The Centre for Health Protection (CHP) of the Department of Health is investigating a suspected case of mad honey poisoning after a 44-year-old man developed dizziness and syncope – fainting – around 30 minutes after consuming honey. He attended the Accident and Emergency Department of Queen Elizabeth Hospital and was hospitalised for observation due to hypotension and bradycardia, or shock. The patient was later discharged. His clinical diagnosis was suspected mad honey poisoning.
Preliminary investigation revealed that the patient had consumed honey brought to Hong Kong by a relative from Nepal.
Mad honey poisoning is caused by ingestion of honey containing grayanotoxins derived from plants belonging to the Ericaceae family, including rhododendrons. Grayanotoxins are neurotoxins which can affect nerves and muscles. Symptoms of poisoning include nausea, vomiting, diarrhoea, dizziness, weakness, excessive perspiration, hypersalivation and paraesthesia shortly after ingestion. In severe cases, hypotension, bradycardia or shock may occur.
Members of the public are advised to remember the following preventive advice:
- Buy honey from a reliable source or apiary;
- Discard honey with a bitter or astringent taste – grayanotoxin-containing honey may cause a burning sensation in the throat; and
- Pay special attention to honey from India, Nepal and the Black Sea region of Türkiye as there have been grayanotoxin poisoning cases connected with honey from these areas.
Mad honey is produced principally in Nepal and Turkey, where it is used both as a traditional medicine and a recreational drug. In the Hindu Kush Himalayan range, it is produced by Himalayan giant honey bees (Apis laboriosa).
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