Mushroom Poisoning Outbreaks — China, 2025

Abstract

What is already known about this topic?

Mushroom poisoning is a major food safety threat in China. Since 2019, systematic investigations by China CDC have mapped the spatial and temporal patterns of poisoning incidents and documented the diversity of poisonous mushroom species nationwide. From 2019 to 2024, the annual number of incidents ranged from 276 to 676, and the case fatality rate ranged from 0.87% to 2.86%.

What is added by this report?

In 2025, China CDC investigated 828 mushroom poisoning incidents across 27 provincial-level administrative divisions (PLADs), affecting 2,165 individuals and causing 13 deaths — a case fatality rate of 0.6%, the lowest of the past six years. In total, 138 poisonous mushroom species were identified, including 34 newly recorded in poisoning incidents in China.

What are the implications for public health practice?

Prompt identification of the mushroom species, detection of toxins, and confirmation of the clinical syndrome are critical for guiding appropriate treatment and implementing effective public health interventions. Continued efforts are needed to strengthen public education and to enforce stricter market regulation of wild mushroom sales.

ABSTRACT

Introduction: Mushroom poisoning is a significant food safety concern in China. Over the past decade, the country has developed an effective system for the prevention and control of mushroom poisoning through the coordinated efforts of government agencies, clinicians, CDC experts, and mycologists.

Methods: Within this established system, we systematically collected information on mushroom poisoning incidents, including identification of the species involved, detection of the associated toxins, and analysis of the spatial and temporal distribution patterns and species diversity.

Results: In 2025, China CDC investigated 828 mushroom poisoning incidents across 27 provincial-level administrative divisions (PLADs), involving 2,165 patients and resulting in 13 deaths — a case fatality rate of 0.6%, the lowest recorded since 2019. Incidents occurred throughout the year but were most frequent between May and November, peaking in September. Geographically, cases were reported in 27 PLADs, the five most affected were Hunan, Guizhou, Yunnan, Sichuan, and Shandong. Deaths occurred in 6 PLADs, led by Guizhou (7 deaths) and Yunnan (2 deaths). Altogether, 138 poisonous mushroom species linked to six distinct clinical syndromes were identified, of which 34 were newly documented in poisoning incidents. The four most lethal species were Galerina sulciceps, Amanita exitialis, Russula subnigricans, and A. abrupta, responsible for 3, 3, 2, and 2 deaths, respectively. Chlorophyllum molybdites caused the most incidents (269, affecting 540 patients, with one death). Notably, Paxillus ammoniavirescens, a species known to cause hemolysis, was identified in a poisoning incident for the first time.

Conclusions: Mushroom poisoning remains a major food safety threat in China. Although summer and autumn are the peak seasons, fatal cases can occur at any time of year, and northern China has shown a marked upward trend. Moreover, a growing number of poisonous mushrooms — including several potentially new species — have been identified in poisoning incidents. This persistent burden calls for sustained public education, robust market supervision, and stronger interdisciplinary collaboration to reduce its incidence.

Mushroom poisoning remains a significant food safety concern in China. Over the past decade, the country has built a robust system for the prevention and control of mushroom poisoning that integrates government agencies, clinicians, China CDC experts, and mycologists, and the system has continued to draw in additional professionals (1–6). Within this framework, CDC personnel and hospital staff collect mushroom specimens, photographs, and biological samples — such as blood and urine — immediately after an incident occurs. The specimens and images are then sent to mycologists for species identification (using both morphological and molecular methods), while the mushroom and biological samples are delivered to CDC experts and hospital specialists for toxin analysis (e.g., LC-MS/MS detection of 12 mushroom toxins). Drawing on the species identification, toxicological findings, and clinical symptoms, patients receive accurate diagnoses and timely treatment (1–6). In 2025, China CDC continued to investigate mushroom poisoning incidents and systematically collected key information — including the time and location of each incident, the number of people poisoned, the death toll, and the species involved, all of which were re-confirmed by local CDC staff or physicians — and analyzed it in depth. That year, China CDC investigated 828 mushroom poisoning incidents across 27 PLADs, affecting 2,165 individuals and resulting in 13 deaths — a case fatality rate of 0.6%. Investigators identified 138 poisonous mushroom species from 1,629 specimens, including 34 newly documented species, associated with 6 distinct clinical syndromes. By the end of 2025, this brought the cumulative number of mushroom species linked to poisoning incidents in China to 280, accounting for over 40% of the country's known poisonous mushrooms (660 species as of the end of 2024).

