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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Four people were taken to the hospital on July 30 after they became ill following a meal at a house in Leongatha, a town in the state of Victoria, the previous day.

Two women, aged 66 and 70, died in the hospital on Aug. 4. A third person, a 70-year-old man, died in the hospital on Aug. 5. A 68-year-old man remains in the hospital in a critical condition.

Don and Gail Patterson and her sister Heather Wilkinson died from symptoms consistent with death cap mushroom poisoning, according to media reports. Ian Wilkinson is the patient still in hospital.  

Investigators from Victoria police executed a search warrant at a residence in Leongatha. Detectives also interviewed a 48-year-old woman who was released pending further enquiries.

Local media said the suspect, Erin Patterson, was the daughter-in-law of the couple who died.

An investigation surrounding the exact circumstances of the incident is ongoing and police are working with the Victorian Department of Health.

Poisonous mushroom risk
In April this year, the Victorian Department of Health warned that eating just one death cap mushroom may kill an adult. Poisonous mushrooms, including death caps, occur in Victoria during autumn, as the weather becomes wetter and cooler.

Cooking, peeling or drying these mushrooms does not remove the poison. There is no home test available to distinguish safe and edible mushrooms from poisonous types.

Symptoms of poisoning can include violent stomach pains, nausea, vomiting and diarrhea and usually occur six to 24 hours after eating the mushrooms. Even if initial symptoms subside serious liver damage may have occurred.

People should urgently attend an emergency department if they believe they’ve eaten a poisonous mushroom and take any remaining mushrooms with them for identification.

The Food Safety Information Council regularly warns people to be extremely careful around wild mushrooms because of the poisoning risk.

In April 2022, a young child was hospitalized in the Australian Capital Territory (ACT) after consuming a death cap mushroom. In 2012, two people died after eating these mushrooms at a New Year’s Eve party in Canberra and in 2014 four people in the ACT were seriously poisoned.

“Death cap mushrooms can appear at any time of year but are more common a week or two after good rains. They have been found in the Canberra region, in and around Melbourne, in Tasmania and in Adelaide. They are not native to Australia and are often found near oak trees growing in warm wet weather,” said Cathy Moir.

“Death cap mushrooms are difficult to distinguish from some other wild mushrooms so we recommend you play it safe and only eat mushrooms that you have purchased from a supermarket, greengrocer or other reputable source.”

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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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The charity said that mushrooms are growing around the country after wet weather. A similar warning was issued in previous years.

Cathy Moir, Food Safety Information Council chair, said that foraging for food is becoming popular but gathering mushrooms outdoors can be dangerous.

“The poison in one death cap mushroom, if eaten, is enough to kill a healthy adult. In April 2022, a young child was hospitalized in the Australian Capital Territory (ACT) after consuming a death cap mushroom. While in 2012, two people died after eating the deadly mushrooms at a New Year’s Eve dinner party in Canberra, and in 2014 four people also in the ACT were seriously poisoned,” she said.

“Deathcap mushrooms can appear at any time of year but are more common a week or two after good rains. They have been found in the Canberra region, in and around Melbourne, in Tasmania, and in Adelaide. They are not native to Australia and are often found near oak trees growing in warm wet weather. Similar native marbled death cap mushrooms have been found in Western Australia, although they may not be as toxic.

“Deathcap mushrooms are difficult to distinguish from some other wild mushrooms so we recommend you play it safe and only eat mushrooms that you have purchased from a supermarket, greengrocer, or another reputable source. People born overseas, especially in Asian countries, should be aware that these deadly mushrooms can look like edible mushrooms they may have gathered in their home countries.”

Children often affected
Toxins in death cap mushrooms are not destroyed by peeling, cooking, or drying. Symptoms of poisoning include vomiting, diarrhea, and stomach cramps and usually appear 10 to 16 hours after eating. They may ease for 2 to 3 days before a terminal phase of 3 to 4 days. Without early medical intervention, people may go into a coma and die after weeks of liver and kidney failure.

Moir said while the death cap variety is linked to the most deaths, other mushroom types can cause illness.

“There are other wild mushrooms in Australia that have caused fatalities or can make you seriously ill with abdominal pain, vomiting, and diarrhea. These include the Cortinarius (webcap) and Galerina species, the ghost mushroom (commonly 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,” she said.

“Many accidental exposures to poisonous mushrooms are in children under 5 years old, remember that small children have a natural inclination to put things in their mouths so keep an eye on them when outdoors. If you suspect you or your child may have eaten a death cap mushroom don’t wait for symptoms to occur but go to a hospital emergency department taking the mushroom with you if you can.”

It is not just Australia where wild mushrooms prompt concern. In 2022, almost 500 mushroom poisoning outbreaks were recorded in China with 28 associated deaths.

In September 2022 in France, at least 60 cases linked to wild mushrooms were reported.

Data from Tox Info Suisse, Switzerland’s poison information center, showed there was an increase in calls related to poisoning by plants and food and drink in 2022 while poisoning or suspected mushroom poisoning reports rose by 25 percent from 2021.

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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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Recent weather conditions have favored the growth of wild mushrooms and more than 60 intoxications have been reported to poison control centers since early September. Only a few cases occurred in July and August likely because of the very hot weather and drought, according to researchers.

Poisonings have a variety of causes: some people mistook a toxic species for an edible one, sometimes it is because of a smartphone app for wild mushroom identification providing incorrect information about the mushrooms picked, or consumption of edible mushrooms that are in poor condition or have been undercooked.

A yearly problem
Between July and December 2021, there were 1,269 cases reported to poison control centers in France. The majority of the mushrooms responsible had been picked in the wild but some cases involved mushrooms purchased commercially.

Symptoms were mainly digestive with abdominal pain, nausea, vomiting and diarrhea. There were 41 severe cases including four deaths. Fifteen young children were poisoned and one of them needed a liver transplant. French authorities said picked mushrooms should not be given to young children.   

Between July and December 2020, there were 1,300 poisonings reported. Overall, 29 life-threatening cases were identified and five people died.

The French Agency for Food, Environmental and Occupational Health and Safety (ANSES), poison control centers, and the Directorate General for Health (DGS) advised people to only pick mushrooms they know very well as some poisonous fungi closely resemble edible species. If there is the slightest doubt about the identification of any picked mushrooms, the agencies said they should not be consumed until they are checked by a specialist.

People should note the time of the last meal and onset of first symptoms, and keep any leftover wild mushrooms for identification. Officials advise taking a picture of the picked mushrooms before eating to help poison control center experts decide on the correct treatment if illness occurs.

Other countries impacted
Data from Tox Info Suisse, the Swiss poisons information center, revealed 529 mushroom poisoning cases in Switzerland in 2021.

The Belgian Poison Center (Centre Antipoisons) received almost 350 calls about potential mushroom poisonings in Belgium and Luxembourg in 2021.

In Germany, an average of 10 cases of mushroom poisoning per year are reported to the German Federal Institute for Risk Assessment (BfR) by doctors, and poison centers in the federal states answer more than 3,000 related inquiries annually. 

Popular domestic edible types include the field mushroom (Agaricus campestris) and edible Russula species. Often collectors confuse edible mushrooms with the highly toxic death cap (Amanita phalloides). Toxins contained in death cap cause liver failure and even eating small amounts can be fatal. 

About five percent of all mushroom poisonings are because of consumption of the death cap mushroom, which grows from July to October, mainly in forests, but also in parks. The BfR estimates that it causes at least 80 percent of all fatal mushroom poisonings in Germany.

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There was a decline in reported Salmonella infections and a survey found fewer people are washing chicken. However, another poll revealed handwashing had decreased while poisonings continue to be recorded linked to wild mushrooms.

The report card was released ahead of the fourth World Food Safety Day on June 7.

Australia sees an estimated 4.1 million cases of food poisoning each year that result in 31,920 hospitalizations, 86 deaths and 1 million visits to doctors.

Mixed results and social media sales
Cathy Moir, FSIC chair, said: “This past 12 months has seen a mixed report card for Australian food safety and now we are out and about with relaxing public health measures required to control COVID-19 infections we need to make sure we are following basic food safety tips such as correct handwashing, cooking processes and refrigeration temperatures.”

The council also criticized some social media firms such as Facebook and WeChat for hosting advertisements for sales of unregulated food and advised people not to risk buying anything from an unregulated seller.

A study in Communicable Diseases Intelligence showed a 27 percent reduction in reported salmonellosis cases in Australia in 2020 linked to public health measures to control COVID-19 transmission compared with the previous five years.

Factors behind the decline include restaurant and food business closures during coronavirus lockdowns and fewer international travelers acquiring food poisoning abroad. People may have been less likely to seek medical attention and there may have been changes in laboratory testing capacity.

A consumer survey found 49 percent of Australian cooks were still washing raw whole chicken before cooking. However, this was down from 60 percent when the question was asked in 2011. Washing raw poultry can spread bacteria to hands, surfaces and other foods that may not be cooked. It is also unnecessary as cooking poultry correctly will kill any bacteria.

Another survey, in October 2021, revealed there had been a 15 percent decrease in the number of times people washed or sanitized their hands a day, on average, since the previous year.

Following floods and wet weather, wild mushrooms have been growing. There have been some cases of death cap mushroom poisoning including a young child in Victoria and two young children and a man in the Australian Capital Territory, all of whom were hospitalized. FSIC advice is not to pick or eat wild mushrooms and to clear any of them growing where children play.

Other WFSD events
Other countries are also marking World Food Safety Day with different activities, including a dance challenge to raise awareness about the importance of food safety from June 7 to 14 in Mongolia.

The Argentinian Food Safety Commission and Argentinian Microbiology Association are holding a webinar on June 6 and the African Union Commission is running a virtual event on June 6 and 7. A symposium is set for June 7 in Saudi Arabia.

INFOSAN is organizing a webinar on improving emergency response in food safety while Environmental Health Australia and the National Environmental Health Association (NEHA) in the United States will present a series of live discussions on June 7.

A virtual run is being organized by the Maldives Food and Drug Authority and a Barcelona Food Safety Forum event will focus on alternative sources of protein.

The European Food Safety Authority (EFSA) and Spanish Agency for Food Safety and Nutrition (AESAN) are holding two roundtables with one promoting the #EUChooseSafeFood campaign.

The Global Food Safety Initiative (GFSI) will be talking about food safety and the United Nations Sustainable Development Goals on June 7.

A Danish Agriculture and Food Council and Food Nation webinar will focus on plant-based foods. Italy’s Scientific Society for Evidence on Environment, Food and Workplace Safety is organizing a webinar about edible and poisonous mushrooms and supplements.

The South African Food Safety Summit, sponsored by Marler Clark, will take place on June 7 and 8.

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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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The FSA is reviewing the controls on imports of food from Japan, that have been in place since a nuclear accident in March 2011, to provide food safety and public health advice to ministers, so a decision can be made on whether they are still needed. Northern Ireland will still follow EU rules and the final decision will be made by ministers in each country of England, Wales and Scotland.

A risk assessment estimated that removing the 100 becquerels per kilogram (Bq/Kg) maximum level of radiocaesium (radioactive forms of caesium) for food imported from Japan to the UK would result in a negligible increase in risk to consumers.

Most foods from Japan can already be imported without restrictions or checks on levels of radioactivity. However, controls remain for some products from certain regions such as a number of fish species, wild mushrooms and foraged vegetables.

Consultation open
A public comment period is giving people the chance to have a say on the next steps including keeping the current controls, removing them, or applying checks to fewer products. It is open until Feb. 11, 2022.

Since 2014, laboratory analysis has been done on a random basis of no more than 5 percent of consignments. In the 10 years that controls have been in place, there have been no instances where checks have found levels above 100 Bq/kg on products imported into the UK.

The potential for harm from radioactivity is measured in millisieverts (mSv). The International Commission on Radiological Protection recommends people should receive no more than the lower end of 1 to 20 mSv per year. The FSA’s risk assessment estimates the dose to UK consumers would be no more than 0.016 mSv per year as a result of eating food imported from Japan.

Some foods imported from Japan would still require declarations and undergo official controls for other food safety reasons when they are classed as high-risk foods.

EU and United States action
Earlier this year, the United States and European Union changed the rules around the import of food from areas near Fukushima. While the U.S. Food and Drug Administration removed an import alert, the EU Commission only amended regulations to modify checks on food imports.

Rebecca Sudworth, director of policy at the FSA, said food safety is a priority in the process.

“Products from this area are only imported into the UK in small quantities, primarily catering for people with a Japanese diet and restaurants specializing in Japanese food,” she said.

“These regulations have since been reviewed on a regular basis by the European Commission. This responsibility has now passed to the FSA, along with Food Standards Scotland, and we have completed a UK import risk assessment and economic impact assessment. We welcome all views on possible changes to the controls, before we advise ministers on next steps.”

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The study published in the journal China CDC Weekly used data on cases reported through the National Foodborne Disease Outbreaks Surveillance System from January to December 2020.

Poisonous mushrooms were the top cause of deaths in private homes. Residents in mountainous areas of southwest and central China tended to pick mushrooms and poisonous plants frequently in the wild.

Researchers said publicity should be increased to reduce the incidence of mushroom intoxications in families. People picking and eating mushrooms could not distinguish between poisonous and non-toxic ones, and the rate of timely treatment after poisoning was low and increased the risk of death.

Overall, most outbreaks, illnesses, and deaths were linked to home cooking and catering services. Home cooking had the most deaths with 128.

Influenced by the COVID-19 pandemic, for the first time in the past five years, outbreaks that occurred in private homes surpassed those in catering service units in 2020, according to the report.

Place of infection
This past year, the majority of outbreaks occurred in households with 4,140, followed by catering services with 2,719, and 27 at school campuses. Most illnesses were reported in catering locations, followed by households and only a few in campuses.

Within catering service sites, street stalls accounted for the largest proportion of outbreaks, and school canteens for the most illnesses. More than 100 outbreaks with 1,807 patients were because of home delivery of the meal.

Poisonous mushrooms were behind 80 deaths, aconite, a plant that contains poisonous chemicals, was responsible for 12 deaths, bongkrek acid for 12, and methanol for 14.

Outbreaks occurring between June and September made up almost two thirds of the total.

For 4,662 confirmed incidents, poisonous mushrooms were the most common cause of outbreaks and deaths while bacterial pathogens were the main cause of illnesses.

Agents responsible for illness
Salmonella with 286 outbreaks and 3,446 illnesses was the top bacterial pathogen linked to outbreaks and illnesses, followed by Vibrio parahaemolyticus at 128 outbreaks and 1,848 illnesses, and Staphylococcus aureus with 75 outbreaks and 954 illnesses.

More than 1,500 people were sick in 54 E. coli outbreaks and 620 illnesses came from 50 Bacillus Cereus outbreaks. Five Clostridium Perfringens outbreaks sickened 287 people, three Campylobacter jejuni outbreaks affected 133 while three Clostridium botulinum reports included 10 people. Only one Listeria monocytogenes outbreak was recorded with 28 patients.

Among the chemical agents, nitrite was the most common factor associated with outbreaks and illnesses, followed by pesticides. Plant and animal toxicants caused more than 1,000 outbreaks with 4,584 sick.

