A guide to mycetisms: A toxicological and preventive overview.

Fungi are often considered a delicacy and are primarily cultivated and harvested, although numerous species are responsible for intoxication due to toxin content. Foodborne diseases are a significant public health concern, causing approximately 420 000 deaths and 600 million morbidities yearly, of which mushroom poisoning is one of the leading causes. Epidemiological data on non-cultivated mushroom poisoning in individual countries are often unrepresentative, as intoxication rarely requires emergency intervention. On the other hand, the lack of specialist knowledge among medical personnel about the toxicological manifestations of mushroom consumption may result in ineffective therapeutic interventions. This work aims to provide an easy-to-consult and wide-ranging tool useful for better understanding the variability of mushroom intoxications, the associated symptoms, and the main treatments for the most severe cases, given the absence of a complete species mapping tool toxic. Moreover, we establish an effective collection network that describes the incidence of mushroom poisonings by reporting the species and associated toxicological manifestations for each case. In conclusion, we highlight the need to establish appropriate primary prevention interventions, such as training the affected population and increasing consultancy relationships between mycological experts and specialised healthcare personnel.

We propose a review of the literature that describes the main syndromes resulting from the consumption of toxic fungal species, reporting symptoms and clinical manifestations, latency times and, where possible, diagnostic tools for recognising the species involved and interventions to be carried out.

A network system for the prevention and treatment of mushroom poisoning in Chuxiong Autonomous Prefecture, Yunnan Province, China: implementation and assessment.

BACKGROUND: Mushroom poisoning is a major public health issue in China. The integration of medical resources from different institutes of different levels is crucial in reducing the harm of mushroom poisoning. However, few studies have provided comprehensive implementation procedures and postimplementation effectiveness evaluations. To reduce the harm caused by mushroom poisoning, a network system for the prevention and treatment of mushroom poisoning (NSPTMP) was established in Chuxiong, Yunnan Province, a high-risk area for mushroom poisoning. METHODS: The NSPTMP consists of three types of institutions, namely, centers for disease prevention, hospitals, and health administration departments, with each kind of institution comprising prefecture, county/city, town, and village levels. After three years of implementation, the network was evaluated by comparing the indices before and after network implementation using data from the "Foodborne Disease Outbreak Surveillance System" and 17 hospitals in Chuxiong. The indices included the fatalities caused by mushroom poisoning, the composition ratios of different types of mushrooms for both outpatients and inpatients and the hospitalization rates. RESULTS: Compared to the average fatality rate of mushroom poisoning from 2015 to 2017, the average fatality rate from 2018 to 2020 significantly decreased from 0.57 to 0.06% (P < 0.001). Regarding the poisonous genus containing lethal mushrooms, the outpatient and inpatient composition ratios significantly decreased for Amanita (9.36-2.91% and 57.23-17.68%, respectively) and Russula (15.27-8.41%) (P < 0.05). Regarding poisonous mushrooms that caused mild symptoms, the outpatient and inpatient composition ratios significantly increased for Scleroderma (5.13-13.90% and 2.89-18.90%, respectively) and Boletaceae (19.08-31.71%) (P < 0.05), and the hospitalization rates significantly increased for Scleroderma (6.33-18.02%) and Boletaceae (5.65-12.71%) (P < 0.05). CONCLUSIONS: These findings suggest that the NSPTMP effectively reduced the harm caused by mushroom poisoning. In addition to the integration of medical resources, the development of poisonous mushroom identification, hierarchical treatment systems in hospitals, public education, and professional training also played important roles in improving the system's effectiveness. The establishment and evaluation of the NSPTMP in Chuxiong Prefecture can provide valuable insights and serve as a model for other regions facing similar challenges in managing mushroom poisoning.

Amanitins: The Most Poisonous Molecules of the Fungal World.

