To emergency department and urgent care center staff:

British Columbia’s Drug and Poison Information Centre (DPIC) and the BC Centre for Disease Control (BCCDC) would like to ensure you are aware of recent cases of aconitine poisoning in Canada.

On August 28^th 2022, eleven people became acutely ill in Ontario after eating a restaurant meal made with sand ginger. Five of these people were admitted to ICU for arrhythmias and complications. The Canadian Food Inspection Agency (CFIA) has determined that the sand ginger was contaminated with aconite, a toxic plant also called monkshood or wolf’s bane. Aconite produces a highly toxic substance, aconitine, which binds to and disrupts sodium channels. The contaminated sand ginger, which was distributed in BC, has been recalled. You can view the recall notice here.

A similar but less severe event occurred in British Columbia in March 2022. Two people presented to hospital with arrhythmias after eating a home prepared meal using sand ginger. BCCDC, together with the BC Institute of Technology and the CFIA, determined this sand ginger was also contaminated by aconite. This product was removed from the market and a public notice was issue, which you can view here.

Symptoms of aconitine poisoning begin shortly after consumption (minutes to hours) and include:

• Numbness of the face or lips and extremities
• Arrhythmias
• Diarrhea
• Nausea and vomiting
• Abdominal pain

Though the product associated with both of the above events has been removed from market, it may still be present in homes or restaurants. If you assess someone or a cluster of people with these symptoms which began shortly after consuming a meal, please consider aconite contamination.

For more treatment information, see the BC Drug and Poison Information Centre treatment monograph.

If you suspect a case of aconitine poisoning, please contact your regional health authority and DPIC (604-682-5050) immediately.

Thank you,

David McVea
Public Health Physician, BC Centre for Disease Control

Jesse Godwin and Roy Purssell
Physician Leads, BC Drug and Poison Information Centre