|Poisoning from Elderberry Juice -- California
On August 26, 1983, eight people with acute gastrointestinal and neurologic symptoms were flown by helicopter to a Monterey, California, hospital. Earlier that day, they had attended a gathering for 25 persons of a religious/philosophic group in a remote area of Monterey County. Within 15 minutes after drinking refreshments, 11 persons began to have nausea and vomiting. The eight persons most ill reported nausea, vomiting, abdominal cramps, and weakness. Some also complained of dizziness and numbness; one was stuporous and was hospitalized. Arterial blood gases were normal for all eight, as were serum cyanide levels (reported later). The San Francisco Bay Area Regional Poison Control Center was promptly consulted regarding treatment for possible cyanide poisoning, but specific treatment was not given because 4 hours had elapsed since exposure, blood gases were normal, and the patients were stable. All recovered quickly, including the patient hospitalized overnight.
Investigation by the Monterey County Health Department revealed that staff at the religious center had gathered local, wild elderberries 2 days before the outbreak and had prepared juice from them the next day. Bunches of berries were crushed with their leaves and branches in a stainless-steel press. Apple juice, water, and sugar were added, and the mixture was stored overnight. The drink was served the next day in a stainless-steel pot to the group of 25 persons. Severity of illness correlated with the amount of elderberry juice consumed; those who drank only tea remained well. The hospitalized person had consumed five glasses of the juice; the others, much less.
Although a review of the medical literature revealed no
other reports of elderberry juice poisoning in the past 20 years, there
are older, anecdotal reports of poisoning in children from the related
elder, S. canadensis. The religious center staff has been advised that,
while elderberries may be safe to consume, particularly if cooked (uncooked
berries may produce nausea), leaves and stems should not be crushed in
when making juice. Reported in California Morbidity (February 24, 1984)
by S Kunitz, MD, RJ Melton, MD, T Updyke, Monterey County Health Dept,
D Breedlove, PhD, California Academy of Sciences, San Francisco, SB Werner,
MD, California State Dept of Health Svcs. Bibliography Casarett LJ, Doull
J, eds. Toxicology: the basic science of poisons. New York: Macmillan Publishing
Company, 1975. Kingsbury JM. Poisonous plants of the United States and
Canada. Englewood Cliffs, New Jersey: Prentice-Hall, 1964. Millspaugh CF.
American medicinal plants. New York: Dover Publications, Inc. Muenscher
WC. Poisonous plants of the United States. New York: Macmillan Company,
1951. Osol A, Farrar GE. The Dispensatory of the United States of America.
25th ed. Philadelphia: JB Lippincott Company, 1955. Pammel LH. A manual
of poisonous plants. Cedar Rapids, Iowa: The Torch Press, 1911.
main elderberry F