Among the toxic metabolites of the fungal world, those that, due to their strong biological effect, can seriously (even fatally) damage the life processes of humans (and certain groups of animals) stand out. Amatoxin-containing mushrooms and the poisonings caused by them stand out from the higher fungi, the mushrooms. There are already historical data and records about such poisonings, but scientific research on the responsible molecules began in the middle of the last century. The goals of this review work are as follows: presentation of the cosmopolitan mushroom species that produce amanitins (which are known from certain genera of four mushroom families), an overview of the chemical structure and specific properties of amanitins, a summary of the analytical methods applicable to them, a presentation of the "medical history" of poisonings, and a summary of the therapeutic methods used so far. The main responsible molecules (the amanitins) are bicyclic octapeptides, whose structure is characterized by an outer loop and an inner loop (bridge). It follows from the unusual properties of amanitins, especially their extreme stability (against heat, the acidic pH of the medium, and their resistance to human, and animal, digestive enzymes), that they are absorbed almost without hindrance and quickly transported to our vital organs. Adding to the problems is that accidental consumption causes no noticeable symptoms for a few hours (or even 24-36 h) after consumption, but the toxins already damage the metabolism of the target organs and the synthesis of nucleic acid and proteins. The biochemical catastrophe of the cells causes irreversible structural changes, which lead to necrotic damage (in the liver and kidneys) and death. The scientific topicality of the review is due to the recent publication of new data on the probable antidote molecule (ICR: indocyanine green) against amanitins. Further research can provide a new foundation for the therapeutic treatment of poisonings, and the toxicological situation, which currently still poses a deadly threat, could even be tamed into a controllable problem. We also draw attention to the review conclusions, as well as the mycological and social tasks related to amanitin poisonings (prevention of poisonings).

Mushroom mycetism - A neglected and challenging medical emergency in the Indian subcontinent: A road map for its prevention and treatment.

Edible mushrooms, a class of macroscopic fungi, serve as delicious and nutritious food supplements around the world. Nevertheless, accidental consumption of poisonous mushrooms that results in fatality or severe illness is typical in all countries, especially among the tribal indigenous communities that forage wild mushrooms for food. In the Indian subcontinent, mushroom poisoning cases are underreported and neglected. Different classes of toxins, characterized from the poisonous mushrooms found globally, show variable clinical symptoms post-consumption. Although the Indian subcontinent is a biodiversity hotspot and home to different classes of fungi and mushrooms, many species of poisonous mushrooms and their toxins, have yet to be identified and characterized. No epidemiological studies or retrospective analyses of mushroom poisoning cases have been reported from the poison control centers in the Indian subcontinent. Nevertheless, some limited clinical and epidemiological data is available from India and Nepal, and therefore, we critically analyse the mushroom poisoning scenario in these countries, and discuss the mushroom toxins that are likely responsible for the post-ingestion toxicities. We also correlate the clinical manifestations of mushroom intoxication in India and Nepal with the pharmacological properties of the prevalent mushroom toxins in these countries. Our limited study of mushroom poisoning demonstrates that the adverse pharmacological effects of amatoxin, one of the deadliest mushroom toxins, are responsible for the highest mortality and morbidity in India and Nepal. Further, no specific antidote is available to treat mushroom intoxication in the region, and systemic and supportive care is all that is available for in-patient management of cases of severe poisoning. We also suggest a roadmap for the prevention and specific treatment against mushroom poisoning in the Indian subcontinent.

Trace elements and C and N isotope composition in two mushroom species from a mine-spill contaminated site.

