13th April 2018, Volume 131 Number 1473

Michael Beasley, Dell Hood, Philippa Anderson, John Reeve, Robin J Slaughter

Toxic honey is a well-defined phenomenon that has been described since the time of the ancient Greeks.1 Poisoning from toxic honey occurs when phytotoxins from plant species are present in…

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Summary

In autumn 2008, an outbreak of toxic honey poisoning was identified in Thames, Waikato, New Zealand. This study aimed to investigate these cases of honey poisoning and determine which toxin was involved and describe the effects of the poisoning. After testing the honey, the causative toxin was identified as tutin, which comes from the New Zealand native plant tutu. Twenty-two people were potentially poisoned with 11 of these cases being confirmed as ingesting toxic honey. There were eight cases of seizures in poisoned patients. Food safety standards have since been enhanced to minimise the risk of toxic honey.

Abstract

Aim

In autumn 2008, an outbreak of toxic honey poisoning was identified. The outbreak was not recognised initially until three cases from one family group presented to hospital, with a common factor of recent consumption of locally produced honey. The aim of this study was to investigate potential cases of this honey poisoning and determine which toxin was involved.

Method

The incident was investigated retrospectively by Waikato District Health Board’s Population Health unit and the New Zealand Food Safety Authority (NZFSA). Identified patients were followed up by questionnaire to gather case information. HortResearch (now Plant and Food Research) tested honey samples for toxins.

Results

The causative agent was identified as tutin, which comes from the New Zealand native plant tutu (Coriaria arborea) which has long been known as a potential source of contamination of honey produced in the warmer parts of New Zealand. Retrospective case investigation identified a total of 22 possible or probable cases, based on a clinical case definition. The spectrum of toxic effects reported were broadly similar to those previously described for tutin, derived either directly from the plant itself or indirectly from honey. There were 13 samples of honey, linked to symptomatic individuals, which were available for testing. Of these, 10 were positive for tutin and its hydroxy metabolite hyenanchin (hydroxytutin) and one was positive for hyenanchin alone.

Conclusion

Toxic honey production is a significant risk in parts of New Zealand. Beekeepers and health professionals need to be informed of this risk and know how best to manage it. Due to this poisoning incident, public and professional awareness of honey poisoning has been substantially enhanced. This incident led to development of new food safety standards for New Zealand honey.

Author Information

Michael Beasley, National Poisons Centre, University of Otago, Dunedin;
Dell Hood, Formerly Waikato District Health Board, Hamilton;
Philippa Anderson, Counties Manukau District Health Board, Auckland;
John Reeve, New Zealand Ministry for Primary Industries, Wellington;
Robin J Slaughter, National Poisons Centre, University of Otago, Dunedin.

Correspondence

Michael Beasley, National Poisons Centre, University of Otago, PO Box 56, Dunedin 9054.

Correspondence Email

michael.beasley@otago.ac.nz

Competing Interests

Nil.

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