From mid-November 2025 through mid-January 2026, California has faced an escalating outbreak of amatoxin poisoning from foraged wild mushrooms, primarily death caps (Amanita phalloides), with the California Poison Control System (CPCS) identifying 39 hospitalized cases across Northern and Central California counties including Monterey, San Francisco Bay Area, Sacramento, and others. The cluster has resulted in four adult deaths, three liver transplants, and severe liver injuries affecting patients from 19 months to 67 years, including family groups, prompting repeated statewide advisories from the California Department of Public Health (CDPH) urging residents to avoid all wild mushroom foraging during the rainy season.
Heavy winter rains have fueled widespread death cap growth under oaks and hardwoods, exacerbating confusion with edible lookalikes amid rising recreational foraging; CDPH and CPCS have issued multilingual public service announcements, clinician guidance, and a joint press conference, while local health departments coordinate case tracking and outreach. National poison center data underscores persistent risks, with over 4,500 U.S. mushroom exposure calls in 2023 highlighting vulnerabilities especially for young children.
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People Involved
Erica Pan
Director and State Public Health Officer, California Department of Public Health (Leads statewide response and public advisory on death cap outbreak)
Alvin C. Bronstein
Board President, America’s Poison Centers (Provides national context on poisoning trends and the role of poison centers)
Organizations Involved
CA
California Department of Public Health
Government Body
Status: Leads statewide response, advisories, and clinician guidance on the mushroom outbreak
The California Department of Public Health (CDPH) is the statewide agency responsible for protecting public health, including surveillance of communicable diseases, environmental hazards, and food‑borne risks.
CA
California Poison Control System
Public Health Program
Status: Tracks 39 cases to Jan 18; coordinates with CDPH on clinician guidance and PSAs
The California Poison Control System (CPCS) is the designated and accredited poison center for the state, providing 24/7 free, confidential advice and treatment recommendations via the national Poison Help hotline (1‑800‑222‑1222).
AM
America’s Poison Centers
Nonprofit / Public Health Network
Status: Provides national data and context for mushroom exposure trends
America’s Poison Centers is the national association representing U.S. poison centers, maintaining the National Poison Data System (NPDS) and coordinating accreditation, certification, and surveillance across 50 states and territories.
MO
Monterey County Health Department
Local Health Department
Status: First local jurisdiction to flag the 2025 spike in severe mushroom poisonings
Monterey County Health Department is the local public health authority for a coastal region of Central California with extensive parks and oak woodlands where death cap mushrooms are known to grow.
Timeline
Sacramento County reports 4 local cases amid statewide total of 35
Local Advisory
Sacramento County Public Health aligns with CDPH warnings, noting 4 amatoxin cases locally as CPCS tallies 35 statewide hospitalized patients; urges no wild foraging.
CDPH dashboard: 39 cases and 4 deaths across 10 counties
Outbreak Update
CDPH reports 39 cases (4 deaths) from Nov 18, 2025–Jan 18, 2026, in counties including Alameda, Sacramento, and Sonoma; emphasizes multilingual outreach.
CDPH and CPCS hold joint virtual press conference; NR26-004 details 35 hospitalized cases to Jan 6 (3 deaths, 3 transplants), releases multilingual PSAs and webpages.
Ongoing warnings and updated coverage as winter rains continue
Developing
As winter rain continues to create ideal growth conditions for death caps under oaks and other hardwoods, outlets reiterate CDPH’s call for residents to avoid all wild mushroom foraging and to contact poison control immediately if exposure is suspected, while CPCS continues monitoring for additional cases.
AP and national outlets amplify California’s warning
Media Coverage
The Associated Press and partner outlets including ABC News, WSLS, and the Guardian report on California’s outbreak, noting 21 amatoxin cases, one adult death, severe liver damage in several patients (including children), and more than 4,500 unidentified mushroom exposure calls to U.S. poison centers in 2023.
Local media detail Monterey‑area cases and recall past outbreaks
Media Coverage
The San Francisco Chronicle and SFGate publish in‑depth pieces on Monterey County’s rise in mushroom poisonings—typically two or three serious cases per year versus at least seven hospitalizations in 2025—and reference the 2016 Northern California death cap outbreak and a 2023 Australian death cap poisoning case as cautionary examples.
CDPH issues clinician health advisory on severe amatoxin poisoning
Clinical Guidance
CDPH circulates a CAHAN Health Advisory titled “Severe, Potentially Fatal Liver Damage in Children and Adults Associated with Consumption of Foraged Wild Mushrooms,” detailing the 21 cases, one death, and two potential liver transplants, and providing recommendations for clinicians, including early admission, toxicology consultation, and consideration of intravenous silibinin.
