Grayanotoxin poisoning is associated with honey produced from rhododendrons. Which option lists this exposure correctly?

• A. Consumption of honey produced from the pollen and nectar of rhododendrons
• B. Eating sub-tropical Bar Jack fish
• C. Eating improperly chilled Tuna or Mahi Mahi
• D. Eating improperly cooked Escolar fish

Answer: (A)

Grayanotoxin poisoning happens when people ingest honey that bees made from rhododendron nectar. Rhododendrons contain grayanotoxins, and these toxins can concentrate in the honey produced from that nectar, leading to symptoms such as dizziness, low blood pressure, slow pulse, and gastrointestinal distress. So the exposure described as consuming honey produced from the pollen and nectar of rhododendrons is the correct match.

The other options point to different toxin exposures: Bar Jack fish can cause ciguatera poisoning from toxins in reef-associated fish; eating improperly chilled tuna or mahi-mahi can lead to scombroid poisoning due to histamine development; and Escolar fish can cause GI symptoms from indigestible wax esters.