In 2025, the number of cases per incident ranged from 1 to 15, with a median of 2, and 9 incidents involved more than 10 patients. Notably, 69 patients from 20 incidents had eaten poisonous mushrooms purchased from markets: 4 incidents were linked to wild mushrooms bought online, 2 to informal street vendors, 1 to a traditional Chinese medicine shop, and 13 to various wild-mushroom or vegetable markets. A further 38 patients from 13 incidents (8 of which involved purchased wild mushrooms) were poisoned after eating dried mushrooms, and 543 patients from 175 incidents after eating mixed mushrooms. In addition, 12 patients from 8 incidents fell ill after eating uncooked wild mushrooms (Supplementary Table S1, available at https://weekly.chinacdc.cn/).

Temporal analysis showed that incidents occurred throughout the year but were most frequent between May and November (802 incidents, 2,082 patients, and 12 deaths), peaking in September (169 incidents, 385 patients, and 2 deaths). That September, poisonings were reported in 18 PLADs nationwide, with Chlorophyllum molybdites alone responsible for 93 incidents — 55% of the month's total. The year's first death occurred on March 8 in Guangdong and was caused by Amanita exitialis. Mortality was highest in November (6 deaths), mainly from Galerina sulciceps (3 deaths), A. abrupta (2 deaths), and A. subpallidorosea (1 death), followed by May and September with 2 deaths each (Figures 1–2).

Figure 1.

Monthly distribution of mushroom poisonings in China, 2025.

Figure 2.

Heatmap of the number of mushroom poisoning incidents in China, 2025.

Note: dried means cases affecting consumption of dried mushrooms.

Geographically, incidents were reported across 27 PLADs, 15 of which recorded more than 10 incidents. The five most affected were Hunan, Guizhou, Yunnan, Sichuan, and Shandong (Table 1, Figure 2). Fatalities occurred in 6 PLADs: Guizhou (7 deaths), Yunnan (2 deaths), and Guangxi, Hubei, Anhui, and Guangdong (1 death each) (Table 1). Southwest China (Guizhou, Yunnan, Sichuan, Chongqing, and Xizang) was hit hardest, with 362 incidents, 1,099 patients, and 9 deaths. It was followed by Central China (Hunan, Hubei, Henan, and Jiangxi) with 205 incidents, 388 patients, and 1 death; East China (Anhui, Jiangsu, Zhejiang, and Fujian) with 96 incidents, 226 patients, and 1 death; and Northern China (Shandong, Hebei, Shanxi, Inner Mongolia, Beijing, and Tianjin) with 80 incidents and 198 patients but no deaths. Southern China (Guangxi, Guangdong, and Hainan) reported 66 incidents, 203 patients, and 2 deaths; Northwestern China (Shaanxi, Ningxia, Qinghai, and Gansu) reported 18 incidents and 49 patients with no deaths; and Northeastern China (Liaoning) recorded a single incident involving 2 patients and no fatalities. Detailed statistics for each PLAD are provided in Table 1 and Figure 2.

Table 1. Geographical distribution of mushroom poisoning incidents in China, 2025.

PLADs	Number of incidents	Number of patients	Deaths	Case fatality (%)
Abbreviation: PLAD=provincial-level administrative division.
Hunan	156	278	0	0
Guizhou	136	513	7	1.36
Yunnan	109	261	2	0.77
Sichuan	80	247	0	0
Shandong	51	119	0	0
Guangxi	44	140	1	0.71
Chongqing	36	77	0	0
Hubei	33	72	1	1.39
Anhui	32	89	1	1.12
Jiangsu	27	63	0	0
Zhejiang	20	37	0	0
Fujian	17	37	0	0
Guangdong	17	29	1	3.45
Henan	15	35	0	0
Hebei	11	27	0	0
Shanxi	9	23	0	0
Shaanxi	8	25	0	0
Ningxia	8	19	0	0
Hainan	5	34	0	0
Inner Mongolia	4	20	0	0
Beijing	3	4	0	0
Tianjin	2	5	0	0
Jiangxi	1	3	0	0
Qinghai	1	3	0	0
Gansu	1	2	0	0
Liaoning	1	2	0	0
Xizang	1	1	0	0
Total	828	2,165	13	0.60

In 2025, the 138 poisonous mushroom species identified in poisoning cases were associated with 6 distinct clinical syndromes. Of these, 19 species (Amanita abrupta, Paxillus ammoniavirescens, Atheniella flavoalba complex, Chlorophyllum palaeotropicum, Collybiopsis yunnanensis, Entoloma cf. subsaundersii, Gerronema nemorale, Gymnopus dryophiloides, Lactarius cf. alpinihirtipes, L. citrinus, Lepista cf. subisabellina, Russula rufobasis nom. prov., R. straminella, Scleroderma australe, S. lunare, Gymnopilus igniculus, Inocybe involuta, I. cf. insinuata, and I. cf. soluta) were newly documented as poisonous mushrooms in China (1–7) (Supplementary Table S1).

