BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7166.1166 (Published 24 October 1998) Cite this as: BMJ 1998;317:1166

Italians from Naples love their shellfish and have high rates of hepatitis A as a result (Eurosurveillance1998;3333:97-8). In a telephone survey of Neapolitan families three quarters reported eating shellfish, and 17% admitted eating it raw. Those who cooked their shellfish did so only briefly until the valves opened before tossing them on to pasta. This practice is hazardous, say researchers, because Neapolitan vendors frequently keep filter feeding molluscs in tubs of seawater from the local ports, which looks fresh but is often contaminated with sewage. They urge consumers to stick to shellfish sold from refrigerated cases in net bags and to cook mussels for at least six minutes.

Mushroom poisoning has been around for a long time, and one correspondent in Clinical Toxicology(1998;36:635-6) suggests that it's time to abandon the unsophisticated “spaghetti western” approach to treatment, whereby doctors administer nasty detoxifying agents to patients before identifying the offending fungus. A reply in the same journal (1998;36:637-8) argues that better identification will not save lives because so few are lost from mushroom poisoning; that only about a quarter of people who eat unknown mushrooms reach hospital for gastric emptying; and that the evidence is often destroyed by cooking and eating anyway. Finally, he says, fungus experts rarely work around the clock, so help is …

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