‘Largest outbreak that we’ve seen in California.’ Death cap mushrooms linked to deaths, hospitalizations
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- Following an exceptionally wet December, death cap mushrooms are blooming across the state, resulting in an unprecedented outbreak of deaths and illnesses.
- The death cap mushroom is one of the most poisonous mushrooms, leading to diarrhea, vomiting, liver damage and even death for those to eat it.
An exceptionally wet December contributed to an abundance of death cap mushrooms, or Amanita phalloides, along the Central Coast and in Northern California, causing what officials describe as an unprecedented outbreak of severe illness and death among people who consumed the fungi.
Public health officials are issuing a second warning this winter, urging the public against foraging for wild mushrooms, noting that many people mistakenly have eaten the death cap, which when consumed can cause severe liver damage and in some cases death.
In the last 26 years, “we have not had a season as deadly as this season both in terms of the total numbers of cases as well as deaths and liver transplants,” said Craig Smollin, medical director of the San Francisco division of the California Poison Control System.
“I believe this is probably the largest outbreak that we’ve seen in California, ever.”
Many cases, officials say, involved people from Mexico and elsewhere for whom the death cap resembles an edible mushroom in their home countries.
The California Department of Public Health reported 35 death cap-related illnesses, including three fatalities and three liver transplants, between Nov. 18 and Jan. 6. Affected people were between the ages of 19 months and 67 years old.
In a typical year the California Poison Control Center may receive up to five cases of poisonous mushroom-related illness, according to authorities.
The last major outbreak occurred in 2016 with 14 reported cases, and while there were no deaths, three people required liver transplants and one child suffered a “permanent neurologic impairment.”
The death cap is the world’s most poisonous mushroom, responsible for 90% of mushroom-related fatalities.
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Where the death-cap outbreak is concentrated
When state public health officials first warned of the dangers of the death cap mushroom in December, significant clusters of reported illnesses occurred in the Monterey and the San Francisco Bay areas. Reported hospitalizations have since grown to include Alameda, Contra Costa, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz and Sonoma counties.
Death cap mushrooms are known to sprout across California and thrive in shady, humid or moist environments under live oak and cultivated cork oak trees.
Death cap mushrooms bloom particularly well after fall and winter rains. Once they sprout, their tall and graceful characteristics are very conspicuous and catch people’s eye, said David Campbell, an expert on mushroom consumption, or a mycophagist.
Who is mistakenly eating the death cap
People who mistakenly consumed the death cap usually were foraging for mushrooms in the wilderness, either alone or with a group, officials say.
Among the affected are monolingual speakers of Spanish, Chinese, Mandarin and Mixteco; some foragers have mistaken the death cap mushroom for edible fungi from their native countries, according to experts.
“So they have a false sense of security in their knowledge, thinking they know what they’re doing, but that only applies to where they’re from,” Campbell said.
“We’re seeing that a number of patients do seem to have a Hispanic background,” said Dr. Rita Nguyen, assistant state public health officer at the California Department of Public Health.
In November, members of a Salinas family went on a hike in their community and found the death cap, which looked similar to an edible mushroom family members would forage for in their hometown in Oaxaca, KSBW Action News reported.
Laura Marcelino and Carlos Diaz took the mushrooms home, cooked and ate them — their children did not. Both parents threw up, had diarrhea for an entire day and later were hospitalized, the news outlet reported. Marcelino’s condition improved, but Diaz’s health declined to the point that he fell into a coma and was put on a list to receive a liver transplant, according to reports.
The case involved an unvaccinated adult who likely contracted the disease while traveling abroad.
Why people are mistakenly eating death cap mushrooms
The three most deadly mushrooms in California are the death cap, the destroying angel (Amanita ocreata) and the deadly Galerina (Galerina marginata), according to the Bay Area Mycological Society.
The death cap mushroom has a dome-shaped smooth cap with olive or yellowish-green tones. On the underside of its cap are white gills and spores. It can be confused with the mushroom species Volvariella, which is edible.
These mushrooms appear similar because they have a volva, a cup-like structure at the base of the mushroom’s stem, and are whitish, but the death caps lack one important characteristic annulus, or ring, around its stem, said Ari Jumpponen, a Kansas State distinguished professor of biology. Jumpponen said some Volvariella species can be found in Oaxaca.
What symptoms can you expect after eating a death cap?
No amount of death cap is safe to consume.
“I also want to just stress that there’s nothing, there’s no cooking of the mushroom or freezing of the mushroom that would inactivate the toxin,” said Smollin, the poison control medical director.
The poisonous toxins from the death cap can result in delayed gastrointestinal symptoms that may not appear until six to 24 hours after eating it. Some early symptoms that can go away within a day include:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Drop in blood pressure
- Fatigue
- Confusion
Mild symptoms may be only the beginning of a more severe reaction. Severe symptoms can develop within 48 to 96 hours, including progressive liver damage and, in some cases, full liver failure and potentially death, Smollin said.
If you’ve eaten a foraged mushroom and start to exhibit any adverse symptoms, call California’s poison control hotline at 1-800-222-1222 for free, confidential expert advice in multiple languages. If you suspect mushroom poisoning, call 911.
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