CDPH public press release warns against any wild mushroom foraging
Public Advisory
In press release NR25‑023, CDPH publicly announces an “outbreak of potentially deadly amatoxin poisoning” linked to wild, foraged mushrooms, confirms 21 cases and one death, and strongly advises Californians not to forage wild mushrooms during the current rainy season, emphasizing that toxins are not destroyed by cooking.
Monterey County warns residents after spike in mushroom‑related liver failure
Local Advisory
Monterey County Health Department issues a health advisory describing severe hepatotoxicity and hospitalizations following consumption of wild mushrooms, including earlier cases tied to death caps sold by an unauthorized seller, and warns residents not to eat wild mushrooms unless identified by experts.
Onset of 2025 amatoxin poisoning cluster in California
Outbreak
Over roughly two and a half weeks starting in mid‑November 2025, CPCS identifies 21 cases of suspected Amanita phalloides poisoning among people who consumed foraged wild mushrooms, with clusters in Monterey County and the San Francisco Bay Area and cases including both adults and children.
Governor Newsom appoints Erica Pan to lead CDPH
Leadership
Governor Gavin Newsom announces that Dr. Erica Pan, then State Epidemiologist and Deputy Director for the Center for Infectious Diseases, will serve as the next Director and State Public Health Officer of CDPH effective February 1, 2025, positioning her to lead future statewide health responses.
CDPH issues broad caution on collecting and eating wild mushrooms
Public Advisory
Following prior poisonings, CDPH releases a statewide press statement urging Californians to use extreme caution when collecting or consuming wild mushrooms, warning that toxic species can resemble edible varieties and that proper identification requires expert mycologists.
Northern California death cap mushroom outbreak provides grim precedent
Historical Precedent
In December 2016, the California Poison Control System identified 14 cases of Amanita phalloides (death cap) poisoning across five Northern California counties, many requiring intensive care and three liver transplants; all survived, though one child had permanent neurologic impairment. The outbreak prompted state and local health warnings and remains a key case study in amatoxin toxicity.
Scenarios
1
Outbreak tapers after intensive warnings, with few additional severe cases
Discussed by: Public health officials and mainstream outlets citing historical patterns of short, intense mushroom poisoning clusters
In this scenario, CDPH’s aggressive messaging, local advisories from counties such as Monterey, and widespread national coverage rapidly change behavior: casual foragers and families stop eating any wild mushrooms, while parks and community groups post visible warnings. As a result, only a small number of new amatoxin cases occur over the remainder of the rainy season, with no further deaths and limited need for liver transplants. The outbreak is recorded as a serious but contained episode that primarily reinforces existing seasonal mushroom cautions in California. This outcome is consistent with the pattern seen in the 2016 Northern California death cap outbreak, which subsided once the bloom passed and warnings were disseminated.
2
More deaths and transplants force new regulations on foraging and informal mushroom sales
Discussed by: Some toxicologists, local officials in hard‑hit counties, and commentators drawing on recent severe poisonings
If winter rains continue and public warnings fail to reach high‑risk groups—such as new foragers, tourists, or people buying mushrooms from informal sellers—the number of severe amatoxin cases could rise, with additional deaths or liver transplants. Counties might respond by restricting mushroom collection in popular parks, mandating warning signage where death caps are known to grow, or cracking down on unauthorized mushroom vendors. Persistent or expanding clusters could also prompt legislative proposals to regulate commercial wild mushroom sales more tightly, mirroring responses in other jurisdictions after high‑profile poisonings.
3
High‑profile legal or civil cases emerge around severe poisonings
Discussed by: Legal analysts and media drawing parallels to the Australian Leongatha death cap murder case
Although most mushroom poisonings are accidental, prior incidents—such as the Leongatha mushroom murders in Victoria, Australia, where a home‑cooked lunch with death caps led to three murder convictions—show that prosecutors may pursue criminal charges when there is evidence of intent or gross negligence. If California investigations find that an individual knowingly sold or served toxic mushrooms, or ignored prior warnings, civil lawsuits or even criminal charges could follow. Even without criminal intent, civil liability for unauthorized sellers or event organizers who serve foraged mushrooms could become a prominent test case, influencing future food safety standards.
