A Retrospective Study of Wild Mushroom Intoxications in the Region of Varna, Bulgaria

Wild mushroom intoxications are a recurrent seasonal public health concern, but long-term epidemiological data from Eastern Europe remain limited. This study characterized the long-term epidemiological patterns of wild mushroom intoxications in the Region of Varna, Bulgaria, including temporal trends, demographic characteristics, seasonality, time to hospital presentation, length of hospital stay, and family clustering. We retrospectively reviewed all consecutive patients hospitalized for wild mushroom intoxication at the Clinic of Toxicology, Naval Hospital of Varna, from January 2005 to December 2022. Temporal trends were assessed using the Mann–Kendall test. The sex distribution of cases was tested against an equal distribution using an exact binomial test, sex-specific incidence was compared using incidence rate ratios with sex-specific population denominators, and the χ2 test was used for the comparison across study periods. Among 672 patients, sex-specific incidence was almost identical in men and women (8.24 versus 8.10 per 100,000 person-years; IRR 1.02, 95% CI 0.88–1.18), and the most affected age groups were 51–60 years (18.90%) and 61–70 years (16.52%). Annual hospitalizations showed a significant downward trend (Mann–Kendall τ = −0.42, p = 0.017), while the estimated crude hospitalization rate declined from 11.5 per 100,000 person-years in 2005–2010 to 6.3 in 2017–2022. A pronounced seasonal pattern was observed, with cases occurring predominantly in autumn. Most patients presented within six hours of ingestion (83.33%), and two-day hospital stays were most common (69.64%). Forty-seven family clusters were identified. No fatalities or severe complications were recorded. These long-term regional data demonstrate persistent seasonal clustering and predominantly early hospital presentation, while the declining hospitalization burden should not diminish the need for continued surveillance and targeted public health prevention before the autumn foraging season.