4 Dead, 3 Liver Transplants In CA: What To Know About 'Death Cap' Mushrooms

Four people have now died, and three have required liver transplants— while dozens more have been hospitalized after eating "death cap" mushrooms in California during the unusual 'super bloom' of the deadly mushrooms.

The death cap is one of the most poisonous mushrooms in the world. Thirty-nine poisonings from the mushrooms have been reported since Nov. 18, according to the California Department of Public Health.

Many who sought medical attention suffered from rapidly evolving acute liver injury and liver failure, according to health officials. Several patients, ranging from 19 months to 67 years old, have been admitted to an intensive care unit.

• Related: Contra Costa County Man Dies After Eating Toxic 'Death Cap' Mushrooms

In a typical year, there are between two and five death cap poisonings, said Dr. Craig Smollin, medical director for the San Francisco Division of the California Poison Control System.

“The main thing this year is just the magnitude, the number of people ingesting this mushroom,” Smollin said. “Having almost 40 is very unusual.”

Warm, fall temperatures coupled with early rains are leading to a kind of “super bloom” of death caps in California this year, experts say.

Eating even a small amount can be fatal, and experts warn that a mushroom’s color is not a reliable way of detecting its toxicity, and whether the death cap variety is raw, dried or cooked does not make a difference.

Laura Marcelino told the San Francisco Chronicle that her family in the Northern California town of Salinas gathered mushrooms that looked like the ones she and her husband used to forage in their native Oaxaca, a state in Southern Mexico.

“We thought it was safe,” Marcelino, 36, said in Spanish.

Her husband was dizzy and tired the next day, but Marcelino felt fine, and they ate the mushrooms again, heating them up in a soup with tortillas. Their kids don't like mushrooms and so didn't have any. The next day, both adults, seasonal farmworkers, became ill with vomiting and stayed home from work.

Marcelino spent five days in the hospital, while her husband had to undergo a liver transplant.

Here's what to know about death cap mushrooms.

About The Mushrooms

The death cap is part of a small group of mushrooms containing amatoxins — the compounds that cause 90 percent of deadly mushroom poisonings worldwide.

They can be found across California, particularly in the vicinity of oaks, other hardwoods and some pines.

Information provided by some affected patients indicates the mushrooms have been collected from various locations across Northern California and the Central Coast regions, including county, city and national park lands.

January rain contributed to their widespread growth, according to health officials.

Hospitalizations have been reported in the following counties: Alameda, Contra Costa, Monterey, San Francisco, San Luis Obispo, San Mateo, Sacramento, Santa Clara, Santa Cruz and Sonoma.

Symptoms

According to the California Department of Public Health, initial symptoms can occur 6 to 24 hours after ingesting death cap mushrooms, including:

• Stomach pain
• Cramping
• Diarrhea
• Nausea
• Vomiting
• Drop in blood pressure
• Fatigue
• Confusion

These early symptoms typically go away within a day. But this brief improvement can be deceptive, as patients can develop serious or fatal liver damage within 48 to 96 hours of eating the mushrooms.

Mushroom poisoning can lead to serious health complications, including:

• Liver damage (sometimes needing a liver transplant)
  
• Kidney damage
• Hallucinations and euphoria
• Seizures
• Death

How To Stay Safe

Since death caps are easily confused with safe-to-eat, lookalike mushrooms, all foraging should be avoided, officials say.

"Avoid picking and eating wild mushrooms during this high-risk season when Death Cap mushrooms are abundant," says the California Department of Public Health. "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 them from street vendors.

Additionally, keep children and pets away from wild mushrooms.

If you or someone you know has eaten a poisonous mushroom, immediately seek medical care or the California Poison Control Hotline at 1-800-222-1222.

Do not wait for symptoms to appear. Treatment is more difficult once symptoms start.

Visit the CDPH's Poisonous Wild Mushrooms webpage for more info.

This article includes Associated Press reporting.