Death cap mushroom looks good, tastes good, and often kills
12/02/2012 12:00 AM
12/02/2012 4:41 PM
It is a killer disguised in a luscious package.
Amanita phalloides, the mushroom suspected of fatally poisoning four elderly people at a Loomis care home, is commonly called the death cap.
The death cap draws in mushroom hunters with its sturdy stem and smooth, bald top, ranging in color from bronze to greenish yellow, and then kills – it is almost singularly responsible for fatal mushroom poisonings worldwide.
"These mushrooms are very, very sexy," said Dr. Todd Mitchell, a Santa Cruz physician who is leading a national study of an antidote to toxic mushroom poisoning. "They look very attractive in the field. They grow virtually side by side to chanterelles, and they look very robust. They smell quite sweet, and by all accounts are quite delicious."
In Northern California, they grow abundantly during the fall and early winter, typically sprouting beneath live oak trees. The fungi, which contains a toxic protein that can cause permanent liver and kidney damage, sicken hundreds of people a year in California. On average, a half-dozen people suffer serious poisonings from the mushrooms annually and one or two die, said Dr. Kent Olson, executive medical director of the California Poison Control System.
Death caps are the primary suspects in the illnesses last month of six people at the Gold Age Villa in Loomis, four of whom have died.
Lilia Tirdea, a caregiver who cooked meals for residents of Gold Age Villa, picked wild mushrooms on the grounds of the care home, then cooked and served them in a gravy for dinner on Tuesday evening, Nov. 6.
By Thursday, nearly everyone who lived at the care home was terribly ill.
At first the home's owner, Raisa Oselsky, who was not home when Tirdea served the mushrooms, suspected a rampant case of the flu. But after speaking with Tirdea, she realized that of the home's six residents, only one had not eaten the mushroom dish. That person was fine.
Everyone else, including Tirdea, ended up in area emergency rooms.
Barbara Marie Lopes, 87, a spirited woman who raised three daughters on her own and worked for decades as an aircraft mechanic at the former McClellan Air Force Base, died Nov. 9. So did Teresa Jania Olesniewicz, 73, who was a physician in her native Poland before she came to the United States in the 1970s.
A week after the two women's deaths, officials announced a third fatality tied to the mushroom gravy: Frank Warren Blodgett, 90. On Thursday, Dorothy Mary Hart, 92, was the fourth to die.
Tirdea and one other person were recovering from the poisonings as of late last week, officials said.
Appeared to be the flu
In the quaint confines of Gold Age Villa, Lopes, whose memory was fading but otherwise was fairly healthy, enjoyed watching TV, playing cards and keeping company with other residents and staffers, said her daughter Annette St. Urbain.
"They were all friends," St. Urbain said. "Raisa and the rest of the staff were wonderful to my mother. We have no animosity toward them at all."
Lopes, who stood just 5 feet tall, was raised on a farm in South Dakota, her daughter said. After moving to California, she took a job at McClellan inspecting aircraft.
"She was our own little Rosie the Riveter, small enough to fit into the nose cones" of planes to check for debris, said St. Urbain. "She was very proud of her work."
Besides her children, her daughter said, Lopes' great loves included big-band music, dancing and solving jigsaw puzzles. Lopes had a strong faith in God and "above all, taught me forgiveness," St. Urbain said.
Lopes had developed a tricky left knee, nerve pain from a bout with shingles and memory problems. She moved into Gold Age Villa nearly two years ago and was happy there, her daughter said.
On the Thursday evening after Lopes ate the poison mushrooms, St. Urbain got a call from Oselsky, telling her that Lopes was ill with what appeared to be the flu. Early the next morning, she heard from an emergency room doctor at Sutter Roseville hospital who said Lopes was near death from wild mushroom poisoning.
"I thought, 'Mushroom poisoning? What?' " St. Urbain recalled. She contacted other relatives and headed to the hospital.
