Death Cap mushrooms on Gabriola

Derek Kilbourn

Sounder News

Wednesday, March 13 2019

Mushroom foragers and health care practitioners should be aware of the potential for dealing with the Amanita phalloides, known commonly as the death cap mushrooms.

That according to a paper published in the Jan/Feb edition of the BC Medical Journal.

For Gabriola, a community where foraging for mushrooms is a long tradition, the non-indigenous Death Cap mushrooms are of particular concern because they have been found on the island - and have a preference for growing amongst the indigenous Garry Oaks.

Dr. Omar Ahmad, a physician with Island Health and head of Critical Care and Emergency Medicine wrote the article in conjunction with Maxwell Moor-Smith, a medical student (class of 2020) in the University of British Columbia Island Medical Program, and Raymond Li, a drug and poison information pharmacist at the BC Drug and Poison Information Centre.

According to the authors, Death Cap mushrooms are considered the most poisonous muhroom in the world, and accound for 90% of global mushroom-related fatalities.

They write that the Death Cap first came to BC on imported european trees, but have now spread to North American oak trees.

In 2016, a three-year-old boy in Victoria died after ingesting death cap mushrooms.

Ahmad said there have not been any reported cases from the gulf islands, but there have been two more cases of humans ingesting death cap mushrooms within Island Health since 2016.

Ahmad said, “there have been multiple cases of ingestion by pets - in particular dogs. Dogs die a fairly horrible death of being unwell for a number of days.

“So it’s the humans, the little kids, the foragers, but also the pets.”

Stephen Levesque, owner of Rooted in Nature Permaculture, has run mushroom picking and growing workshops on Gabriola. 

According to Levesque, Death Caps have been found in previous years on Gabriola. Conditions are too cold right now for the mushrooms to have grown, but, “give the weather three weeks and a warming trend they will start to show.”

In terms of being able to forage for mushrooms safely, Levesque said, “It is necessary to have a guide and even take a foraging course to hone the knowledge needed to safely harvest wild mushrooms.”

Ahmad offered similar advice saying they know the spread is happening, and the host (Garry Oaks) are present on Gabriola.

“In terms of things to look out for mushrooms, the best advice is to skip out - there are several varieties - this one is the most serious, and at the least, you’ll feel miserable for piece of time.”

For health care providers, in particular those who would first encounter a sick person, Ahmad said they should be aware of the three stages a potential patient will go through.

Usually when a person ingests a non-toxic mushroom, symptoms show up within 6 hours.

Death Cap symptoms can begin anywhere from 6 to 24 hours after ingestion.

Most patients first present with abdominalpain, vomiting, and severe diarrhea.

Then they start to feel better.

Ahmad said, “initially you feel ok - then you get flulike - then you feel ok for a period of time, then you really present quite sick.”

This second phase (dubbed false recovery) appears 24 to 72 hours after ingestion.

The third phase happens four to nine days after ingestion and according to Ahmad’s paper, “is characterized by acute liver and multisystem organ failure that can lead to convulsions, hemorrhage, coma, and death.”

Ahmad said practioners should be asking patients presenting with any of the stages if they have eated any mushrooms.

“It sounds kind of ridiculous. But with all these cases - everyone now asks, ‘have you had any mushrooms lately.’

“It becomes part of the routine questions, have they eaten anything out of the ordinary, or eaten out where someone may have served mushrooms.

“This is the preventative medicine - we can get information out to clinicians and make sure we can treat it. Then we say if you’re out there foraging, if you’re not sure, you’re best off not to forage, not to ingest.

“Prevention is always key - avoid the toxins in the first place.”

Asked if there was a photo available to show what a Death Cap looked like, Ahmad said a lot of people have been asking for photos to identify it.

“You can look at the photo and digest it, to know what it looks like. But there are a lot of similarities with benign mushrooms. The [Death Cap] mushroom goes through different stages of growth and development. So depending on where it is in development, it might not look like the photo. It can be green, brown, white, depending on the development stage.

“People should be extremely careful.”