HEALTH MATTERS: Wild mushrooms? Extreme caution!

The folklore surround ing poisonous mush rooms is just that — folklore. It should not be believed.

By Craig A. Gronczewski, M.D. PrincetonHealthCare System
    As children, many of us were taught to avoid eating wild mushrooms — those kinds that pop up in our backyards or we spot along wooded trails — or risk becoming extremely ill.
    As adults, that lesson still holds true and is a message we should be passing on to our own children.
    The recent poisoning of writer Nicholas Evans, author of the international best-selling book “The Horse Whisperer,” from eating toxic mushrooms he picked in Scotland made headlines around the world last month.
    Given that mushroom season is upon us right here in Central Jersey — they tend to grow best in the spring and fall — now is an opportune time to learn about the risks associated with consuming wild mushrooms and how to avoid these risks.
    There are thousands of varieties of mushrooms in North America, and while only about 100 are unsafe, the consequences of eating a poisonous variety can be severe and in rare cases, fatal.
    Last year, the North American Mycological Association received 29 reports involving 45 people, including one fatality, who were poisoned by eating wild mushrooms. However, in 2006, a record number of people — 132 — reported being sickened by mushrooms, according to the association. Of those, more than half became ill after eating one of the Amanita varieties, which are the deadliest and bear names like Death Cap and Destroying Angel.
    According to the U.S. Food and Drug Administration, mushroom poisonings in the United States occur most commonly when:
    • hunters of wild mushrooms (especially novices) misidentify and consume a toxic species;
    • recent immigrants collect and consume a poisonous American species that closely resembles an edible species from their native land, or
    • hallucinogenic mushrooms are intentionally consumed by people desiring to get high.
    Additionally, children and the elderly are at a higher risk for mushroom poisoning. Children are especially vulnerable because they play more outside and have a greater tendency to confuse wild mushrooms with the cultivated type we buy from the grocery store or farmers’ market and think they are safe to eat.
    Signs of mushroom poisoning vary greatly, but in the case of poisoning by the Amanita variety symptoms generally occur in three stages.
    • The first stage includes classic gastrointestinal distress symptoms such as sudden and severe nausea, vomiting, abdominal cramping and diarrhea. These symptoms, however, tend to be delayed and do not appear for six to 24 hours after the toxic mushroom is ingested.
    • In the second stage, the symptoms retreat and the patient appears to go into remission. Unfortunately, while the patient may feel well, the toxins are affecting the kidneys and liver and causing severe damage.
    • In the third stage, the patient starts to experience liver and kidney failure and internal bleeding may occur. The patient will likely appear jaundiced and experience reduced muscle function and an altered mental state.
    If a patient experiences these symptoms after eating wild mushrooms, they should immediately call the New Jersey Poison Control Center at 800-222-1222 for emergency help. It is important to provide doctors a sample of the toxic mushrooms, if possible.
    The sooner a patient seeks treatment the better their chances for a full recovery. Patients who are hospitalized and treated almost immediately have a mortality rate of only 10 percent, whereas those admitted 60 or more hours after ingestion have a 50 percent to 90 percent mortality rate.
    While wild mushroom hunting has grown in popularity over the years, the best way to avoid poisoning is to leave foraging to the experts. People who are not mycologists (mushroom experts) should not pick wild mushrooms. Even they at times have trouble distinguishing the difference between poisonous and non-poisonous varieties because of their similarities.
    Moreover, the folklore surrounding poisonous mushrooms is just that — folklore. Some people believe that poisonous mushrooms don’t grow on wood or are insect- free. Some believe that poisonous mushrooms are always brightly colored. Others believe that poisonous mushrooms turn silver black. And others think removing the cap can take away the poison, that poisonous mushrooms taste bad or that cooking the mushrooms will make them safe.
    Unfortunately, these are all myths and should not be believed.
    The truth is that wild mushrooms are potentially dangerous. There are no general identifiers for poisonous mushrooms, which is why it is best to avoid the danger all together.
To find a physician with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Dr. Craig A. Gronczewski is board- certified in emergency medicine and is the chairman of the Department of Emergency Medicine at Princeton HealthCare System.