Lopes was conscious when they arrived, even joking, St. Urbain said. But within hours, she was dead.
"It was just a sad mistake. A lapse in judgment," St. Urbain said of the circumstances of her mother's death. "I feel terrible for everyone."
A fatal accident
Oselsky declined to talk to a reporter when approached at the care home last week. "We are having a hard time here," she said, and referred all questions to her attorney.
"She is very, very distraught about the whole situation, very concerned for everyone affected and their families," said the lawyer, James Hazen.
The California Department of Social Services has determined that the poisonings were accidental. Even so, Tirdea no longer is allowed to work in care facilities licensed by the state.
Regulators have deemed Tirdea a "threat to the health and safety" of clients, according to a report issued last week. But she will not face criminal charges. A police investigation concluded that "this was an accident," said Placer County Sheriff's Lt. Mark Reed.
Reed was among those who interviewed Tirdea and others at the care home about the poisonings.
"At first you hear about something like this and you think, 'Well, all of the sudden all of these people were sick from food that someone gave them. Was there some sort of sinister motive or foul play?' " said Reed.
"Then we found out the caregiver herself picked the mushrooms and thought they were good to eat. She served them up, and she also got sick. We determined that there was no criminal intent. It's just a tragedy all the way around."
Gold Age Villa, which is perched on a hill amid equestrian property along Horseshoe Bar Road, continues to be licensed to care for up to six people ages 60 and older. Residents of such residential care facilities usually require less intensive care than those in nursing homes, although caretakers are available around the clock, said social services department spokesman Michael Weston.
Oselsky has held a license to operate the home since 2007, and the facility has an unremarkable record with state regulators. Following an inspection earlier this year Gold Age Villa received one citation, for "excessive water temperature" in its faucets.
The type and scope of the tragedy at Gold Age Villa, Weston said, "is like nothing that I can recall. We have had cases of where a fire killed a number of people, but something like this is highly unusual."
The apparent culprit, the death cap mushroom, is one of several toxic fungi that grow in California.
In the north state, the death cap generally grows under live oak trees, but recently has been found alongside pine trees in Marin County, among other places.
"They look pretty good, almost identical to an edible variety," Olson said. But they contain deadly amatoxins, a protein that the body has trouble eliminating. Amatoxins cannot be killed by heating, Olson said.
Initial symptoms of mushroom poisoning include abdominal pain, vomiting and severe diarrhea. Symptoms may not surface for six to 12 hours.
Once consumed, the mushroom's toxin attacks the lining of the gut, causing fluids to "pour out of the system" and leading to life-threatening dehydration, Olson said. The amatoxins then get absorbed by the liver, damaging it and other vital organs. At that point, patients often need a liver transplant to survive.
The earlier the treatment, the better the prospects for recovery.
Typically, patients receive intravenous fluids to replace those they have lost, along with high doses of penicillin to prevent the poison from being absorbed by liver cells, said Olson. Doctors may also give them activated charcoal as an antidote.
People who consume a "mild to moderate" amount of toxic mushrooms and get treatment before they become severely dehydrated stand an 80 percent to 90 percent chance of survival, experts said.
A new treatment may lead to even better recovery rates, said Mitchell.
Since 2009, he and colleagues have been leading a national study of a drug derived from milk thistle that is showing promise, he said.
More than 60 patients have received the intravenous drug, called Legalon SIL, including one of the six people sickened in Loomis, Mitchell said. That person survived, he said.
Lopes and Olesniewicz had already died by the time the surviving patient received the investigational drug, he said. The fourth person whose death officials attributed to mushroom poisoning, Dorothy Mary Hart, did not receive the Legalon treatment, nor did Blodgett.
Their stories, said Olson, should serve as a warning to Northern Californians who stumble across enticing patches of mushrooms while hiking, exploring or mowing the backyard.
"The lesson I would take from all of this is to never eat a mushroom that has not been properly identified by an expert," said Olson.
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