only experience minor digestive problems such as nausea, vomiting and abdominal pain. However, ingesting a larger number of berries can lead to symptoms such as excessive salivation, vomiting and persistent diarrhea, drowsiness or seizures.

Holly leaves and berries are also toxic to animals like dogs and cats. If ingested they can develop diarrhea and vomiting or neurological symptoms such as drowsiness and coma after eating a large number of berries.

Calls to poison centers
Poison control centers receive around 40 calls per year concerning children who have put Mistletoe leaves or berries in their mouths. Three-quarters of these cases take place in November and January.

Most children do not develop symptoms or show only mild digestive signs after having a small amount of berries. However, cardiac rhythm disorders or a drop in blood pressure or neurological disorders such as drowsiness can be observed if many berries are ingested.

Mistletoe leaves and berries are possibly lethal if they are consumed by domestic animals or grazing herbivores such as cows, sheep or horses.

Placing a Poinsettia leaf in the mouth can cause mild digestive symptoms in children. However, for a pet, chewing several leaves or stems can have serious consequences, such as digestive problems or excessive salivation.

ANSES advised the public that if a child has placed leaves or berries of holly, mistletoe or another ornamental plant in their mouth to clean the child’s mouth with a wet cloth, do not give them anything to drink, and call a poison control center. The label should be kept or a photo of the plant taken to help with identification.

In other news
The Singapore Food Agency (SFA) and ANSES have signed a Memorandum of Understanding to promote scientific and technical cooperation between the two agencies on food safety. The MOU was signed by Lim Kok Thai, chief executive officer of SFA, and Roger Genet, director-general of ANSES.

Lim said the food system has become increasingly complex and globalized.

“SFA will continue to forge strong partnerships with our counterparts from like-minded countries to keep Singapore’s food safety regulatory framework robust and stay abreast of global food safety developments,” he said.

Potential areas of collaboration include risk assessment of chemical and microbiological food safety hazards; testing programs for chemical and microbiological food safety; safety assessments of novel foods; and emerging food safety risks.

Swedish and Norwegian advice
Meanwhile, Livsmedelsverket (Swedish Food Agency) has provided information on which fish are good to eat at Christmas and which may contain high levels of environmental toxins. The agency reported it receives a lot of questions on the topic so it published tips for the festive season.

Fish is a good and healthy food which contains important nutrients. The advice is to eat it two to three times a week and have different varieties.

However, some fish also contain high amounts of organic environmental pollutants such as dioxins and PCBs. This is influenced by where the fish comes from. For children, young people and those who want to get pregnant in the future, it is important to reduce exposure to these substances.

In the EU, there are maximum limits for the amount of dioxins and PCBs that some animal foods may contain. However, species exempt from these limits are wild-caught herring larger than 17 centimeters, salmon, char, trout and river lamprey caught in the Baltic Sea area, including Lake Vänern and Lake Vättern, and sold in the Swedish market.

Livsmedelsverket has produced a video with Sofia B Olsson, kitchen manager at a seafood restaurant in Gothenburg, about fish with high levels of environmental toxins.

Tips for leftovers
Finally, Mattilsynet (Norwegian Food Safety Authority) has published tips on preparation and storage of food at Christmas.

The most common causes of food poisoning are inadequate cooking, delayed cooling of food, storage at too high a temperature and poor cleaning, according to the agency.

Advice covers potential sources of infection, serving hot food, eating leftovers, making food the day before, refrigerator space and temperature, cross contamination and handwashing.

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The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) reported that since the start of the mushroom-picking season in early autumn, poison control centers have recorded a sharp increase in cases, particularly in recent weeks.

Poisoning risks include confusion of an edible type with a toxic species, or consumption of edible mushrooms that are in poor condition, undercooked, or have been incorrectly stored. Most cases are due to foraged mushrooms but occasionally they are because of the purchase at a market or in a shop, or consumption in a restaurant.

Latest intoxication stats
Since July 2020, poison control centers have recorded 732 cases of intoxication, including five people with serious life-threatening illnesses.

Confusion between species sometimes happens through the use of fungi recognition apps on smartphones, which incorrectly identify the foraged mushrooms, according to ANSES.

In 2019, more than 2,000 cases were reported to poison control centers between July and December. While most poisonings were minor, there were 24 cases of high severity with life-threatening prognosis and three deaths. More than half of all cases occurred in October when weather conditions combining rainfall, humidity, and cooler temperatures favored wild mushroom growth and picking.

Symptoms are mainly digestive and include abdominal pain, nausea, vomiting, and diarrhea. The onset of illness varies and is usually within a few hours of consumption, but maybe longer and exceeds 12 hours. People should note the time of the last meal and onset of first symptoms, and keep any leftover wild mushrooms for identification.

This type of poisoning can have serious health consequences such as severe digestive disorders, kidney complications, or liver damage requiring a transplant leading to hospitalization or death.

A problem elsewhere
In October this year, the Ontario Poison Centre warned the public of the dangers of mushroom foraging after an increase in calls. The rise included cases where people had to be hospitalized after consuming wild mushrooms. In September, the center received 72 calls directly related to mushroom exposures, compared to 38 in September 2019.

In the same month, officials in the Italian city of Sassari detected three cases of wild mushroom poisoning. The first involved a child who ate edible porcini mushrooms. The second intoxication was caused by consumption in excessive quantities of mushrooms from the species Leucopaxillus lepistoides. The third case occurred after eating Amanita phalloides and the patient needed hospital treatment.

Authorities in Hong Kong investigated suspected poisoning related to the consumption of wild mushrooms in September. A five-year-old boy and 47-year-old woman developed nausea, vomiting, and diarrhea for about one hour after consuming mushrooms at home. One month earlier, a 54-year-old woman reported nausea, abdominal pain, and diarrhea one hour after having cooked mushrooms at home and required hospital treatment.

