Health officials are racing to trace the supply of a spice product suspected of poisoning a dozen diners at a Toronto-area restaurant, fearing it may be elsewhere in Canada.
At least 12 people have become seriously ill, four of whom required intensive care, after eating at Delight Restaurant & BBQ in Markham, Ont., over the weekend. Five remained in hospital on Tuesday, and York Region Public Health said they are all expected to make a full recovery.
Officials believe all 12 consumed the toxin from a aconite plant, popular in traditional Chinese medicine, in a chicken dish at the restaurant.
Aconite toxin affects the nerves that control the muscles of the body, causing numbness in the face and extremities, severe gastrointestinal distress, and in some cases, irregular heartbeat. Ingested in sufficient quantity, aconite can induce a fatal arrhythmia of the heart.
Dr. Barry Pakes, York Region’s medical officer of health, told CBC News on Tuesday that officials believe the restaurant used an “accidentally contaminated” spice product, and that provincial and federal agencies are trying to determine if it had been distributed elsewhere in Canada.
“It looks like it’s a fairly small batch type situation, or a fairly niche distributor or product,” he said.
“The main focus of our work is to figure out where it might have gone and to make sure we get all of this product off the shelf.”
Pakes said York Region Public Health is awaiting test results from a federal lab to confirm the cause of the poisoning. The Canadian Food Inspection Agency only said it was “providing support while the source is being investigated.”
Delight Restaurant & BBQ was closed on Monday and Tuesday and did not respond to requests for comment.
“The Poison Queen”
There are about 240 species of aconite, also known as aconite and aconite, in Asia, North America and Europe. Although popular with gardeners for their bright flowers, which are usually purple or blue, most species are extremely poisonous and should be handled with care.
“There are aconites in gardens all over the world because they are beautiful plants. They bloom late. Bumblebees love them,” said Roger Gettig, director of horticulture at the Toronto Botanical Garden.
He recommended wearing rubber or leather gloves when handling the plant to avoid coming into contact with the toxin.
The plant’s poison has been used for centuries in hunting and battle, applied to arrows and spears used to kill animals and enemies, and its name in pop culture – from the poem by John Keats Ode to melancholy Harry Potter’s wolfsbane potion.
It’s not just fictional killers who are drawn to the poisonous plant: in 2010, a British woman was found guilty of killing her former lover by putting aconite in his curry leftovers.
“The lethal dose in humans can be as low as two milligrams, which is very small amounts – a bit the size of a sesame seed,” said Dr. Prateek Lala, assistant professor and associate director of the Applied Clinical Pharmacology at the University of Toronto. .
“The dose that each [Toronto] the patient must have been much, much lower than that if he is already on the road to recovery. And that’s obviously a good thing.”
Aconite poisonings are “unusual” in Canada
In 2004, 25-year-old actor Andre Noble died after apparently ingesting aconite sap in his home province of Newfoundland.
And in early February this year, two people in British Columbia had to be hospitalized after eating ginger powder containing aconite.
But such cases are rare, says Dr. Margaret Thompson, medical director of the Ontario Poison Centre. She estimated that the center records one case every five years.
Previous cases have involved people ingesting too high a concentration of a medicinal product, while others have mistaken the plant for another herb, such as parsley, she said.
“It actually happens when it’s not flowering, because they [think] it’s just a nice green plant. People would actually think, “Oh, I can put some in a salad,” Thompson said. “It’s just an accidental misidentification.”
There is no antidote for aconite poisoning, so treatment focuses on supportive care, including activated charcoal if the patient seeks treatment early enough, and anti-inflammatory drugs and fluids. nausea if he suffers from vomiting or diarrhoea. Patients may need a ventilator to help with breathing, or even defibrillation to restore a normal heartbeat, Thompson said.
Aconite as a remedy, not as a recipe
Aconite roots are regularly used in oriental herbal remedies, including traditional Chinese medicine and Ayurvedic medicine for rheumatoid conditions or as a topical or internal anesthetic – but only after a complex process to remove toxins from the plant.
Tim Sibbald, a teacher at the Ontario College of Traditional Chinese Medicine, says TCM protocol calls for aconite roots to be boiled for one to two hours to reduce their toxicity. A TCM practitioner will then take chopsticks, dip them in the concoction, then put the liquid on their tongue to check for toxicity.
“If there’s a numbness and tingling feeling, then you haven’t gotten rid of the toxicity of that herb yet, and therefore it can’t be used yet,” Sibbald said.
“The problem is less of a dosage issue, because with almost any dose there is a risk of death,” he said. “It’s about whether or not he was treated correctly.”
Sibbald and Chris Pickrell, a Toronto naturopath, herbalist and traditional Chinese medicine practitioner, said it would be unusual for aconite to be used in a Chinese cooking recipe.
“There are no traditional recipes that I know of where it would appear… It has many interesting uses in Chinese medicine, but it’s never used in cooking,” Pickrell said.
Although sliced aconite root and dried ginger may look similar, their Chinese names are quite different, so their labels were unlikely to be confused, he said.
York Region Public Health said anyone who had leftovers from the restaurant weekend should throw them away. If someone who has eaten at the restaurant has symptoms, they should see a doctor.