It looked like the mushroom he knew from Burma

In October 2018, a middle-aged Karen man from Burma arrived at a Minnesota
emergency department with **altered mental status, vomiting, diarrhoea,
incontinence, sweating, swelling of the lip and tongue, and excessive
salivation** — beginning two to three hours after eating mushrooms at home.

He needed endotracheal intubation and mechanical ventilation for four days
because of acute respiratory failure, and was discharged after eight days.
His daughter, who ate the same mushrooms but substantially fewer, had mild
sweating and nausea and was kept overnight for observation.

Why he picked them

He had arrived in Minnesota in 2015, and **this was the first time he had
picked mushrooms since.** He chose these ones because:

**They resembled the Ochre mushroom (Amanita hemibapha var. ochracea)
from his native Burma.**

He picked them near his workplace and cooked them in turmeric, oil and water.
A site visit found one remaining mushroom matching his description —
Amanita muscaria.

There is no carelessness in that story. He applied knowledge that was correct
where he learned it, to a genus whose members look alike across continents and
do not behave alike.

What the mushroom does

A. muscaria contains ibotenic acid and muscimol, structurally
similar to glutamate and GABA respectively — which is why the effects
pull in two directions at once:

Plus gastrointestinal symptoms.

The internet is not help here

**An Internet search revealed multiple recipes by avid foragers for
A. muscaria reported as safe for consumption; however, A. muscaria
toxins might not be deactivated by cooking.**

Someone checking whether their find is edible will find enthusiasts saying it
is, with a preparation method, and the preparation may not do what they
believe it does.

It had happened before, to a different community

In 2006, two Hmong families in Minnesota ate Amanita bisporigera, which
produces amatoxin — gastrointestinal distress, liver failure, high
mortality. Nine people affected, one death. Outreach then focused on Hmong
residents, including new arrivals.

Twelve years later the same shape recurred with a different community and a
different species. The health department **reached out to the Karen
Organization of Minnesota**, looked for further cases, and started community
messaging. No additional cases were found.

**Newly arrived people might benefit from education about the dangers of
consuming wild mushrooms** — because some local toxic mushrooms resemble
edible ones from South-East Asia, and the resemblance is the whole problem.

Source: Centers for Disease Control and Prevention, MMWR.