Gastro-intestinal poisoning due to consumption of daffodils mistaken for vegetables at commercial markets, Bristol, United Kingdom.
BACKGROUND
In February 2012, we investigated a cluster of people who presented at a local emergency department with sudden onset of vomiting after mistaken consumption of daffodils.


METHODS
We interviewed patients to collect information on daffodil purchase and consumption. With Local Authority we investigated points of sale to understand the source of confusion.


RESULTS
We identified 11 patients (median age: 23 years, range 5-60 years, eight females) among Bristol (UK) residents of Chinese origin. The most commonly reported symptoms were vomiting (n = 11) and nausea (n = 9) that developed within 12 h of daffodil consumption. There were no hospitalisations or deaths. Patients were clustered in two family dinners and one party. Bunches of pre-bloom daffodil stalks were purchased in two stores of one supermarket chain, which displayed daffodils next to vegetables, not marked as non-edible. Patients cooked and consumed daffodils mistaking them for Chinese chives/onions.


CONCLUSIONS
Gastro-intestinal poisoning should be considered in differential diagnoses of gastroenteritis. Multi-cultural societies are at risk of confusion between non-edible and edible plants. Supermarket presentation of daffodils may have contributed to mistaken consumption. We recommended explicit labelling and positioning of daffodils, away from produce. The supermarket chain introduced graphic 'non-edible' labels. No further patients were reported following action.
Health Protection Agency South West, Regional Epidemiology Unit, Temple Quay, Bristol, UK. Petra.Matulkova@hpa.org.uk
Petra
P
Matulkova
Maya
M
Gobin
Mark
M
Evans
Phil Charles
PC
Parkyn
Casey
C
Palmer
Isabel
I
Oliver
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000208:ethnology; D003132:Commerce; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005515:Food Labeling / Q000592:standards; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D031427:Narcissus / Q000506:poisoning*; D011356:Product Labeling / Q000592:standards*; D006113:United Kingdom / Q000453:epidemiology; D014675:Vegetables; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult