​Key Messages

• As an update to the December 2025 Health Advisory describing the emergence of an outbreak of severe, potentially fatal liver damage associated with accidental consumption of Death Cap mushrooms, CDPH and the California Poison Control System (CPCS) are alerting health care providers of an increase in mushroom poisoning cases identified in the Northern California and Central Coast regions.
• As of January 6, 2026, 35 cases have been reported to CPCS, with severe illnesses resulting in three deaths and at least three liver transplants so far (Figure 1). This greatly exceeds the typical report of less than 5 cases of mushroom poisonings a year. 17 hospitals across 9 counties have provided treatment to patients with poisoning symptoms (Figure 2). Death Cap mushrooms have reportedly been collected in a wide variety of locations including city, county, and national park areas across the Northern California and Central Coast regions beyond the initial clusters identified in the Monterey and San Francisco Bay areas.
  
• Health care providers should consider mushroom poisoning as a differential diagnosis in patients presenting with recent or active gastrointestinal symptoms or elevation of liver enzymes. Ask patients about possible consumption of Death Cap mushrooms or unknown foraged wild mushrooms, which warrants careful evaluation for amatoxin poisoning and consideration for hospital admission. Contact California Poison Control System at 1-800-222-1222 for guidance on diagnosing and treating patients with suspected mushroom poisoning and to report cases.
• CDPH and CPCS have developed materials in multiple languages to support outreach and education on Death Cap mushrooms.​ 
  

​Background

Death Cap mushrooms are currently widespread in parts of Northern California and the Central Coast (adjacent to many types of trees, especially oaks and pines), and CDPH is urging individuals to avoid picking and eating wild mushrooms while risk of potentially deadly amatoxin poisoning is high. Death Cap mushrooms can be mistaken for varieties that are safe to consume. Death Cap mushroom toxins are not removed by boiling, cooking or drying the mushrooms before consumption. 

Amatoxin poisoning from accidental consumption of toxic Death Cap mushrooms in this ongoing outbreak has led to unprecedented numbers of serious illnesses and deaths, with three adult fatalities and three liver transplants to date. Whereas in a typical year fewer than 5 cases are reported (Albertson et al., 2023), between November 18, 2025, and January 6, 2026 California Poison Control System (CPCS) identified 35 cases in a stretch of Northern California and the Central Coast ranging from Sonoma to San Luis Obispo (Figures 1 and 2 below). Though most clusters have been reported in the Monterey and San Francisco Bay Areas, there is risk statewide.  Medical treatment for patients with amatoxin poisoning has been provided in the following counties: Alameda, Contra Costa, Monterey, San Francisco, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz, and Sonoma counties (Figure 2 below, Table 1 below).

The 35 known amatoxin poisoning cases range in age from 19 months to 67 years, with both linked cases (family groups) and individual cases. Affected individuals are known to speak Spanish, Mixteco, Mandarin Chinese, and English, highlighting the need for multilingual outreach. While incomplete,  some cases have reported locations where Death Cap mushrooms were foraged, including the following: Alameda County (Berkeley – unspecified park; Oakland Hills area), Marin County (Novato – unspecified nature preserve), Monterey County (Pinnacles National Park; Toro Park), San Benito County (Pinnacles National Park), San Mateo County (Millbrae area), Sonoma County (not further specified). This information is being shared to encourage local jurisdictions to consider whether additional measures, such as warnings in parks or at trailheads, may be warranted.

CDPH is continuing to coordinate with CPCS and public health partners on case investigation and tracking as well as outreach and education. In response to the ongoing outbreak of severe illnesses associated with the consumption of death cap mushrooms, including two additional deaths in the week of December 29, 2025, CDPH has developed three public service announcements (PSAs)—one in En​glish, one in Spa​nish, and one in Mi​​xteco (with assistance from the County of San Luis Obispo Health Agency). These PSAs warn the public about the risks of mushroom hunting during this high-risk season with abundant Death Cap mushrooms. In addition, CDPH has developed webpages in English and Spanish on poisonous mushrooms. The webpages now include updated information on the current case count for the outbreak.  CDPH also has a PDF in Chinese with the current content from the live webpages.

