Investigation into a food poisoning incident caused by accidental ingestion of wild plants containing aconitine in a township of Xinjiang

Objective To investigate a food poisoning incident caused by accidental ingestion of wild plants in a township of Xinjiang, clarify the cause and characteristics of the poisoning, and provide a reference for the prevention of similar incidents.

Methods Case definitions were formulated. Through on-site or telephone epidemiological investigations, video retrieval and other means, case searches were conducted at the hospitals where cases were treated, among the diners and staff of the implicated restaurant on June 21, 2025, as well as family members and villagers. The suspected plant sample (including the leftover part), vomitus, blood and urine of the cases were collected for laboratory testing. The occurrence, development, exposure factors and clinical manifestations of the poisoning incident were systematically investigated in combination with case data, field epidemiological investigation data and environmental hygiene data. Descriptive epidemiological methods were employed to analyze the association between exposure and disease occurrence. Aconitine alkaloids were detected by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).

Results A total of 5 cases were identified, all of which were confirmed cases, including 1 death, 2 severe cases and 2 mild cases. There were 4 male cases and 1 female case. All five consumers became ill, and the case fatality rate was 20.00%. The clinical manifestations were mainly numbness of the lips and limbs, vomiting and abdominal pain. All the cases had consumed a homemade wild plant cold dish. The first case developed symptoms at 19:56 on June 21, and the fatal case developed symptoms at 20:37 and died at 23:30 on the same day. The epidemic curve of this incident indicated a point-source exposure. The shortest incubation period was 5 minutes, the longest was 96 minutes, and the median was 60 minutes. Aconitine and indaconitine were detected in the vomitus, blood and urine samples of the cases; aconitine, indaconitine, aconine and karacoline were detected in the suspected wild plant sample. All cases had consumed the wild plant cold dish, while no illness occurred among non-consumers, suggesting that the dish was the suspected causative factor.

Conclusion This poisoning incident was identified as a plant-based food poisoning event caused by accidental ingestion of wild plants containing aconitine. It is recommended that public education on the identification of toxic plants such as Aconitum be strengthened, supervision over catering units' use of wild-sourced ingredients be standardized, the capacity of primary medical institutions to identify and treat food poisoning be enhanced, and the surveillance and emergency response mechanisms for foodborne diseases be improved, so as to reduce the risk of accidental ingestion and protect residents' health and safety.