Findings provide a basis for prevention and control measures and support food safety risk assessment, formulation and revision of standards, and risk management, said researchers.

The top 10 pathogen-food category pairs resulting in outbreaks, illnesses, and deaths were analyzed. Salmonella in eggs was top followed by Salmonella in sauce-marinated meat and in pastry. Fourth was Bacillus cereus in rice flour and then Vibrio Parahaemolyticus in sauce-marinated meat.

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While the Food and Drug Administration has removed an import alert, the European Commission has amended regulations to modify checks on food imports.

In March 2011, an accident at the Fukushima Daiichi nuclear power plant released radiological contamination to the surrounding areas.

After the disaster, the Government of Japan determined that certain food products in affected prefectures, also known as states, were not fit for human consumption, because of the public health risk associated with radionuclide contamination and prohibited these items from sale in Japan and for export.

American measures
The U.S. Food and Drug Administration put in place an import alert on certain food products from Japanese prefectures near the damaged Fukushima Daiichi nuclear power plant in 2011. It instructed FDA field personnel to detain shipments from Japan if the food is likely to contain radionuclide contamination.

After analysis of Japan’s control measures that include decontamination, monitoring and enforcement; reviewing results of 10 years of sampling food products; and after determining a very low risk to American consumers from radioactive contaminated foods imported from Japan, the FDA decided the import alert was no longer necessary to protect public health and should be removed.

As of late July, the FDA had tested 1,749 import and domestic samples for contamination from the Fukushima facility. Three contained detectable levels of Cesium, but they were below the established Derived Intervention Level and posed no public health concern.

Japanese controls and FDA’s standard surveillance and sampling measures will continue to help ensure that food imported from Japan does not pose a food safety risk to consumers from radionuclide contamination.

EU action
In 2011, the European Commission imposed conditions on the import of food and feed originating in or consigned from Japan. Regulations set out the maximum radionuclide levels to match the values in Japanese law.

After reviewing the latest data, the EU said the obligation to sample and analyze products before export must be maintained or established for certain products but may be lifted for others.

This takes into account more than 87,000 occurrence data on radioactivity in feed and food other than beef and more than 429,000 occurrence data on radioactivity in beef provided by Japanese authorities for the 9th and 10th growing seasons following the accident. Data was reported from January 2019 until December 2020.

The EU said it was appropriate to require the sampling and analysis of wild mushrooms and derived products from the prefectures of Iwate, Nagano, Niigata and Ibaraki, of fish and fishery products from Gunma, of wild bracken and derived products from Fukushima and of Japanese royal fern and derived products from the prefecture of Miyagi in addition to products already on the list.

However, requirements have been removed for Aralia sprout and derived products from the prefectures of Fukushima, Miyagi and Gunma, bamboo and derived products from Fukushima, mushrooms and derived products from Gunma, and koshiabura and derived products from Shizuoka, Yamanashi and Yamagata.

No cases of non-compliance with EU law have been found during import controls for more than nine years so the frequency of official controls has been kept low.

The regulation will be reviewed in mid-2023 when results of sampling and analysis for the presence of radioactivity in feed and food in the 11th and 12th growing seasons in 2021 and 2022 are available.

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In July and August, 330 cases of poisoning were reported to French poison control centers. Three of these were very serious and potentially life-threatening and three deaths have been recorded.

Weather conditions in July and August favored early picking of mushrooms, according to the French Agency for Food, Environmental and Occupational Health and Safety (ANSES).

Poisoning risks include confusing edible types with toxic species, or consumption of edible mushrooms that are in poor condition, undercooked, or have been incorrectly stored.

Five deaths in 2020; three in 2019
Results from the previous season show that between July and December, 2020, 1,300 poisonings were reported to poison control centers in the country with more than half of them in October. This was when conditions such as rain, humidity and freshness favored the growth of mushrooms and their picking.

The majority of illnesses were linked to picked mushrooms, but in 4.5 percent of cases, they had been bought in a market or shop. A few incidents were caused by confusion with an edible species related to the use of a digital recognition app available on smartphones.

People were most often poisoned during a meal but 3 percent of cases followed ingestion, by a child or a vulnerable adult, of a piece of an inedible mushroom found in the garden or schoolyard.

Although most intoxications were not serious, 29 life-threatening cases were identified and five people died.

In 2019, more than 2,000 cases were reported to poison control centers between July and December. While most were minor, there were 24 cases of high severity with life-threatening prognosis and three deaths.

Swiss and Belgian figures
Data from Tox Info Suisse, the Swiss poisons information center, revealed at least 76 mushroom poisoning cases in Switzerland in 2020 including two serious cases.

The Belgian Poison Center (Centre Antipoisons) reported almost 500 mushroom poisonings in Belgium and Luxembourg in 2020 with children slightly more affected than adults.

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 exceed 12 hours. People should note the time of the last meal and onset of first symptoms, and keep any leftover wild mushrooms for identification.

Officials advise taking a picture of the picked mushrooms before eating to help poison control center experts decide on the correct treatment if illness occurs.

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Mushroom poisoning is the leading cause of foodborne disease outbreaks and outbreak-associated deaths in the country despite people being advised to not collect or eat wild mushrooms.

The 10,036 outbreaks resulted in at least 38,676 illnesses, 21,967 hospitalizations and 788 deaths from 2010 to 2020. The number of recorded outbreaks increased each year, from 37 in 2010 to 2,705 in 2020.

A large proportion of outbreaks occurred between May and October, according to data from the Foodborne Disease Outbreaks Surveillance System, which is managed by the China National Center for Food Safety Risk Assessment.

Risk of picking wild mushrooms
Among all reported outbreaks, 84.7 percent were associated with food prepared in private homes, followed by 8.8 percent from food prepared in street stalls, and 2.5 percent in canteens. The major cause of domestic outbreaks was self-harvest of wild mushrooms. Non-expert wild mushroom picking increases the risk of poisoning because of the difficulties of distinguishing between poisonous and edible mushrooms.

Most outbreaks involved fewer than 10 patients but 12 had more than 30 patients, according to the study published in the journal China CDC Weekly.

A rise in incidents between 2010 and 2020 is associated with implementation of compulsory surveillance in 2011, increasingly strict requirements for outbreak reporting, and enhancement of reporting awareness.

Mushroom poisonings were reported throughout the country, but was highest in the southwest and central areas, likely due to the warm and damp conditions, said researchers.

Only 3,872 outbreaks were reported with mushroom names. Absence of relevant mushroom samples and ingestion of multiple mushrooms increased the difficulty of identifying causative species. More than 180 mushroom names were reported. Accurate and prompt species identification is crucial for diagnosis and treatment.

Educating people
Mushroom poisoning occurred every month, the study found, with peaks in summer and autumn. Seasonality suggests health education is crucial in those periods. Mushroom picking is more frequent in rural environments so education targeted for specific groups in such areas is also essential to reduce poisonings.

Researchers said efforts should be made to improve investigative procedures, reporting practices, and data collection as some of the epidemiological information is not complete or accurate.

Another study found the amount of mushroom poisonings and number of people affected doubled this past year in China compared to 2019.

Other work revealed poisonous mushrooms were the most common cause of outbreaks in China during a 14-year period.

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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) 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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Researchers looked at data reported to the National Foodborne Disease Outbreak Surveillance System from 2003 to 2017 and published findings in the journal Food Control.

A total of 19,517 outbreaks, which resulted in 235,754 illnesses, 107,470 hospitalizations, and 1,457 deaths, were recorded during the period.

Stats on mushroom outbreaks
Of the 13,307 outbreaks with known etiology, almost a third were caused by poisonous mushrooms, followed by Vibrio parahaemolyticus at 11 percent while the percentage linked to saponin, Salmonella, nitrite, pesticides, Staphylococcus aureus and Bacillus cereus were all in single figures.

Of 13,305 outbreaks associated with a single food category, fungi – mainly poisonous mushrooms – were most commonly implicated, followed by meats, vegetables, aquatic animals, condiments, poisonous plants such as saponin, tung oil or seed and aconite, as well as grains such as rice and noodles.

Among almost 19,000 outbreaks with reported settings, nearly half were associated with food prepared in a household, followed by less than a quarter with food made in a restaurant, and less than a fifth prepared in a canteen.

“Analysis of foodborne disease outbreaks can provide insight into the most important causative agents and sources of foodborne disease, and assist public health agencies determine the high-risk etiology and food pairs, specific points of contamination and settings to reduce foodborne disease illnesses,” said researchers.

Wild mushroom poisoning incident
Another study, published in China CDC Weekly, described 10 cases of wild mushroom poisoning in a city of Zhejiang Province this past year.

From late June to mid-July, 2019, three suspected food poisoning events occurred in Shaoxing City, Zhejiang Province. Ten patients with different degrees of liver damage were found and one person died. Poisonings were caused by ingestion of a wild mushroom (Amanita rimosa) containing amanitin toxins.

The Xinchang County CDC of Shaoxing City, received a report from a local hospital that six patients in a family went to a doctor with suspected food poisoning in late June. Patients had gastrointestinal irritation symptoms including nausea, vomiting, and diarrhea in the early stages.

They then developed different degrees of liver function damage. One person died of acute liver failure but the other patients improved after medical treatment and were discharged one week later. On July 11, the Shaoxing City CDC got a report from the local hospital of another two patients with similar symptoms.

Until July 25, 10 patients meeting the case definition were found, including six in Xinchang County and two each in Keqiao District and Zhuji County. Before 2019, there were one to two cases of wild mushroom containing amanitin toxins poisoning each year in Zhejiang Province.

All patients came from three families in Shaoxing City, who lived tens of kilometers apart. The families did not know each other, nor did they have any other common exposure factors. All patients became sick 10 to 22 hours after family dinners. Wild mushrooms were collected on mountains near the residences and were one of the main foods with noodles or as a soup. Amanitin toxins were found in eight patients’ plasma samples and two people’s urine samples.

CDCs in Shaoxing city carried out publicity and education about wild mushroom poisonings and prohibited residents from picking and eating them. No similar incidents occurred until mid-August 2019. In China, about 20 species of mushrooms can cause death, and most people are not able to identify which types are edible.

The rainy season in Zhejiang Province is from the middle of June to mid-July and with the average temperature, combined to make suitable growing conditions for wild mushrooms. Local CDCs decided to set up warning signs prohibiting the picking and eating of wild mushrooms in mountain areas to prevent such incidents.

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This certification extension comes after the untimely passing of the Midwest American Mycological Information (MAMI) Executive Director Chris Wright, according to the state department. Wright was a nationally recognized mushroom expert and researcher at Michigan State University. He instructed MAMI certification exams. The certification and training courses have been suspended for 2020 as the organization looks for someone to succeed Wright beginning in 2021.

Michigan’s Food Code requires wild-foraged mushrooms to only be sold by mushroom identification experts or after being inspected individually by an expert.

Rules regarding wild mushrooms vary by jurisdiction, but many states’ food codes include safety controls. 

“Wild mushrooms, like morels and chanterelles, help define the forests of Michigan and provide potential income streams for foragers, farmers, restaurateurs and food entrepreneurs,” said Tim Slawinski, MDARD Food and Dairy Division director.

“However, if improperly identified, mushrooms can pose serious health risks. If you are purchasing wild mushrooms, you should only purchase them from a certified mushroom identification expert, as required by Michigan’s Food Code, to assure they are safe and edible.”

Many edible mushroom species grow wild in Michigan, however, there is risk involved because of toxic and poisonous species. These toxic species include lookalikes that can cause serious illness or even death when eaten. This is why it is important that a certified mushroom expert properly identify the mushrooms.

“Please enjoy hunting for and eating your favorite wild mushrooms, but make sure you know how to properly identify them,” said Slawinski.

“If you plan to sell your wild mushroom harvest, you must be a certified mushroom identification expert or have the mushrooms inspected by one; and if you operate a store or restaurant and plan to purchase mushrooms for resale to your customers, they must be purchased from an approved source and individually inspected by a certified mushroom identification expert. Finally, if you’re purchasing wild mushrooms, especially online through social media platforms, always ask for proof of certification before purchasing any mushrooms.”

Mushroom poisoning can range from an upset stomach to death. Common symptoms include, vomiting, diarrhea, abdominal pain, weakness, lethargy known as jaundice. Illness and death can come on quickly in some instances.

Anyone suspecting mushroom poisoning should get immediate assistance and call the Michigan Poison Control Center 800-222-1222.

For information about mushroom identification experts in Michigan or how to become certified, visit the Midwest American Mycological Information website.

Illegal sales of wild-forged mushrooms can be reported to the Michigan Department of Agriculture and Rural Development at 800-292-3939.

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The issue constitutes a growing national health threat, wrote Dr. Douglas Hamilton and Dr. Gerard Meagher, from the department of public health, HSE Midlands in the first edition of Epi Insight Volume 21, Issue 1 for 2020.

They said there is currently no established coordination system for surveillance, public information and advice about wild mushrooms. Investment in effective prevention would lead to significant human and economic cost savings, the researchers reported.

The Health Protection Surveillance Centre (HPSC) is Ireland’s agency for surveillance of communicable diseases and part of the Health Service Executive (HSE).

Poisoning stats and case study
Based on data from the National Poisons Information Centre, from the start of 2019 to end of September 2019, there were 18 confirmed mushroom poisonings, with two patients having had severe or life threatening symptoms. From the end of September to Nov. 19, 2019, a six more cases were recorded. From 2014 to 2018, there were 85 mushroom poisonings reported, with two being severe or life threatening.

The centre receives calls on ingestion of poisonous mushrooms. Poisonous mushrooms in the wild may be misidentified and used to cook meals, or unsupervised children may eat them from yards, parks or gardens. Incorrect mushroom identification by health professionals via the Internet has been reported.

The numbers compare to France where more than 10,600 people were poisoned by mushrooms and 22 deaths were reported from 2010 to 2017.

In Ireland in September 2019 an individual developed liver failure after foraging for mushrooms in a local wood. They went to the hospital emergency department complaining of vomiting and abdominal pain, having eaten wild mushrooms the previous evening.

Admission was followed by rapid deterioration of liver function tests, transfer to the intensive care unit, and then to St Vincent’s University Hospital liver unit, where an emergency liver transplant was done – all within three days.

The individual progressed well in the 24 hours post-transplant but deteriorated to multi-organ failure. This was followed by slow recovery, with weeks in ICU, remaining in hospital for almost three months. There was no underlying illness, history of viral hepatitis or use of medications so the incident was attributed to consumption of Amanita virosa. An expert mycologist consulted by the National Poisons Information Centre identified the mushroom as Amanita virosa known as the Destroying Angel. 

There are hundreds of different species of mushrooms growing in the Ireland. The Amanita genus is one of the most toxic worldwide and flourishes in Ireland. It is recognized by a bulbous cup around the base of the stem. It does not have a repugnant taste and can be mistaken for button mushrooms especially Amanita virosa. They tend to grow around broad leaved trees.

Raising public awareness
Most patients with mushroom poisoning experience minor symptoms, like nausea or one or two episodes of vomiting and only need normal fluid intake. Some toxic species can cause sweating, salivation, hallucinations, flushed skin, dilated pupils, delirium, and drowsiness.

