An outbreak of "mad" honey poisoning from the Black Sea area of Turkey is reportedin the Emergency Medicine Journal. Researchers warn the problem is likely to spread to other countries because of the demand for natural or unprocessed imported honey.

Researchers from Abbant Izzet Baysal University in Turkey, describe 19 patients admitted to hospital who suffered nausea, vomiting slowed heart rate and fainting after eating honey. The researchers say they had been poisoned with andromedotoxins found in the leaves and flowers of plants and extracted by bees.

"Mad" honey is used in the Black sea region as a sexual stimulant and as a treatment for stomach and bowel problems. Fifteen of the patients had been diagnosed with duodenal ulcers which, according to local tradition, can be healed by continuous eating of honey.

The authors say it is unclear how much is necessary for a toxic dose but it may be as little as a teaspoon.