SAN DIEGO (AP) — Four people have died and three others have required liver transplants after eating the aptly named death cap mushroom that is proliferating in California following a rainy winter.

The California Department of Public Health is urging people to avoid mushroom foraging altogether this year because death cap mushrooms are easily confused with safe, edible varieties.

Since Nov. 18 there have been more than three dozen cases of mushroom poisonings reported, including the four deaths and three liver transplants, according to the health department. Many who sought medical attention suffered from rapidly evolving acute liver injury and liver failure. Several patients required admission to an intensive care unit. They have ranged in age from 19 months to 67 years old.

“This greatly exceeds the typical report of less than 5 cases of mushroom poisonings a year,” the department said in its public health warning.

U.S. Poison Centers said in an email to The Associated Press that it handled 2,315 mushroom exposures from September 2025 through January 2026 — a 40% increase compared to the same period in the previous year. Exposures do not always result in illness or poisoning.