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San Francisco health officer reports rare aconitine poisoning from contaminated herbal tea
Summary
San Francisco Department of Public Health reported two severe cardiac poisoning cases linked to herbal tea purchased from a local vendor; toxicology found aconitine, investigators embargoed implicated products, and wholesalers were advised to stop selling five shared ingredients while state partners joined the probe.
San Francisco27s health officer, Dr. Tomas Aragon, told the commission that toxicology tests identified a plant-derived alkaloid, aconitine, in patients who developed cardiac arrhythmias after drinking herbal tea from a single retailer. He said the department received an initial notification on March 7 and, after tracing cases, environmental health inspectors conducted six site visits and embargoed all products containing the 35 herbal ingredients found in the patients27 teas.
The health officer said the two hospitalized patients consumed a mix of 35 ingredients and investigators narrowed the implicated items to five shared components; subsequent laboratory testing at Zuckerberg San Francisco General27s toxicology lab detected aconitine in patient specimens and in one seized sample identified as a lovage/Lubbdige (lovage) root. "We first learned of the herbal tea poisoning on March 7," Aragon said, noting the California Department of Public Health later joined the investigation.
Why it matters: aconitine is a potent cardiotoxin sometimes present when aconite (processed aconitum species) contaminates other roots. Dr. Aragon told commissioners contamination likely occurred earlier in the supply chain (harvest, processing or packaging in China) because wholesalers and retailers do not handle unprocessed aconite locally. Environmental health staff advised wholesalers to stop selling the five shared ingredients and seized products to prevent additional exposures; no other cases have been identified in California since the recall.
What investigators did and next steps: DPH issued a public press release urging customers to discard implicated teas and a clinical health alert to raise awareness among clinicians. Laboratory and field work focused on tracing the ingredient27s origin; investigators said they were unable to conclusively determine the contamination point but described the rapid interdiction of products and outreach to wholesalers as successful containment. The department plans to publish a fuller written report with recommendations for clinicians and consumers.
Commissioners asked whether routine enhanced surveillance would be required; Aragon said the event appears rare and DPH will rely primarily on clinical surveillance and poison control reports. He praised the California Poison Control Center laboratory at Zuckerberg San Francisco General for rapid testing and case identification.
