Letters
Metabolic diseases Environmental health
Volume 199 - Issue 10

Amanita phalloides poisoning and treatment with silibinin in the Australian Capital Territory and New South Wales

Authors:  Andrew J Pengilley and Paul M Kelly

Med J Aust 2013; 199 (10): 659-660. || doi: 10.5694/mja13.10418
Published online: 18 November 2013
Whenever a case of “deathcap” mushroom poisoning occurs, the possibility of ongoing risk of poisoning should be investigated by public health units.
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To the Editor: Roberts and colleagues recently reviewed the frequency and clinical outcomes of poisoning with Amanita phalloides (“deathcap”) mushrooms in the Australian Capital Territory and New South Wales.1 Two widely publicised cases of fatal ingestion occurred on 31 December 2011 after a chef had prepared a meal containing wild mushrooms for his colleagues in the kitchen of an ACT restaurant. The link with the restaurant was only discovered after emergency department staff notified public health authorities, who then interviewed unaffected associates of the index case. It was fortunate that no wild mushrooms were used to prepare food for the public. Material at the restaurant was inspected by the public health unit and destroyed to ensure no Amanita mushrooms entered the food supply.

However, the potential for a cluster of poisonings to occur, for people to be in the early stages of toxicity, and for uneaten mushrooms to pose an ongoing risk to food safety should be considered when a sentinel clinical case of poisoning occurs. Because acutely unwell patients may not provide a thorough account of who consumed wild mushrooms, public health units must seek out contacts to clarify the extent of exposure. The ultimate goal of public health programs is to prevent people collecting and eating the deadly A. phalloides mushroom. But, should poisoning occur, a potential public health emergency may arise. ACT Health has now formalised reporting of cases to the relevant public health unit in the protocol for managing cases of poisoning. Public health messaging has also been strengthened and targeted at high-risk groups.

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