Fungi play a key role in the functioning of soil in terrestrial ecosystems, and in particular in the remediation of degraded soils. The contribution of fungi to carbon and nutrient cycles, along with their capability to mobilise soil trace elements, is well-known. However, the importance of life history strategy for these functions has not yet been thoroughly studied. This study explored the soil-fungi relationship of two wild edible fungi, the ectomycorrhizal Laccaria laccata and the saprotroph Volvopluteus gloiocephalus. Fruiting bodies and surrounding soils in a mine-spill contaminated area were analysed. Isotope analyses revealed Laccaria laccata fruiting bodies were 15N-enriched when compared to Volvopluteus gloiocephalus, likely due to the transfer of 15N-depleted compounds to their host plant. Moreover, Laccaria laccata fruiting bodies δ13C values were closer to host plant values than surrounding soil, while Volvopluteus gloiocephalus matched the δ13C composition to that of the soil. Fungal species presented high bioaccumulation and concentrations of Cd and Cu in their fruiting bodies. Human consumption of these fruiting bodies may represent a toxicological risk due to their elevated Cd concentrations.

Mushroom poisoning epidemiology in the United States.

Ingestion of wild and potentially toxic mushrooms is common in the United States and many other parts of the world. US poison centers have been logging cases of mushroom exposure in The National Poison Data System (NPDS) annual publications for over 30 years. This study compiles and analyzes US mushroom exposures as reported by the NPDS from 1999 to 2016. Over the last 18 years, 133 700 cases (7428/year) of mushroom exposure, mostly by ingestion, have been reported. Cases are most frequently unintentional (83%, P < 0.001); cause no or only minor harm (86%, P < 0.001); and in children <6 years old (62%, P < 0.001). Approximately 704 (39/year) exposures have resulted in major harm. Fifty-two (2.9/year) fatalities have been reported, mostly from cyclopeptide (68-89%)-producing mushrooms ingested by older adults unintentionally. The vast majority of reported ingestions resulted in no or minor harm, although some groups of mushroom toxins or irritants, such as cyclopepides, ibotenic acid, and monomethylhydrazine, have been deadly. Misidentification of edible mushroom species appears to be the most common cause and may be preventable through education.

Uranium, Thorium, Potassium, and Cesium Radionuclides Concentrations in Desert Truffles from the Governorate of Samawah in Southern Iraq.

Studies have been conducted in some southern Iraqi governorates to measure the radioactive contamination in the soil and have revealed that these areas are contaminated with radioactive materials. In these test sites, where many military operations have been conducted and that may have been affected by the Chernobyl accident, pollution and its impact on the truffle crop have been examined. Truffles are fungi that grow in the ground and can be contaminated by radiation from polluted soil. Uranium, thorium, potassium, and cesium activities were analyzed in truffles collected from the desert of Samawah governorate in the southern part of Iraq, and the results were compared with global values. The radionuclide activities were measured with a high-purity germanium detector. The average activities of 238U, 232Th, 40K, and 137Cs were 3.9500, 2.5300, 260.36, and 1.7800 Bq kg-1 dry biomass, respectively. These results indicate that radionuclide activities are low and that desert truffles are suitable for human consumption.

[Consultation of Mushroom Experts As a Part of the Public Health Service in Mecklenburg-West Pomerania]. / Pilzberatung als Aufgabe des Öffentlichen Gesundheitsdienstes (ÖGD) in Mecklenburg-Vorpommern.

The consultation of people regarding the edibility of mushrooms is realized by mushroom experts, who are working on behalf of public health authorities. State and district authorities are involved in this process. How does the division of labour works, which legal backgrounds exist and which tasks do have the responsible actors, is content of this work.

Rapid Identification Method of Omphalotus japonicus by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP).

Omphalotus japonicus is a poisonous mushroom that grows in Japan. It can be mistaken for edible mushrooms (Shiitake, Hiratake and Mukitake), and if ingested, it causes food poisoning within 30 min to 1 hr. We established a rapid detection method using PCR-RFLP to identify O. japonicus by restriction digestion of the amplified ITS region. By using Sau96I, Bpu10I, SfcI or DrdI/HincII as a restriction enzyme, it was possible to rapidly identify and discriminate O. japonicus based on the fragment length. This study also provided a short PCR-RFLP system comprising amplification and digestion of a short 200-bp DNA fragment within the ITS region. The system could identify and discriminate O. japonicus after in vitro gastric digestion of native and heated mushroom samples as a model of food poisoning. In addition, a confirmatory assay using real-time PCR was developed to achieve more sensitive detection of O. japonicus.