In May, a number of serious poisonings occurred in Victoria, Australia due to Death Cap and Yellow-staining mushrooms. The mushroom season in South Australia coincided with more people being at home and there was an increase in calls to the poisons information hotline from those seeking help after eating wild mushrooms. In total, 21 of 30 calls in 2020 involved young children, and five were referred to the hospital.

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The action by the Public Prosecutor’s Office of Minas Gerais includes 10 people allegedly involved in the contamination of Backer’s beers and a witness for reportedly making a false statement during the police investigation.

If any of the 10, including the three-part owners of the brewery and seven staff involved in making the beer, are convicted they could face between four and eight years in prison.

Glycol poisoning
The complaint alleges that between 2018 and Jan. 9, 2020 the three owner-partners of the business in Belo Horizonte sold beer adulterated by a toxic substance in the production process that harmed consumers.

People were poisoned by diethylene glycol after drinking beer from the Backer brewery. The company had said it never bought diethylene glycol but did use mono ethylene glycol.

Police in Minas Gerais found a leak in a tank that started in September 2019. This hole allowed the coolant liquid circulating in an external system to mix with the drink inside the container. Eleven people linked to the company were indicted as part of that investigation which concluded in June that it was an accident likely caused by a manufacturing defect.

Also in June, the Minas Gerais State Department of Health reported 42 suspected cases of poisoning by diethylene glycol with symptoms including blindness and facial paralysis.

Mapa final report
A report this past month by the Ministry of Agriculture, Livestock, and Supply (Mapa) said more than 80 thousand liters of beer of various brands and batches from the company had been removed from the market or seized at the brewery. This included more than 56,600 bottles. In the state of Espírito Santo, more than 9,000 bottles of potentially contaminated beer were withdrawn from sale.

This 76-page report claimed contamination had occurred since January 2019 and diethylene glycol and mono ethylene glycol contamination was not restricted to batches that passed through one tank as it occurred in beers prepared prior to the installation of this unit. From about 600 samples tested, glycols were found in 36 lots produced in 2019 and 2020 in varying concentrations.

MAPA said the company had gaps in its internal control and management systems, with incomplete information in production reports and inefficient traceability.

As of August, the Backer factory remained shut until it could be confirmed there are no risks for the production of beers on site, according to authorities.

In January, the Brazilian Health Regulatory Agency (Anvisa) banned the sale of Backer beers with an expiration date from August 2020 onwards.

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In March and April, there were four incidents in two food markets of different retail chains in the west of Munich.

An as-yet-unidentified individual introduced a lethal dose of toxic substances from the group of solvents into bottles of soft drinks. The manipulated beverage bottles were then placed on store shelves.

In three cases, the bottles were purchased and consumed in small quantities. All three people affected – a 34-year-old woman, a 42-year-old woman, and a 48-year-old man, all from Munich – complained of dizziness, nausea, and circulatory problems after consumption.

An investigation also found a fourth bottle that was tampered with before it was sold.

The motive of the individual is not yet known and so far no demands have been made, according to police.

German media reported more cases are under investigation since the initial warning and officials have identified the substance in the drinks but they have not publicly said what it is yet.

Authorities urged the public to pay attention to the retained ring when buying screw-top drinks. In some cases, visible impurities could be seen in the bottles. If people believe the bottle is suspicious, they should not dispose of the substance but inform the police immediately.

When opening a bottle, there is a noticeable smell and taste has been described by the people affected as bitter and artificially chemical.

Officials said the investigation was ongoing and they appealed for witnesses to identify if there had been other incidents of bottle tampering since March.

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Sixteen males and one female aged 23 to 76 years old are thought to have suffered diethylene glycol poisoning. Four cases have been confirmed and the remaining 13 are under investigation as they have showed similar symptoms, according to the Minas Gerais State Department of Health.

The first person was admitted to a hospital on Dec. 30, 2019, suffering from acute renal failure and neurological issues such as facial paralysis, blurred vision and sensory alteration. For suspected cases, the earliest onset of symptoms is Dec. 19, 2019. The average number of days between onset of symptoms and hospitalization was two and a half.

Mapa calls for mass recall
The Ministry of Agriculture, Livestock and Supply (Mapa) has told Cervejaria Backer to recall all products manufactured from October 2019 to the current date. The company has challenged this as it believes only Belorizontina branded beers could be affected.

Analyzes on samples of Belorizontina and Capixaba products made by the brewery have confirmed presence of the contaminants monoethylene glycol and diethylene glycol. The latter substance has also been found in the blood of some of those sick. Both substances are used as antifreeze in the brewing industry.

Mapa has stopped Cervejaria Backer’s Três Lobos unit in Belo Horizonte, Minas Gerais, for precautionary reasons. A total of 139,000 liters of bottled beer and 8,480 liters of draft beer has been seized and tanks and other production equipment were also sealed.

Source of contamination under investigation
Only monoethylene glycol is used in the production process, according to the company.

However, tests on a cooling tank used in the production of Belorizontina beer batch L2 1354 came back positive for diethylene glycol. The substance had been detected in samples of two beers from batches L1 1348 and L2 1348 provided by family members of patients. Capixaba beer from batch L2 1348 was positive for monoethylene glycol and diethylene glycol.

Bottles from the families of victims and the company were found to be intact and showed no signs of tampering.

Officials believe the beer was contaminated sometime between the second half of November and start of December 2019. Several lines of enquiry are being followed including accidental contamination and possible adulteration by a former employee.

A statement from the company said it was focused on patients and their families.

Brewery officials said the firm was collaborating with official enquiries and internally investigating to find out how the lots identified by police were contaminated. Results of independent tests are pending.

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