The four most lethal mushrooms were Galerina sulciceps, Amanita exitialis, Russula subnigricans, and A. abrupta, causing 3, 3, 2, and 2 deaths, respectively (Supplementary Table S1). Chlorophyllum molybdites caused the most poisoning incidents (269 incidents affecting 540 patients, with 1 death), either alone or together with other species. It also showed the widest geographical range (16 PLADs) and the longest period of activity (from late April to mid-November). Its high incidence can be attributed to its resemblance in appearance and taste to certain edible mushrooms and to its growth in areas close to people — vegetable fields, roadside grasslands, and parks — which makes it easy to forage and eat.

In 2025, 10 amatoxin-producing species from the genera Amanita, Galerina, and Lepiota were identified as causes of acute liver failure in China (Supplementary Table S1). The most lethal were Amanita exitialis and Galerina sulciceps, each responsible for three deaths, while Amanita fuligineoides and A. subpallidorosea each caused one. The three species involved in the most incidents were Lepiota brunneoincarnata (24 incidents, 56 patients), Galerina sulciceps (16 incidents, 44 patients, 3 deaths), and Amanita subjunquillea (10 incidents, 33 patients).

Seven species — Amanita abrupta, A. gymnopus, A. kotohiraensis, A. neoovoidea, A. oberwinkleriana, A. pseudoporphyria, and A. virginioides — were identified as causes of acute kidney injury in 2025 (Supplementary Table S1). A. oberwinkleriana was the most common, appearing in 6 incidents involving 13 patients, either alone or with other species. Amanita abrupta caused 2 deaths in Guizhou on November 1.

Russula subnigricans caused 12 incidents of rhabdomyolysis, affecting 35 patients and resulting in 2 deaths, either alone or together with other mushrooms. Paxillus ammoniavirescens caused hemolysis in 1 patient in Inner Mongolia on October 7 (Supplementary Table S1). Both rhabdomyolysis and hemolysis have an incubation period of less than 6 hours, after which gastrointestinal symptoms appear — signs that are easily mistaken for gastroenteritis-type mushroom poisoning.

In 2025, 78 mushroom species were identified as causes of gastroenteritis in China (Supplementary Table S1), of which 22 were newly recorded in poisoning incidents (1–7). The three most frequently encountered were Chlorophyllum molybdites (269 incidents, 540 patients, 1 death), Russula aff. japonica (41 incidents, 100 patients), and Entoloma omiense (34 incidents, 90 patients).

In 2025, 41 mushroom species associated with psycho-neurological disorders were documented in China (Supplementary Table S1), of which 10 were newly identified in poisoning incidents (1–7). The three most frequently involved were Gymnopilus dilepis (13 incidents, 31 patients), Pseudosperma triaciculare (7 incidents, 16 patients), and Amanita subglobosa (7 incidents, 15 patients).

Overall, mushroom poisoning incidents rose markedly in 2025. Summer and autumn remained the peak seasons for poisonings, whereas winter saw a notable peak in fatalities. Southern regions continued to bear the heaviest burden, but northern regions showed a marked upward trend. A growing number of poisonous mushrooms have been identified in poisoning incidents, including several potentially new poisonous species.

DISCUSSION

In 2025, the numbers of mushroom poisoning incidents and affected patients reached a seven-year high, whereas the number of fatalities was the lowest over that period (1–6). This paradox of more incidents but fewer deaths can be attributed to greater public awareness, faster medical intervention, and more effective treatment. Of the 138 poisonous mushrooms identified from poisoning incidents in 2025, 104 had been documented previously (1–6), bringing the cumulative number of species implicated in poisoning incidents in China to approximately 280 by the end of 2025. The year's most lethal species were Galerina sulciceps and Amanita exitialis, each responsible for three deaths. Acute liver failure was the deadliest clinical presentation, accounting for eight deaths, followed by rhabdomyolysis and acute renal failure with two each. Notably, one death was attributed to Chlorophyllum molybdites, a species that typically causes only gastroenteritis. Many specimens could not be identified to species level and were therefore labeled as "sp.," largely because the taxonomy of many mushroom groups remains poorly understood and numerous species await discovery; in other cases, identification was limited to a preliminary level because specimens were unavailable or in poor condition. Consistent with the trends of the past six years, most poisoning incidents continued to be caused by mushrooms that induce gastroenteritis and psycho-neurological disorders.