Intoxicación por Chlorophyllum molybdites: Presentación de dos casos y revisión de la literatura / Intoxication by Chlorophyllum molybdites: Presentation of two cases and review of the literature

La intoxicación por hongos, especialmente con fines alimenticios, es un importante problema terapéutico. El hongo Chlorophyllum molybdites, es uno de los principales agentes causantes de intoxicación en países Latinoameri-canos, debido a su similitud con el hongo Agaricus comestible. Se presentan dos casos de intoxicación por Chlorophyllum molybdites los cuales fueron ingeridos y posteriormente desarrollaron manifes-taciones clínicas. Se presenta con su revisión bibliográfica centrada en las diferentes opciones terapéuticas...(AU)

Intoxicaciones por setas, una actualización / Mushroom poisoning, an update

Las intoxicaciones por setas, motivadas por el consumo accidental de especies tóxicas, se producen todos los años durante la temporada de crecimiento de las mismas. Desde los motivos de la ingestión hasta los tratamientos médicos extremos como el trasplante hepático, pasando por la primera orientación diagnóstica, la derivación a urgencias y el ingreso en algunos casos, estas intoxicaciones son susceptibles de tener repercusiones médico-legales. Este trabajo ofrece una puesta al día sobre las intoxicaciones por setas que además de contribuir a mejorar su abordaje y tratamiento subraya diversos aspectos importantes desde la perspectiva médico-legal. Se describen diferentes aspectos clínicos, de diagnóstico y tratamiento de las principales intoxicaciones por setas, incluidas algunas descritas recientemente (AU)

Mushroom poisonings, caused by accidental intake of toxic species, occur every year during their growing season. From the cause of the ingestion to the application of extreme medical treatments such as liver transplantation, through the first diagnostic work up, referral to the emergency department and hospital admission in some cases, these poisonings are likely to have medico-legal implications.This paper provides an update on the subject of mushroom poisoning, which will help to improve their management and additionally highlight various important aspects from a forensic perspective. Diverse clinical, diagnostic and therapeutic matters of mushroom poisonings are depicted, including some new syndromes recently described (AU)

Seguridad alimentaria por la presencia de 137Cs en hongos comestibles comerciales recogidos en Galicia / Food safety for the presence of 137Cs in commercial edible mushrooms collected in Galicia

Las setas son captadoras de 137Cesio, radionucleido artificial de origen antropogénico, y en España apenas hay datos sobre la presencia de 137Cs en hongos silvestres comestibles. El objeto de este trabajo fue determinar los niveles de 137Cs en las principales especies de hongos silvestres comerciales de Galicia y valorar la influencia de diversos factores en su captación y sus repercusiones alimentarias. Se recogieron 54 muestras de hongos (9 especies silvestres y 5 cultivadas), siendo procesadas y analizadas mediante espectrometría gamma de germanio hiperpuro (HPGe). Como resultados, la concentración media de 137Cs en los hongos silvestres fue 249,2 Bq/kg peso seco (p.s.), equivalente a 24,9 Bq/kg peso fresco (p.f.). La especie más acumuladora fue Hydnum repandum (1016,4 Bq/kg p.s.) y las especies cultivadas mostraron niveles muy inferiores (1,6 Bq/kg p.s.). La contaminación por 137Cs probablemente tenga su origen en el accidente de Chernóbil, aunque con niveles mucho más bajos a los de países próximos al lugar del desastre. La acumulación por hongos estuvo favorecida por su ecología micorrízica, cuyo micelio se distribuye en horizontes del suelo contaminado; asimismo, factores genéticos (especie) influyeron en la captación. En este estudio, ninguna muestra alcanzó el límite de 600 Bq/kg p.f. indicado en la legislación europea vigente (aproximadamente 6000 Bq/kg p.s. referido a hongos si tenemos en cuenta el nivel medio habitual de peso seco del 10%), concluyendo que no existe riesgo alimentario asociado al consumo habitual de las especies de hongos comerciales recogidos en Galicia (AU)

