Mushroom poisoning surveillance analysis, Yunnan province, China, 2001-2006
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2010-06-02
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Outbreak, Surveillance and Investigation Reports
Abstract
Background: In Yunnan, China, 17,000 tons of mushrooms are harvested annually. Yunnan is home to at least 150 poisonous species of mushrooms. From 1985 to 2000, 378 mushroom poisoning events were reported, including 326 deaths. In 2004, China established new reporting criteria and report forms. We undertook a descriptive study of mushroom poisoning in Yunnan from 2001-2006. Methods: We reviewed surveillance data from 2001-2006. We analyzed all investigation forms submitted from 2004-2006, including data on mushroom species. County level climactic and demographic data were collected and analyzed for association with mushroom poisoning. Double-entry was performed and data was analyzed using Epi Info 3.3.2. Results: From 2001-2006, 97 events including 662 cases and 148 deaths were reported. The overall case fatality rate was 22.4 % (Mean: 30.7%; SD: 15.7). The mortality rates due to mushroom poisoning in 2001-2006 were 0, 0.01, 0.03, 0.07, 0.17, and 0.06 per 100,000 respectively. Most (86.6 %) events occurred from May to August. Most events occurred in rural settings and were limited to a single household. Counties reporting events had higher average rainfall and lower average income compared to non-reporting counties. All poisoning were associated with ingestion of wild mushrooms, and the Amanita group was the most commonly implicated type. Majority (94.3%) of events was associated with serving fresh mushrooms, and 97.3% of suspected mushrooms were picked by the victims themselves in rural areas. Most (91.6%) victims sought health care service, and majority (65.6%) went to primary care facilities for initial management. Conclusion: Mushroom poisoning is the most common lethal food poisoning with a high CFR in Yunnan. However, the mortality is low. Mushroom poisoning was likely underestimated prior to 2004 due to lack of food poisoning reporting criteria. Event-based surveillance has limited sensitivity and probably overestimates CFR. Prevention efforts are hindered by the difficulty of identifying mushroom species in the field. Cultivated mushroom could be the safer alternatives but altering eating customs is difficult.
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Outbreak, Surveillance and Investigation Reports; Issue 1, Vol 1, 2008; 8-11