An investigation of mushroom poisoning (Amanita brunneitoxicaria) in Ban Sakrajai, Village 4, Satuek Subdistrict, Satuek District, Buriram Province, 9–23 July 2024

Abstract

Introduction: Food poisoning from wild mushrooms is frequently reported in Thailand during the rainy season, with the highest incidence in the northeastern region. On 20 July 2024, the Communicable Disease Control Unit of Buriram Provincial Public Health Office was notified by an epidemiologist at Buriram Hospital of a death suspected to be due to mushroom poisoning in Satuek District, Buriram Province. This investigation aimed to confirm the diagnosis and outbreak, describe the epidemiological characteristics, identify the cause, and propose control and prevention measures.

Methods: This descriptive study collected data through interviews with patients and relatives, review of medical records and laboratory results, and an environmental assessment around the incident site. Fresh mushroom samples from the foraging area were collected and submitted to the National Biobank of Thailand for species identification.

Results: A total of four probable cases were identified (two males and two females), including three deaths (case fatality rate 75%). Predominant symptoms included abdominal pain, nausea, vomiting, and fatigue. All patients had consumed a mixed mushroom soup prepared from wild mushrooms collected in the local forest, with an incubation period of 9–17 hours. Laboratory findings revealed abnormalities in liver and kidney function, and coagulation profiles, with more severe derangements in fatal cases. Mushroom species analysis showed 99.85% similarity to Amanita brunneitoxicaria, a highly toxic Amanita species containing amatoxins. The outbreak was associated with consumption of wild mushrooms harvested from the same source.

Discussion: The investigation findings are consistent with previous reports of mushroom poisoning in Thailand, which commonly occur during the rainy season and involve highly toxic Amanita species. Collecting multiple wild mushroom species and cooking them together without proper species identification was a key risk factor. Satuek District has reported similar cases annually, indicating that existing community risk communication and preventive measures may be insufficient. Strengthening surveillance and public warnings during the rainy season is therefore essential. Risk communication activities should be intensified to raise community awareness. Development of mushroom identification guides, installation of warning signs in high-risk areas, and implementation of the “Safe Community: Free from Poisonous Mushrooms” program are recommended to prevent recurrence. Enhanced surveillance and proactive public alerts are particularly necessary during the rainy season, when the risk is highest.