An outbreak of mushroom poisoning in Israel during the 2020 fall and winter season: an unexpected outcome of COVID-19 restrictions?

INTRODUCTION: Mushroom poisonings occur every year in Israel, mainly in the fall and winter seasons. During the fall/winter of 2020, we experienced an increase in calls to the Israel Poison Information Center (IPIC) concerning mushroom ingestions. METHODS: We conducted a retrospective review of mushroom poisonings reported to the IPIC during 2015-2020 using the electronic IPIC data base. For all calls about mushroom poisonings in 2020, we extracted data on patient demographics, geographic location of the picked mushroom, mycological identification (if available), IPIC recommendations, and clinical outcomes. RESULTS: The IPIC received 105 calls concerning mushrooms ingestion in 2020, 65 (62%) during the last quarter. This corresponded to a 2.5-fold increase compared to the median annual rate between 2015 and 2019, and a 5-fold increase compared to the same fall/winter period in 2019. Most cases had no or only minor signs and symptoms, but 6% had moderate to severe poisoning. The severe poisonings, including one life-threatening were due to Lepiota brunneoincarnata and Amanita proxima ingestion. DISCUSSION: Possible explanations for this outbreak include favorable climate conditions and increased outdoor activities of the public in response to restrictions on other leisure activities imposed during the COVID-19 pandemic.