Amanita cause severe vomiting and diarrhea followed by liver damage, sometimes leading to liver failure, even after consuming only one 30-gram mushroom. Amatoxins are thermo-stable so toxic effects are not reduced by cooking. Symptoms of vomiting are often delayed for more than six hours after ingestion.

The Food Safety Authority of Ireland (FSAI) has raised public awareness on poisonous mushrooms in the past, but as foraged berries and mushrooms are for personal consumption and not commercial foods it does not fall within its remit.

A campaign of social media, alerts, radio interviews and signs was held to raise awareness and may have prevented poisonings in the latter part of the season.

Hamilton and Meagher said awareness campaigns need to be repeated pre-season every year and a notification system for mushroom poisoning should be established.

They also said a coordination system for health protection should be determined with public health as the lead agency but including the National Poisons Information Centre and Safefood.

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Eight people were recently hospitalized in New South Wales due to wild mushroom poisoning. Almost 40 calls were made to the NSW Poisons Information Centre in the past week and last year in the state 70 people were admitted to hospital.

Australian poisons information centers received almost 900 calls about possible wild mushroom poisoning in 12 months and a third were referred to a hospital or for medical treatment.

Since 2002, four people have died after eating death cap mushrooms found in the Australian Capital Territory. In 2012, two people died after eating these mushrooms at a New Year’s Eve dinner party in Canberra, and in 2014 four people were seriously poisoned.

Death cap mushroom

Cathy Moir, FSIC council chair, said that foraging for wild food is becoming popular but gathering wild mushrooms can be a life-threatening risk.

“While this latest spate of wild mushroom poisonings weren’t from death cap mushrooms be aware that the poison in one death cap mushroom if eaten, is enough to kill a healthy adult.”

Death cap mushrooms can appear at any time of year but are more common during autumn after a period of rain.

“They are not native to Australia and are often found near oak trees growing in warm wet weather. The similar marbled death cap mushrooms have also been recently found in Western Australia, although they may not be as toxic,” said Moir.

“Death cap mushrooms are difficult to distinguish from other wild mushrooms so we recommend you play it safe and only eat mushrooms that you have purchased from the supermarket, greengrocer or other reputable sources. People born overseas, especially in Asian countries, should be aware that these deadly mushrooms can look like edible mushrooms that they may have gathered in their home countries.”

ACT and Victoria alerts

Last month, Dr. Kerryn Coleman, acting Australian Capital Territory chief health officer, warned people not to eat or pick wild mushrooms.

Dr. Coleman said it was the first time death cap mushrooms had been seen in Canberra this year, marking the start of the cooler weather season.

“Death cap mushrooms can be lethal if ingested. It is crucial for people to understand that all parts of the mushroom are poisonous and cooking them does not make them safe to eat.”

Dr. Coleman warned people not to touch the mushroom with bare hands and to keep children and animals away from it.

“If you think you have eaten a death cap mushroom, seek urgent medical attention at a hospital emergency department and take any remaining mushroom to the hospital for identification,” she said.

“Symptoms of poisoning generally occur six to 24 hours or more after eating mushrooms and include pains, nausea, vomiting, and diarrhea. The sooner treatment begins, the better the chances of survival.”

The toxin in death cap mushrooms is not destroyed by peeling, cooking or drying. Symptoms may ease for two to three days before a terminal phase of three to four days begins. Without effective medical intervention, people may go into a coma and die after two or three weeks of liver and kidney failure.

Nine out of ten deaths from mushroom poisoning in Australia result from death caps said Moir.

“However there are other wild mushrooms in Australia that, while not fatal, can make you ill with abdominal pain, vomiting, and diarrhea. These include the yellow stainer which resembles a field mushroom and is the most commonly ingested poisonous mushroom in Victoria.”

Dr. Brett Sutton, Victoria’s chief health officer, issued a warning this month for people to avoid gathering wild mushrooms around Melbourne and in rural Victoria.

“Autumn conditions create ideal growing conditions for poisonous mushrooms, and recent rains have seen them start to sprout in Victoria. While commercially-sold mushrooms are safe, poisonings can occur when people gathering wild mushrooms inadvertently include toxic species. Poisonous mushrooms may appear very similar to edible varieties.”

Two toxic mushrooms are the Death Cap fungus, Amanita phalloides and the Yellow Staining mushroom, Agaricus xanthodermus.

The Death Cap is large, with a cap ranging from light olive green to greenish yellow in color. The gills are white and the base of the stem is surrounded by a cup-shaped sac. The commonly found Yellow Staining mushroom turns yellow when the cap or stem is bruised by a thumbnail.

In Hong Kong, The Centre for Health Protection (CHP) is investigating a food poisoning outbreak related to the consumption of wild mushrooms.

Three women aged 36 to 45 developed abdominal pain, nausea, vomiting, diarrhea and sweating 30 minutes after consuming wild mushrooms at home. They were admitted to hospital on the same day but remained in a stable condition and have been discharged.

Investigations revealed the wild mushrooms were picked near Bowen Road on Hong Kong Island.

Late last year, French authorities issued a warning after a spike in poisoning cases.

From July to mid-October, poison control centers recorded between five and 60 cases a week but 249 poisoning cases were recorded in early November. Every year, one thousand cases of mushroom poisoning occur in France.

