The California Department of Public Health is issuing an update to its Dec. 5 health advisory as an outbreak of amatoxin poisoning continues across California.

This outbreak is linked to the consumption of wild, foraged mushrooms and has caused severe liver damage in both children and adults, resulting in three adult deaths and three liver transplants to date. CDPH urges Californians not to pick or eat wild mushrooms.

Between Nov. 18 and Jan. 6, the California Poison Control System has identified 35 hospitalized cases across Northern California and the Central Coast, spanning regions from Sonoma to San Luis Obispo. Affected individuals range in age from 19 months to 67 years and include family groups and individual cases. Medical treatment for amatoxin poisoning has been provided in the following counties: Alameda, Contra Costa, Monterey, San Francisco, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz and Sonoma. Most cases are in the Monterey and San Francisco Bay Area, though Death Cap mushrooms can be found across the state, particularly adjacent to oaks, other hardwoods and some pines.

Information provided by some affected individuals indicates that Death Cap mushrooms were collected from various locations across Northern California and the Central Coast regions, including, county, city and national park lands.

What CDPH is Doing:

CDPH continues to coordinate with CPCS and public health partners on case investigation, tracking, and developing outreach and education materials. CDPH has released public service announcements in three languages: English, Spanish, and Mixteco (with assistance from the San Luis Obispo Health Agency). These PSAs warn the public about the risks of mushroom foraging, or mushroom hunting, during this high-risk season when Death Cap mushrooms are abundant. Additionally, CDPH has developed poisonous mushroom webpages in English and Spanish; a PDF in Chinese that provides important health information; flyers in English, Spanish and Chinese; and, updated outbreak details and additional education resources.

What Californians Can Do:

-Avoid picking and eating wild mushrooms during this high-risk season when Death Cap mushrooms are abundant. Death Cap mushrooms are still poisonous even after cooking, boiling, freezing or drying.

-Purchase mushrooms from trusted grocery stores and retailers and exercise caution when buying mushrooms from street vendors.

-Keep children and pets away from wild mushrooms.

Seek help immediately if you or someone you know has eaten a poisonous mushroom. Contact the CPCS hotline: 1-800-222-1222. Do not wait for symptoms to appear. Treatment is more difficult once symptoms start.
Initial symptoms, such as watery diarrhea, nausea, vomiting, abdominal pain, and dehydration can occur within 6 to 24 hours following ingestion of these toxic mushrooms and usually go away within a day. However, this brief improvement can be deceptive, as patients may still develop serious to fatal liver damage within 48 to 96 hours after eating the mushrooms.
What Public Health Professionals Can Do:

Advise residents to avoid picking and eating wild mushrooms during this high-risk season when Death Cap mushrooms are abundant. Share educational materials on Death Cap mushrooms with your communities.
Assess whether Death Cap mushrooms are blooming in your local area. Regional and local mycological societies such as the North American Mycological Association, may be useful resources.
Work with local partners to reduce exposure by posting advisories in public spaces where these mushrooms may be found, including in county and city parks, and coordinate with veterinarians and animal health services.
For the latest information on wild mushroom related poisonings, please visit California Poison Control System or CDPH Poisonous Wild Mushrooms (go.cdph.ca.gov/PoisonMushrooms) also available in Spanish at CDPH Hongos Silvestres Venenosos (go.cdph.ca.gov/HongosVenenosos).