Analysis of temporal patterns showed that the 2025 poisoning season extended from May to November. This duration matched 2021 and 2022 but was longer than in 2019–2020 and 2023–2024 (1–6). Surprisingly, and unlike the summer or autumn peaks seen in 2019–2024, poisonings in 2025 peaked in September, while fatalities peaked in November (1–6). Geographically, a rapid rise in incidents pushed Shandong to fifth place in 2025. These shifts in the timing and regional pattern of poisonings may be partly attributable to climate change: in 2025, China's climate showed pronounced warming and wetting, breaking multiple records and triggering frequent extreme-weather events.

In 2025, Amanita exitialis, a cause of acute liver failure, was recorded for the first time in Zunyi, northern Guizhou, after an incident involving five patients on June 12. This finding contrasts with previous studies, which had reported the species only in the Qianxinan Buyi and Miao Autonomous Prefecture(1–6). In addition, A. molliuscula caused three poisonings — in Hubei, Shaanxi, and Yunnan — extending its known range to include Yunnan in Southwest China (6). These marked geographical expansions of A. exitialis and A. molliuscula may reflect both genuine range expansion (e.g., climate-driven) and improved surveillance and identification.

In 2025, seven Amanita species were identified as causes of acute kidney injury, an increase over 2019–2024 (1–6). Notably, Amanita abrupta was associated with two deaths in Guizhou — the first time the species had been recorded as a cause of death in China. As in previous studies (1–6), A. oberwinkleriana and A. pseudoporphyria remained the two species most often implicated in acute kidney injury. This upward trend underscores the need to strengthen public education about mushrooms that cause acute kidney injury in order to prevent and reduce poisoning incidents. It is also important to recognize that symptoms vary by species: A. pseudoporphyria, for example, can cause acute kidney failure and, in some cases, myocardial injury, while animal experiments have shown that A. abrupta can cause some degree of liver damage (8). Meanwhile, Russula subnigricans caused 12 incidents of rhabdomyolysis — comparable to 2020 but lower than in 2019 and 2021–2024 (1–6). In addition, Paxillus ammoniavirescens was documented for the first time as a cause of hemolysis in poisoning incidents (2–4,6). In the future, hemolytic poisoning should be carefully distinguished from gastroenteritis and rhabdomyolysis to avoid misdiagnosis.

In 2025, the number of mushroom species identified as causes of gastroenteritis reached 78, including 21 newly recorded species — more than the annual total in each of the previous six years (1–6). Chlorophyllum molybdites remained the most common, accounting for 32.49% of all poisoning incidents, and its range expanded to Hebei and Shaanxi in northern and northwestern China. Over the same period, 41 species linked to psycho-neurological disorders were documented, also an increase over 2019–2024 (1–6).

Eating raw wild mushrooms is extremely risky. In 2025, four patients from three separate incidents developed gastroenteritis after eating the raw fruiting bodies of the Atheniella flavoalba complex, Collybiopsis yunnanensis, and Gerronema nemorale, whose edibility had not previously been established. These cases reinforce a critical public health message: people should never taste wild mushrooms, even species they believe to be familiar.

This study is based solely on incidents investigated through our collaborative system of CDC staff, clinicians, and mycologists. Several limitations — including underreporting of mild gastroenteritis cases, difficulty identifying species from mixed-mushroom meals, and possible data-collection biases across PLADs — also pose major challenges for the prevention and control of mushroom poisoning. Moreover, in many cases no specimens or photographs were available, so the causative species could not be definitively identified, which limited the scope for targeted treatment. This highlights the need for better field documentation in future poisoning incidents.

To reduce the burden of mushroom poisoning, we call for closer collaboration among CDC staff, clinicians, and mycologists. Priorities include jointly developing varied, accessible educational materials on poisonous mushrooms and mounting broad public-awareness campaigns to promote mushroom safety.

Funding Statement

Supported by Ministry of Science and Technology of the People's Republic of China National Natural Science Foundation of China (32270021, 32570009)

Conflicts of interest

No conflicts of interest.