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The Poison Lab: Outbreak – Markham Aconite Poisoning
On August 29, 2022, twelve diners at a Markham, Ontario restaurant fell critically ill with vomiting, numbness, and life-threatening arrhythmias. The culprit? A deadly plant toxin: aconite.
In this episode—the first of a new Poison Lab Outbreak series—we go inside the Markham mass poisoning case. Join host Ryan Feldman, clinical toxicologist and emergency medicine pharmacist, as he investigates how a rare and lethal toxin ended up in a restaurant spice jar and nearly cost lives.
You’ll hear firsthand from the experts who responded to the outbreak:
- Dr. Jessica Kent, toxicology fellow at the time at the University of Toronto
- Dr. Abhay Sathia, intensivist at Markham Stouffville Hospital
- Dr. Margaret Thompson, toxicologist and on-call consultant for the Ontario Poison Centre
- Dr. Randy Purves, research scientist at the Canadian Food Inspection Agency (CFIA)
- Bryn Shurmer, MS- analytical chemist at the Canadian Food Inspection Agency (CFIA)
Together, they walk us through the outbreak timeline—from the first patients in VT to the public health investigation that uncovered a mislabelled spice bag full of pure aconite root.
💡 Key topics:
- Clinical presentation and toxic effects of aconite
- Challenges in mass poisoning recognition and coordination
- The crucial role of poison centers in outbreak response
- Public health trace-back to contaminated galangal powder
- Lessons for emergency departments and toxicologists
Time Stamps
00:00 Breaking News: Markham Restaurant Poisoning Incident
00:47 Introduction to The Poison Lamp Podcast
01:05 Special Series: Outbreaks and Poisoning Mysteries
02:44 Case Study: Aconite Poisoning in Markham
03:56 Meet the Experts: Frontline Responders
07:42 Initial Response and Patient Management
11:33 Identifying the Poison: Aconite
15:42 Communication and Coordination During the Outbreak
31:43 Public Health Involvement and Confirmation
34:55 Identifying the Culprit: Sodium Channel Toxins
35:36 Tracing the Source: Public Health Investigation
36:54 Confirming the Toxin: Aconite Discovery
37:36 Global Context: Aconite in Traditional Medicine
39:25 Forensic Analysis: The Chemists' Perspective
40:48 Introduction to Analytical Chemists
43:44 Targeted vs. Non-Targeted Analysis
46:51 Case Study: Melamine Contamination
49:58 Managing the Outbreak: Clinical Insights
01:00:01 Future Preparedness: Preventing Mass Poisonings
01:04:34 Conclusion: Team Effort and Final Thoughts
📍 Resources & Mentions:
🎧 Listen now at: www.ThePoisonLab.com
💬 Have thoughts or questions? Connect on Instagram @tox_talk, Twitter @LabPoison, or email [email protected].