4
National treatment protocols and antidote access are strengthened
Discussed by: Medical toxicologists and guideline authors cited in CDPH’s clinician advisory
The 2025 outbreak could accelerate national efforts to standardize management of amatoxin poisoning, including earlier consultation with poison centers, routine consideration of transfer to transplant‑capable centers, and streamlined access to intravenous silibinin (Legalon SIL) through FDA’s Expanded Access mechanisms. CDPH’s advisory already references UpToDate and Medscape guidance as well as prior MMWR reports, signalling an alignment with emerging best practices. A formalized, widely adopted protocol might reduce mortality and organ failure in future outbreaks, even if the underlying risk of death cap exposure persists.
5
Public health messaging broadens into a long‑term campaign on foraging and environmental toxins
Discussed by: Poison center leaders and public health communicators referencing NPDS trends
America’s Poison Centers’ data highlight not just mushroom exposures but a wider landscape of environmental and unregulated substance risks, and leaders have repeatedly stressed the need for robust prevention campaigns. Building on the visibility of the 2025 California outbreak, CDPH, CPCS, and national partners could develop sustained educational campaigns targeting foraging safety, children’s exposure risks, and the misconception that natural foods are inherently safe. Such a campaign might include school curricula, multilingual outreach in parks, and collaboration with mycological societies, shifting the narrative from episodic warnings to a standing, seasonal risk framework.
Historical Context
Northern California Amanita phalloides Outbreak (2016)
December 2016 – June 2017 (publication of MMWR report)
What Happened
In December 2016, the California Poison Control System investigated 14 cases of Amanita phalloides (death cap) poisoning in Northern California after local mycologists reported an unusually large bloom following heavy rains. Patients developed delayed gastrointestinal symptoms followed by severe liver injury; three required liver transplants, and one child was left with permanent neurologic impairment, though all survived.
Outcome
Short Term
State and county health departments, working with CPCS, issued press releases warning residents against eating foraged wild mushrooms and advising clinicians to consider amatoxin poisoning when evaluating gastroenteritis with evolving liver failure.
Long Term
The event became a reference case in toxicology literature and informed later advisories, including CDPH’s 2016–2017 mushroom warnings and its 2025 guidance, establishing a template for clinician education and public messaging during similar outbreaks.
Why It's Relevant Today
The 2016 outbreak closely mirrors the 2025 situation in geography, mushroom species, rainfall‑driven bloom, and clinical course, offering a direct precedent for how quickly clusters can grow and how early recognition and aggressive care can prevent deaths despite severe liver injury.
Leongatha Death Cap Mushroom Murders (Australia, 2023–2025)
July 29, 2023 – September 8, 2025
What Happened
In July 2023, Erin Patterson hosted a lunch in Leongatha, Victoria, serving beef Wellington later found to contain death cap mushroom toxins; three relatives died from fulminant liver failure and a fourth required a liver transplant. She was charged with multiple counts of murder and attempted murder and, after a widely covered trial, was convicted and sentenced to life imprisonment with a lengthy non‑parole period.
Outcome
Short Term
The case triggered intense media attention, emergency public health investigations into possible contaminated commercial mushroom supplies, and international coverage of death cap toxicity and forensic mushroom identification.
Long Term
Leongatha became a touchstone example of both the lethality of death caps and the potential for mushroom poisonings to cross from public health events into criminal law, shaping global public perception of foraged mushrooms as a possible vector for homicide as well as accident.
Why It's Relevant Today
While the California outbreak appears accidental, the Australian case shows how death cap poisonings can have legal and social ramifications far beyond individual exposures, informing how authorities might respond if any California cases involve negligence or intent, and underscoring how high‑profile mushroom incidents can shift public attitudes about foraging risk.
National Poison Data System Reports on Mushroom Exposures (U.S., 1980s–2023)
Ongoing, with 2023 Annual Report as latest benchmark
What Happened
Since the 1980s, the National Poison Data System maintained by America’s Poison Centers has compiled detailed statistics from all U.S. poison centers, documenting hundreds of thousands of environmental and food‑related exposures annually. The 2023 report logged more than 2.08 million human exposures overall and over 4,500 calls about unidentified mushrooms, about half in young children.
Outcome
Short Term
NPDS data provide baseline context every year for public health agencies assessing whether localized spikes—such as California’s 2025 death cap outbreak—represent unusual clusters versus expected background levels of mushroom exposure.
Long Term
Decades of surveillance have informed poison prevention campaigns, pediatric injury prevention efforts, and clinical guidance for environmental toxicology, reinforcing the value of poison centers as sentinel systems for emerging risks.
Why It's Relevant Today
The California outbreak is best understood against this national backdrop: the state’s 21 serious amatoxin cases over a few weeks stand out against thousands of generally less severe mushroom exposures nationwide, justifying aggressive intervention despite the small absolute numbers.
