Figure 1.
Distribution of 395 sudden unexplained deaths (SUD) in intervention area, 1975–2009, Yunnan Province, China.
Deaths increase gradually by year to reach an average of 21 per year from 1990 to 2005. Following warnings in 2006 to villagers about eating unfamiliar mushrooms deaths decrease abruptly. A specific warning about Trogia venenata in 2008 is followed by a sustained decrease to near zero.
Table 1.
Clustered and single sudden unexplained deaths (SUDs) by Trogia venenata exposure from SUD surveillance in 22 counties, 2006–2009, Yunnan Province, China.
Figure 2.
Trogia venenata from Tengchong County, Yunnan Province, China.
Growing in characteristic natural environment at 2120 m, 102 42 E longitude; 25 04.007 N latitude. Scale of measurement in centimeters (Height = 5cm–10cm, width = 3cm–7cm).
Figure 3.
Sudden unexplained deaths (SUDs) by village and presence of Trogia venenata, 2006–2009, Yunnan Province, China.
SUD clusters with the presence of T. venenata occur throughout the intervention area with the exception of the far eastern section. All affected villages are in mountainous terrain from 1800 to 2800 meters. One village outside the south central boundary of the area we also found T. venenata and clusters and single SUDs in different years.
Table 2.
Symptoms among 13 SUD and 10 mild cases associated* with Trogia venenata during 2006–2009, Yunnan, China.
Figure 4.
Heart muscle section from the right ventricle from a sudden unexplained death case.
Heart muscle section from the right ventricle from a SUD case, 100x, hematoxylin-eosin, showing focal lymphocytic infiltrates and dissolution and breaking of muscle fibers.
Table 3.
Selected clinical chemistry determinations from serum of persons with mild cases and other villagers (controls) 6 villages with clusters of sudden unexplained death, 2006–2009, Yunnan Province, China.