Cent Eur J Public Health 2023, 31(1):69-73 | DOI: 10.21101/cejph.a7501

Worldwide distribution and clinical characteristics of mad honey poisoning cases

Abdülkadir Gunduz¹, Perihan Şimşek², Faik Ahmet Ayaz³

¹ Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

² School of Applied Sciences, Trabzon University, Trabzon, Turkey

³ Department of Biology, Faculty of Science, Karadeniz Technical University, Trabzon, Turkey

Objectives: Mad honey poisoning is a common public health problem that can be seen in many parts of the world. In this study, the symptoms and clinical findings of mad honey poisoning cases and their distribution worldwide were investigated based on current data.

Methods: PubMed, Scopus, Web of Science and Google Scholar databases were searched. The demographic characteristics of the cases, clinical findings, amount of consumed honey, duration of hospitalization, and data of the region where mad honey was produced were recorded.

Results: 900 cases were identified. The majority of poisoning cases (91.44%) were reported from mad honey produced in Turkey, Nepal (4.67%) came second and Korea (1.56) third. The majority of cases in Turkey were due to honey produced in the Black Sea Region. It was also determined that the mad honey was produced in the west Black Sea Region in most of the cases (35.22%), followed by the east Black Sea Region with a rate of 33.22%. In poisonous cases, it was determined that the mad honey was mostly produced in Rize, followed by Trabzon and Kastamonu, respectively. The most common signs of mad honey poisoning were bradycardia (88.48%) and hypotension (76.04%).

Conclusion: The majority of cases have been reported from Turkey. When examining where the mad honey was produced in Turkey, it was seen that the western Black Sea Region came first, and the eastern Black Sea Region came second. Rize came first among the provinces, followed by Trabzon and Kastamonu. There is a parallelism between the distribution of mad honey poisoning cases and the distribution areas of Rhododendron species. However, although Rhododendron species show a widespread distribution throughout the world, why the majority of the cases were reported from Turkey draws attention as an issue that needs to be investigated.

Keywords: Black Sea Region, Rhododendron, geographic distribution, grayanotoxin, intoxication, mad honey, poisoning, toxicity

Received: June 18, 2022; Revised: January 5, 2023; Accepted: January 5, 2023; Published: March 31, 2023  Show citation