Recommendations

Medical Professionals

• Any patient who presents with recent or active gastrointestinal symptoms or elevation of liver enzymes should be asked about possible consumption of Death Cap mushrooms or unknown foraged wild mushrooms. Such consumption warrants careful evaluation for amatoxin poisoning and consideration for hospital admission.
• Continue to follow guidance in the December 5, 2025, health advisory for treatment of potential amatoxin poisoning cases. Obtain early consultation with a medical toxicologist with expertise in managing patients with mushroom poisoning. Contact CPCS (1-800-222-1222) to report cases of illness after consumption of amatoxin-containing mushrooms and/or for advice on medical management of these patients.
• Remind patients to avoid mushroom hunting/foraging while risk of amatoxin poisoning is high.​
  

• Continue to evaluate the risk level in your area – it may change over time, especially with rain events. Regional and local mycological societies may be useful resources. 
• ​Visit  https://bayar​eamushrooms.org/california_clubs.html and https://na​myco.org/clubs/ for directories of such organizations.
• Continue to advise residents to avoid picking and eating wild mushrooms while risk of amatoxin poisoning is high. Share educational materials on Death Cap mushrooms with communities.
• Continue to work with local partners to identify and report cases and minimize exposure. Consider coordination with local healthcare systems, and community groups who have a cultural tradition of foraging food from their environments, outreach to foraging groups, coordination with veterinarians and animal health services, as well as coordination with parks departments to post advisories in public spaces where these mushrooms may be found.​
  

Californians

• Avoid picking and eating wild mushrooms or eating food prepared with wild mushrooms while risk of amatoxin poisoning is high.
• Buy mushrooms from trusted grocery stores and retailers. Take care when buying mushrooms from street vendors.
• Keep pets away from wild mushrooms – animals can be poisoned too. There have been several reports of dog deaths related to amatoxin poisoning during this outbreak.
• Seek help immediately, if you or someone you know has eaten a poisonous mushroom. Do not wait for symptoms to appear. Treatment is more difficult once symptoms start.      ​
  

Figure 1: Case count over ongoing Death Cap mushroom poisoning outbreak 

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Figure 2: Map indicating counties where hospitals have provided treatment in the ongoing outbreak 

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Figure 3: Outreach Material Examples

 

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Resources

CDPH has developed materials in multiple languages to support Death Cap mushroom education and outreach efforts, including:

• English PSA (YouT​ube)
• Spanish PSA (YouTube)
  
• Mixteco PSA (YouT​ube)
• English CDPH Poisonous Wild Mushrooms webpage (go.cdph.ca.gov/PoisonMushrooms)
• Spanish CDPH Poisonous Wild Mushrooms webpage (go.cdph.ca.gov/HongosVenenosos)
• Chinese CDPH Poisonous Wild Mushrooms (PDF)
  

CPCS has developed materials in multiple languages to support Death Cap mushroom education and outreach efforts:

• “Wild Mushrooms: Think Before You Pick" Flow Page has materials in English, Spanish, Mixteco, Chinese, Tagalog, and Vietnamese: https://flow.page/poiso​​nousmushroomsafety ​
  

References

Albertson, T.E., Clark, R.F., Smollin, C.G., Vohra, R., Lewis, J.C., Chenoweth, J.A. and Stocking, J.C., 2023. A ten-year retrospective California Poison Control System experience with possible amatoxin mushroom calls. Clinical Toxicology, 61(11), pp.974-981.

Peredy, T.R. Amatoxin-containing mushroom poisoning (eg, Amanita phalloides): Clinical manifestations, diagnosis, and treatment. In: UpToDate. Last updated March 25, 2024. https://www.uptodate.co​​m/contents/amatoxin-containing-mushroom-poisoning-eg-amanita-phalloides-clinical-manifestations-diagnosis-and-treatment 

Horowitz, B.Z. et al. Mushroom Toxicity. In: Medscape: Tools & Reference: Emergency Medicine. Last updated November 11, 2025. https://emedicine.medscape.com/ar​ticle​/1008902-overview

Amanita phalloides Mushroom Poisonings — Northern California, December 2016. Vo, K.T. MMWR Morb Mortal Wkly Rep 2017; 66:549-553. 

Monterey County. 2025. Health Advisory: Severe Hepatotoxicity Following Consumption of Wild Mushrooms. December 1, 2025. https://www.countyofmonterey.gov/Home/Componen​ts/New​s/News/11687/

CDPH. 2025. Health Advisory: Severe, Potentially Fatal Liver Damage in Children and Adults Associated with Consumption of Foraged Wild Mushrooms. December 5, 2025. https://www.cdph.ca.gov/Programs/O​PA/Pages/CAHAN/Foraged-Wild-Mushrooms.aspx

CDPH. 2016. Use Caution When Collecting, Eating Wild Mushrooms. Press Release. Last updated March 22, 2017. https://www.cdph.ca.gov/Programs/OPA/Pages/NR16-077.aspx  ​

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