EVERY summer at the height of the rainy season, villagers in a corner of southwestern China would suddenly die of cardiac arrest.
No one knew what caused Yunnan Sudden Death Syndrome, blamed for an estimated 400 deaths in the past three decades.
Now, after a five-year investigation, an elite unit from China's Center for Disease Control and Prevention believes it has pinpointed the cause: an innocuous-looking small mushroom known as Little White.
The search began in 2005 and took investigators to remote villages spread over the rural highlands of Yunnan Province, said Robert Fontaine, an epidemiologist with the US Centers for Disease Control and Prevention.
There was "this very obvious clustering of deaths in villages in very short periods of time in the summer," said Fontaine, who helped in the investigation.
By 2008, investigators had discovered a relatively unknown mushroom in a number of homes where people had died.
The mushroom is not usually sold in the markets, because it's too small.
A public information campaign to warn against eating the mushrooms dramatically reduced the number of deaths. However, the mystery has not yet been definitively solved.
Testing found the mushroom contained some toxins, but not enough to be deadly. Chinese scientists need to isolate the toxin and test whether it triggers cardiac arrests.
Researchers have hypothesized that there is a second agent. "There is a lot of work left to do," Fontaine said. "We really need additional lab investigations."