GI illness outbreak, deaths linked to consumption of undercooked morel mushrooms
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Key takeaways:
- Fifty-one people reported mild to severe GI symptoms after eating at a restaurant in Bozeman, Montana.
- A stronger association was found between uncooked vs. partially cooked morel mushrooms and GI symptoms.
Consumption of uncooked or undercooked morel mushrooms was “strongly associated” with a gastrointestinal illness outbreak in spring 2023 that resulted in two deaths, highlighting the importance of proper food preparation procedures.
“On April 18, 2023, the Montana Department of Public Health and Human Services and health departments in Gallatin and Broadwater counties were notified of two persons who experienced severe nausea, vomiting and diarrhea after separately dining at restaurant A in Bozeman, Montana, on April 17,” Heather Demorest, MPH, of the Gallatin City-County Health Department in Bozeman and colleagues wrote in Morbidity and Mortality Weekly Report. “One restaurant patron was hospitalized and later died; the second died hours after being discharged from a hospital emergency department.”
Image: Adobe Stock
According to the report, the two index patients had consumed a special sushi roll that contained salmon and morel mushrooms, which the restaurant had prepared in various ways from March 27 to April 17. An inspection of the restaurant on April 18 revealed multiple violations, including temperature and storage issues and improper sanitation procedures. A total of 51 people reported mild to severe GI symptoms after eating at the restaurant during that time, with 88% reporting consumption of morels.
In a matched, case-control study, Demorest and colleagues aimed to identify foods associated with illness among 41 patients (36.9% women, 75.6% aged 20-49 years) who experienced GI symptoms after eating at the restaurant between March 27 and April 18. Researchers also included 22 controls, or individuals who did not experience illness after eating at the restaurant. Overall, the analysis represented 29 unique dining parties.
Most patients reported diarrhea (90.2%), followed by nausea (82.9%), abdominal pain (68.3%), loss of appetite (61%), fatigue (58.5%), vomiting (53.7%) and abdominal distension (53.7%).
Results from matched logistic regression analyses by dining party showed the odds of eating the special sushi roll with morels or eating any morels was 15.78 times and 10.77 times higher, respectively, among case patients vs. controls. An unmatched analysis also “suggested a dose-response relationship,” with case status associated with how many pieces of the sushi roll were consumed.
Further, when stratified by meal date, consumption on April 17 (OR = 99.57), when uncooked morels were served, was more strongly linked with illness vs. consumption of partially cooked morels (OR = 11.67) on April 8.
“The findings from this investigation suggest that uncooked or undercooked morel mushrooms were the likely source of the outbreak,” Demorest and colleagues wrote. “The epidemiologic study demonstrated a clear association between consumption of the special sushi roll with morels and gastrointestinal illness, including a dose-response relationship, and an apparent stronger association among persons who ate the morels on a day when the morels served by restaurant A were reportedly uncooked.”
They continued: “Morel mushrooms should be cooked before human consumption to mitigate their potential toxicity.”
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