environmental health investigations branch

Banner

Investigation Spotlight: Acute Illnesses Linked to Diamond Shruumz Microdosing Products

Problem

In June 2024, CDPH was notified by U.S. Centers for Disease Control and Prevention (CDC) about a nationwide outbreak of acute illnesses and hospitalizations linked to Diamond Shruumz microdosing products. Illnesses included seizures, loss of consciousness, abnormal heart rate, nausea, vomiting and more. There were also deaths that were potentially associated with the products.

The Diamond Shruumz products included chocolate bars, gummies, and cones that were advertised as containing a proprietary mushroom blend. The marketing of the products aimed to appeal to youth and young adults. The U.S. Food and Drug Administration (FDA) tested product samples and discovered harmful chemical compounds, some of which were not on the ingredients lists. In June 2024, the manufacturer, Prophet Premium Blends, initiated a recall of all Diamond Shruumz products.

As of October 2024, the CDC confirmed 180 total cases of illnesses in 34 U.S. states, including 73 hospitalizations and 3 potentially associated deaths.

Investigation

Shortly after the CDC’s advisory in June 2024, CDPH began investigating potential cases of illnesses in California associated with the Diamond Shruumz outbreak. The Toxicological Outbreak Program, within CDPH’s Environmental Health Investigations Branch, led the case investigation. As of October 2024, CDPH confirmed a total of three cases of illnesses in the California linked to eating Diamond Shruumz chocolate bars. Each involved emergency department treatment.

During its investigation, the Toxicological Outbreak Program:

Coordinated with California Poison Control System (CPCS) to identify potential cases in California. Our team worked with CPCS to integrate a case-finding survey into their workflow. All known cases in California were found via CPCS.
Gathered information on potential cases in California, including patient demographics, symptoms and outcomes, type and amount of product consumed, and location where product was purchased.
Worked closely with CDHP’s Food and Drug Branch (FDB), which was responsible for regulatory actions related to the product and the manufacturer. FDB notified California retailers about the recall and the need to remove the product from store shelves.
Reported illnesses associated with the outbreak to the CDC. This helped to support the federal investigation of the outbreak in order to prevent further illnesses and hospitalizations.

Communications

The Toxicological Outbreak Program also alerted the public, medical providers, and public health professionals about the Diamond Shruumz outbreak. Specifically, our team:

Issued a press release in coordination with CDPH’s Food and Drug Branch.
Posted a social media alert.
Disseminated an advisory via the California Health Alert Network (CAHAN) to county public health officers and health departments, hospitals across the state, and all licensed physicians in California.

Implications

The Diamond Shruumz outbreak in California was limited to three known cases of illnesses. It is possible there were additional unknown or unreported cases, as well as individuals who may have had mild symptoms. Our team continues to seek effective strategies to reach medical providers so that they are aware of toxicological outbreaks and notify us when they encounter a potential case.

There is growing concern about the risks associated with taking microdose products. Consumers cannot be certain what these products contain and where or how they were made. The products may contain toxic ingredients that are not listed on the packaging or include ingredients in high enough amounts that they become toxic. Additionally, it is possible for ingredients to interact with each other in ways that become toxic.