Mushrooms can capture the artificial radionuclide 137Cesium and in Spain there are no data on the presence of 137Cs in wild edible mushrooms. The purpose of this study was to determine the levels of 137Cs in the main commercial wild mushroom species in Galicia and assess the influence of various factors on its uptake and its implications in food safety. 54 samples of fungi (9 wild and five cultivated) were collected, being processed and analyzed by gamma spectrometry hyperpure germanium (HPGe). As results, the average concentration of 137Cs in wild mushrooms was 249.2 Bq/kg dry weight (dw), about 24.9 Bq/kg fresh weight (fw). Hydnum repandum was the most accumulator species (1016.4 Bq/kg dw), and the cultivated species showed much lower levels (1.6 Bq/kg dw). 137Cs contamination, probably, has its origin in the Chernobyl accident, although with far lower levels than those of countries close to the disaster site. The accumulation was favored by fungal mycorrhizal ecology, whose mycelium is distributed in contaminated soil horizons; also, genetic factors (species) influenced the uptake. In this study, no sample reached the limit of 600 Bq/kg fw, indicated in the European legislation (about 6000 Bq/kg dw based on fungi, if we consider the usual average of 10% dry weight in these matrices), concluding that there is no health risk associated with the regular consumption of fungal species collected commercial in Galicia (AU)

[Factors determining students' knowledge on wild mushrooms]. / Czynniki warunkujace wiedze studentów o grzybach dziko rosnacych.

A survey was conducted among students of university schools in Nowy Sacz, Biala Podlaska and Zamosc to determine the guidelines of mushroom poisoning prevention. The study included 580 people. The dependence of knowledge about mushrooms from the place of origin of students, frequency of participation in mushrooming, preferred sources of information about mushrooms, major of study and self-competence in discsriminating of mushrooms was determined. Mushrooms gathered nearly 80% of respondents. Residents of large cities more often that those living in villages and small towns have difficulites in distinguishing the edible and poisonous mushrooms. People often participating in mushrooming retain proper habits during the harvesting and processing of mushrooms. Irrational ways of distinguishing edible mushrooms from poisonous are often rejected by inexperienced people than by frequently gathering mushrooms. Nearly 20% of respondents, regardless of their own experience and self-assessment of their competence in discriminating mushrooms belive that after culinary preparation can by safely consume even deadly poisonous species. The primary source of knowledge on mushrooms for the majority of responents are parents. There was no correlation between the preferred source of information about mushrooms and belief in the myths about them. Knowledge on the mushrooms of medical students (nursing, emergency medical service) is not greater than students other courses.

Amanita poisonings resulting in acute, reversible renal failure: new cases, new toxic Amanita mushrooms.

BACKGROUND: Renal failure as a consequence of eating mushrooms has been reported repeatedly after ingestion of webcaps of the Cortinarius orellanus group. But mushrooms of the genus Amanita can also cause renal failure: Amanita smithiana (North America) and Amanita proxima (Mediterranean area). Here, we discuss poisonings caused by other white amanitas. A German and--independently--two Portuguese patients reported the ingestion of completely white mushrooms with ring. Similar to intoxications with A. smithiana or A. proxima, the clinical picture was characterized by nausea and vomiting 10-12 h after ingestion, severe acute renal failure and mild hepatitis. Renal biopsy showed acute interstitial nephritis and tubular necrosis. Two patients were given temporary haemodialysis. All have fully recovered their renal function. Poisonings caused by mushrooms containing the toxin of A. smithiana were suspected. We tested 20 Amanita species for the presence of this toxin. METHODS: Thin layer chromatography was applied to detect A. smithiana nephrotoxin in herbarium specimens using authentic material of A. smithiana as reference. RESULTS: A. smithiana toxin could be detected in Amanita boudieri, Amanita gracilior and in Amanita echinocephala. A. boudieri was collected by the Portuguese patients. A. echinocephala is the only nephrotoxic Amanita growing North of the Alps and is suspected to be the cause of renal failure in the German patient. No A. smithiana toxin was detectable in the nephrotoxic A. proxima. CONCLUSIONS: A. boudieri, A. gracilior and A. echinocephala are nephrotoxic. These intoxications are clinically similar to that of A. smithiana, with acute reversible renal failure and mild hepatitis but are different in their clinical picture from Orellanus syndrome characterized by a delayed onset of severe and often irreversible renal failure.

