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Journal Article

Citation

Shi GQ, Huang WL, Zhang J, Zhao H, Shen T, Fontaine RE, Yang L, Zhao S, Lu BL, Wang YB, Ma L, Li ZX, Gao Y, Yang ZL, Zeng G. PLoS One 2012; 7(5): e35894.

Affiliation

Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China.

Copyright

(Copyright © 2012, Public Library of Science)

DOI

10.1371/journal.pone.0035894

PMID

22615743

Abstract

INTRODUCTION: Since the late 1970's, time-space clusters of sudden unexplained death (SUD) in northwest Yunnan, China have alarmed the public and health authorities. From 2006-2009, we initiated enhanced surveillance for SUD to identify a cause, and we warned villagers to avoid eating unfamiliar mushrooms. METHODS: WE ESTABLISHED SURVEILLANCE FOR SUD, DEFINED AS FOLLOWS: sudden onset of serious, unexplained physical impairment followed by death in <24 hours. A mild case was onset of any illness in a member of the family or close socially related group of a SUD victim within 1 week of a SUD. We interviewed witnesses of SUD and mild case-persons to identify exposures to potentially toxic substances. We tested blood from mild cases, villagers, and for standard biochemical, enzyme, and electrolyte markers of disease. RESULTS: We identified 33 SUD, a 73% decline from 2002-2005, distributed among 21 villages of 11 counties. We found a previously undescribed mushroom, Trogia venenata, was eaten by 5 of 7 families with SUD clusters compared to 0 of 31 other control-families from the same villages. In T. venenata-exposed persons SUD was characterized by sudden loss of consciousness during normal activities. This mushroom grew nearby 75% of 61 villages that had time-space SUD clusters from 1975 to 2009 compared to 17% of 18 villages with only single SUD (p<0.001, Fisher's exact test). DISCUSSION: Epidemiologic data has implicated T. venenata as a probable cause of clusters of SUD in northwestern Yunnan Province. Warnings to villagers about eating this mushroom should continue.


Language: en

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