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From July to mid-October this year, poison control centers recorded between five and 60 cases a week but 249 poisoning cases have been recorded in recent weeks.

Seven serious cases have been noted since July 2018 and four of them were in the past few weeks.

Poisonings due to eating wild mushrooms in France are reported to the French Poison Control and Monitoring Centers (CAP-TVs).

The sharp increase prompted the French Agency for Food, Environmental and Occupational Health and Safety (ANSES) and the Directorate General for Health (DGS) to issue a warning to wild mushroom gatherers and remind them of good practices.

Although weather conditions in September and the first half of October with dry, high temperatures were not conducive to the growth of wild mushrooms, the cooler and wetter conditions of recent weeks have been more favorable, said the agencies.

ANSES and the DGS said the poisoning cases are regularly observed year after year and in most cases, poisonings result from confusion with other edible mushrooms.

Last year, 181 poisoning cases, with five of a serious nature, were recorded in two weeks of September. In 2016, 87 cases, including three serious, were recorded in October.

Poisoning can have serious health consequences such as severe digestive disorders, liver damage that may require a transplant and can be fatal. Symptoms generally appear within 12 hours of consumption and the patient’s condition may deteriorate rapidly. In the event of symptoms, it is useful to note the time of the last meal and onset of the first symptoms and to keep any leftovers from the harvest for identification.

The Centre Antipoisons in Belgium receives around 400 calls a year involving mushrooms with most between June and September. The foundation Tox Info Suisse identified almost 600 poisonings in Switzerland last year.

Mushroom poisoning worldwide

Earlier this year, more than 1,200 people fell sick, 112 were hospitalized and 19 died in Iran with a link to eating wild mushrooms.

New South Wales (NSW) Health warned against eating wild mushrooms in May after 38 poisoning hospitalizations this year, including 14 children, were reported to the NSW Poisons Information Centre. Between 2014 and 2017, there were 281 hospitalizations from mushroom poisoning in NSW and the Australian Capital Territory.

Last month, the Illinois Poison Center (IPC) also issued a warning about mushrooms.

While many types of toxic mushrooms can be found in Illinois, most are minimally to moderately toxic. In rare cases, they can be poisonous and require hospitalization.

“The Illinois Poison Center receives hundreds of calls each year about mushrooms found in lawns, neighborhood parks and forest preserves. Adults, and especially children, should be aware of the health risks associated with consuming wild mushrooms and what to do if they are ingested,” said Michael Wahl, medical director at the IPC.

One of the main concerns when consuming poisonous mushrooms is liver damage from those that contain amatoxin. Amatoxin-containing mushrooms may not produce symptoms until six to 24 hours after ingestion.

From the start of July to mid-August, 45 mushroom exposure cases (38 in humans) were managed by the medical experts at the New Jersey Poison Control Center.

Diane Calello, NJ Poison Control Center executive and medical director, said even experienced mushroom pickers can be fooled by toxic look-a-likes.

“Don’t be fooled – many edible mushrooms have toxic look-a-likes. The cooking process does not prevent the toxic health effects of some mushrooms. Depending on the type of mushroom, eating even a few bites can cause serious health concerns,” she said.

In December 2016, 14 cases of Amanita phalloides (also known as the “death cap”) poisoning were identified by the California Poison Control System (CPCS) among persons who had consumed foraged wild mushrooms. Three patients received liver transplants and while all recovered, a child had permanent neurologic impairment.

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As seasonal rains promote the growth of wild mushrooms, California Department of Public Health Director and State Public Health Officer Dr. Karen Smith is again reminding people that eating wild mushrooms can cause serious illness and even death.

Unseasonably warm, wet weather in other areas of the country is also prompting mushroom growth where frozen ground and snow are the norm for February.

“Telling the difference between wild mushrooms that are safe and those that are poisonous can be difficult for many people,” Smith said in a news release earlier this week. “Wild mushrooms should not be eaten unless they have been examined by a mushroom expert and determined to be edible.”

The most serious illnesses and deaths have been linked primarily to wild mushrooms known to cause liver damage, including Amanita phalloides, which are also known as the “death cap,” and Amanita ocreata, known as “destroying angel.” A bloom of Amanita phalloides in winter 2017 resulted in 14 mushroom poisonings in California that required hospitalization. Three of the people needed a liver transplants.

According to the California Poison Control System, 1,038 cases of poisonous mushroom ingestion were reported throughout the state from November 2016 to Jan. 15, 2018. Among those cases:

• 16 suffered major health problems, such as liver failure leading to coma and/or a liver transplant, or kidney failure requiring dialysis.
• 51 suffered moderate health problems, such as dehydration due to vomiting and diarrhea, or injury to the liver or kidney.
• 433 were children younger than 6, most of whom ate a small amount of a mushroom from yards or neighborhood parks.
• 522 were treated at health care facilities.
• 16 were admitted to intensive care units.

Eating poisonous mushrooms can cause abdominal pain, cramping, vomiting, diarrhea, liver damage or death. Anyone who develops symptoms after eating wild mushrooms should seek immediate medical attention. People in California who develop these symptoms, or their treating health care providers, should immediately contact the state’s Poison Control System at 800-222-1222.

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