[Knowledge of students of tourism and recreation Academy of Physical Education on wild mushrooms]. / Wiedza studentów turystyki i rekreacji Akademii Wychowania Fizycznego na temat grzybów dziko rosnacych.

Prophylaxis of acute poisoning with mushrooms is justified because of the relatively high risk of death associated with these intoxications. Mushrooming in Poland has a long tradition and knowledge about mushrooms is usually passed on in families. In recent years the mushrooming becomes an organized form of recreation. Graduates of tourism and recreation should have a minimum of reliable knowledge about mushrooms, to ensure the safety of persons entrusted to their care. The knowledge of wild mushrooms among students of tourism and recreation was tested by means of questionnaire. Mushrooms gathered 108 out of 125 respondents. The primary source of knowledge about mushrooms for 84% of the mushrooms pickers were the parents. Up to 70% of respondents considered at least one of irrational methods useful to distinguish edible mushrooms from the poisonous. Thirteen percent of those polled believed that by simple means mushrooms may be deprived of their toxic properties. Knowledge of the only one deadly poisonous mushrooms growing in Poland was 53%. The tourism and recreation students must pass basic knowledge about mushrooms and identify reliable sources of knowledge in this field.

[Hiking and useful advices to patients: part II]. / Randonnée: conseils utites aux patients (2e partie).

The attraction of walking as a pastime has grown enormously in Switzerland over the past few years. Synonym of health and wellbeing, this activity carries some risks which more and more patients are questioning; answering these questions is not always obvious, so we wanted to tackle the subject. This second section concerns risks linked to food which can be found in the forest. Echinococcosis is an underestimated parasite which affects a large proportion of foxes in Switzerland. This infectious disease can also affect man following contamination which usually occurs through eating berries. Prevention is the most effective way to avoid poisoning by mushrooms. In case of poisoning, the physician must try and determine the toxidrome. The key element is the length of time before symptoms develop. Treatment is always symptomatic, using activated charcoal.

Wild mushroom poisonings in the Middle Black Sea region in Turkey: analyses of 6 years.

Wild mushroom poisoning (MP) is an important medical emergency that may have serious clinical outcome. The aim of this study was to evaluate the demographic and clinical features of patients with wild MP. This study was designed retrospectively by examining files of the patients with wild MP who were admitted to Ondokuz Mayis University Emergency Department, between January 2002 and December 2007. Patients > or =16 years of age were included in the study. A total of 317 patients poisoned by wild mushrooms (mean age, 42.0 +/- 16.3 years; 67.5% female) were studied. All poisonings were accidental, i.e. consumption of wild mushrooms collected from open fields and woodlands or purchased from local bazaars. The common symptoms and complaints on admission were nausea (86.8%) and vomiting (79.8%). The poisoning latent phase in most cases was <6 hours (86.8%). Most of the poisonings occurred in autumn (59.6%). Three patients died in the hospital due to acute liver failure and complications. The duration of hospitalization was a median 3 days (range: 1-12 days). The public should be informed about the probable hazards of wild mushroom ingestion.