Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022
Background: Three aconitine poisoning events occurred in two Canadian provinces in 2022: one in British Columbia (BC) and two in Ontario (ON). Aconitine is a potent alkaloid found in several species of the plant <i>Aconitum</i>, containing cardiotoxins and neurotoxins. It is used in trad...
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MDPI AG
2025-03-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/17/3/125 |
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| author | Lorraine McIntyre Stefanie Georgopoulos Dorianna Simone Emily Newhouse JoAnne Fernandes David A. McVea Arnold Fok Ania-Maria McIntyre Bryn Shurmer Marie-Claude Gagnon Michael Chan Marina Chiaravalloti Nikita Saha Turna Debra Kent Dennis Leong Katherine Paphitis Christina Lee the Outbreak Investigation Teams |
| author_facet | Lorraine McIntyre Stefanie Georgopoulos Dorianna Simone Emily Newhouse JoAnne Fernandes David A. McVea Arnold Fok Ania-Maria McIntyre Bryn Shurmer Marie-Claude Gagnon Michael Chan Marina Chiaravalloti Nikita Saha Turna Debra Kent Dennis Leong Katherine Paphitis Christina Lee the Outbreak Investigation Teams |
| author_sort | Lorraine McIntyre |
| collection | DOAJ |
| description | Background: Three aconitine poisoning events occurred in two Canadian provinces in 2022: one in British Columbia (BC) and two in Ontario (ON). Aconitine is a potent alkaloid found in several species of the plant <i>Aconitum</i>, containing cardiotoxins and neurotoxins. It is used in traditional Chinese medicine (TCM) for pain management, and in powdered form, <i>Aconitum</i> is similar in appearance to sand ginger (<i>Kaempferia galanga</i>), which can lead to poisonings from misidentification and mislabeling. Methods: Aconitine poisoning is rare in Canada; here, we compare communications, collaborations, laboratory testing options and actions during investigations. Results: Fourteen cases occurred from the consumption of sand ginger: in BC (<i>n</i> = 2), purchased at an Asian health food store; in ON (<i>n</i> = 11), <i>Kaempferia galanga</i> powder (KGP) spices were used to prepare meals at a restaurant, and in one ON case, KGP was purchased. Traceback found product imported from China contained aconitine levels ranging from 1304 to 5500 ppm. Later investigations revealed mislabeling of <i>Aconitum</i> as KGP from the same imported lot (January 2020). Plant DNA testing found no KGP in any spice packets, including lots not linked to illness, suggestive of adulteration. Conclusion: Method development for aconitine in BC led to an improved response time for testing in ON. BC and ON updated outbreak response protocols and communications. |
| format | Article |
| id | doaj-art-43e61a29d59e407e9f37f95cdfa8aebe |
| institution | DOAJ |
| issn | 2072-6651 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj-art-43e61a29d59e407e9f37f95cdfa8aebe2025-08-20T02:43:09ZengMDPI AGToxins2072-66512025-03-0117312510.3390/toxins17030125Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022Lorraine McIntyre0Stefanie Georgopoulos1Dorianna Simone2Emily Newhouse3JoAnne Fernandes4David A. McVea5Arnold Fok6Ania-Maria McIntyre7Bryn Shurmer8Marie-Claude Gagnon9Michael Chan10Marina Chiaravalloti11Nikita Saha Turna12Debra Kent13Dennis Leong14Katherine Paphitis15Christina Lee16the Outbreak Investigation TeamsEnvironmental Health Services, BC Centre for Disease Control, Vancouver, BC V5Z 4R4, CanadaOffice of the Chief Medical Officer of Health, Ontario Ministry of Health, Toronto, ON M5G 2C8, CanadaRegional Municipality of York, Public Health, Newmarket, ON L3Y 2R2, CanadaFraser Health Authority, Surrey, BC V3T 5X3, CanadaRegional Municipality of York, Public Health, Newmarket, ON L3Y 2R2, CanadaEnvironmental Health Services, BC Centre for Disease Control, Vancouver, BC V5Z 4R4, CanadaFraser Health Authority, Surrey, BC V3T 5X3, CanadaOffice of Food Safety and Recall, Canadian Food Inspection Agency, Ottawa, ON K1A 0Y9, CanadaSaskatoon Toxin Laboratory, Canadian Food Inspection Agency, Saskatoon, SK S7N 2R3, CanadaGenotyping/Botany Laboratory, Canadian Food Inspection Agency, Ottawa, ON K2J 4S1, CanadaNatural Health and Food Products Research Group, British Columbia Institute of Technology, Burnaby, BC V5G 3H2, CanadaCentre of Forensic Sciences, Ministry of the Solicitor General, Toronto, ON M3M 0B1, CanadaEnvironmental Health Services, BC Centre for Disease Control, Vancouver, BC V5Z 4R4, CanadaBC Drug and Poison Information Centre, Vancouver, BC V5Z 4R4, CanadaBC Drug and Poison Information Centre, Vancouver, BC V5Z 4R4, CanadaPublic Health Ontario, Toronto, ON M5G 1M1, CanadaPublic Health Ontario, Toronto, ON M5G 1M1, CanadaBackground: Three aconitine poisoning events occurred in two Canadian provinces in 2022: one in British Columbia (BC) and two in Ontario (ON). Aconitine is a potent alkaloid found in several species of the plant <i>Aconitum</i>, containing cardiotoxins and neurotoxins. It is used in traditional Chinese medicine (TCM) for pain management, and in powdered form, <i>Aconitum</i> is similar in appearance to sand ginger (<i>Kaempferia galanga</i>), which can lead to poisonings from misidentification and mislabeling. Methods: Aconitine poisoning is rare in Canada; here, we compare communications, collaborations, laboratory testing options and actions during investigations. Results: Fourteen cases occurred from the consumption of sand ginger: in BC (<i>n</i> = 2), purchased at an Asian health food store; in ON (<i>n</i> = 11), <i>Kaempferia galanga</i> powder (KGP) spices were used to prepare meals at a restaurant, and in one ON case, KGP was purchased. Traceback found product imported from China contained aconitine levels ranging from 1304 to 5500 ppm. Later investigations revealed mislabeling of <i>Aconitum</i> as KGP from the same imported lot (January 2020). Plant DNA testing found no KGP in any spice packets, including lots not linked to illness, suggestive of adulteration. Conclusion: Method development for aconitine in BC led to an improved response time for testing in ON. BC and ON updated outbreak response protocols and communications.https://www.mdpi.com/2072-6651/17/3/125aconitinepoisoningmonkshoodoutbreaktoxinmislabeling |
| spellingShingle | Lorraine McIntyre Stefanie Georgopoulos Dorianna Simone Emily Newhouse JoAnne Fernandes David A. McVea Arnold Fok Ania-Maria McIntyre Bryn Shurmer Marie-Claude Gagnon Michael Chan Marina Chiaravalloti Nikita Saha Turna Debra Kent Dennis Leong Katherine Paphitis Christina Lee the Outbreak Investigation Teams Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022 Toxins aconitine poisoning monkshood outbreak toxin mislabeling |
| title | Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022 |
| title_full | Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022 |
| title_fullStr | Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022 |
| title_full_unstemmed | Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022 |
| title_short | Learnings from Separate <i>Aconitum</i> Poisonings in British Columbia and Ontario, Canada in 2022 |
| title_sort | learnings from separate i aconitum i poisonings in british columbia and ontario canada in 2022 |
| topic | aconitine poisoning monkshood outbreak toxin mislabeling |
| url | https://www.mdpi.com/2072-6651/17/3/125 |
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