| Haff disease | |
|---|---|
| Other names | Haffkrankheit |
 | |
| Satellite photo of the Vistula Lagoon, formerly known as Frisches Haff. Haff disease was first described in the location of Königsberg. [1] | |
| Specialty | Toxicology |
Haff disease is the development of rhabdomyolysis (swelling and breakdown of skeletal muscle, with a risk of acute kidney failure) within 24 hours of ingesting fish. [2]
The disease was first described in 1924 in the vicinity of Königsberg, Germany (now Kaliningrad, Russia) on the Baltic coast, in people staying around the northern part of the Vistula Lagoon (German: Frisches Haff). [3]
Over the subsequent fifteen years, about 1000 cases were reported in people, birds and cats, usually in the summer and fall, and a link was made with the consumption of fish (burbot, eel and pike). [2] Since that time, only occasional reports have appeared of the condition, mostly from the Soviet Union and Germany. [2]
In 1997, six cases of Haff disease were reported in California and Missouri, all after the consumption of buffalo fish (Ictiobus cyprinellus). [4]
In July and August 2010, dozens of people contracted rhabdomyolysis after eating Procambarus clarkii in Nanjing, China. A month later, the Chinese authorities claimed they had Haff disease. [5]
An outbreak was reported in Brooklyn, New York on 18 November 2011, when two household members were stricken by the syndrome after eating buffalo fish. [6] On February 4, 2014, two cases of Haff disease were reported in Cook County, Illinois following the consumption of buffalo fish. [7]
A group from Brazil identified a Haff disease outbreak in the State of Bahia that lasted from December 2016 to April 2017, [8] with 67 cases identified. In August 2018, a couple from São Paulo, southeastern Brazil, fell ill and needed semi-intensive hospital care after eating fish of the species known in Portuguese as "arabaiana" or "olho-de-boi" (ox-eye), possibly the southern yellowtail amberjack, Seriola lalandi , which they had bought in the city of Fortaleza, State of Ceará, northeastern Brazil, and, according to them, looked "perfect". The day following their admission to hospital the patients already presented an alteration of their urine, which, according to the woman who fell ill, "was very dark, indeed looked like Coca-Cola". [9]
On March 2, 2021, a 31-year-old woman from Recife, Brazil, died from Haff disease after ingesting yellowtail amberjack. [10]
The exact nature of the poison is still unclear. In the U.S. outbreak, the source of the fish was traced by the Centers for Disease Control and Prevention, and studies of other fish from the same sources showed a hexane-soluble (and hence non-polar lipid) substance that induced similar symptoms in mice; other food-borne poisons commonly found in fish could not be detected. [2] It cannot be inactivated by cooking, as all six CDC cases had consumed cooked or fried fish. [2] Palytoxin has been proposed as a disease model. [11] It has also been suggested that the toxin may have thiaminase activity (i.e. it degrades thiamine, also known as vitamin B1). [12]
Some of the reported symptoms include: [13]
Dry mouth, numbness of thighs or whole body, back pain, and stomach cramps are also reported, but seen less frequently. [13]
Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down rapidly. Symptoms may include muscle pains, weakness, vomiting, and confusion. There may be tea-colored urine or an irregular heartbeat. Some of the muscle breakdown products, such as the protein myoglobin, are harmful to the kidneys and can cause acute kidney injury.
Ciguatera fish poisoning (CFP), also known simply as ciguatera, is a foodborne illness caused by eating reef fish whose flesh is contaminated with certain toxins called ciguatoxins. Such individual fish are said to be ciguatoxic. Symptoms may include diarrhea, vomiting, numbness, itchiness, sensitivity to hot and cold, dizziness, and weakness. The onset of symptoms varies with the amount of toxin eaten from half an hour to up to two days. The diarrhea may last for up to four days. Some symptoms typically remain for a few weeks to months. Heart difficulties such as slow heart rate and low blood pressure may also occur.
Ainhum, also known as dactylolysis spontanea, is a painful constriction of the base of the fifth toe frequently followed by bilateral spontaneous autoamputation a few years later.
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Anisakis is a genus of parasitic nematodes that have life cycles involving fish and marine mammals. They are infective to humans and cause anisakiasis. People who produce immunoglobulin E in response to this parasite may subsequently have an allergic reaction, including anaphylaxis, after eating fish infected with Anisakis species.
The yellowtail amberjack, yellowtail kingfish, hiramasa or great amberjack is a large fish found in the Southern Ocean. Although previously thought to be found in all oceans and seas, recent genetic analysis restricts S. lalandi proper to the Southern Hemisphere waters. However, they are found in Northern Hemisphere waters during certain times of the year. The fish was given its name by Monsieur de Lalande, a naturalist who first informed zoologist Achille Valenciennes of the existence of this species. His reason for the use of the word Seriola to name the fish is uncertain, but the second word lalandi was derived from his surname. These fish are now being farmed offshore in Maine.
Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra.
Tricholoma equestre or Tricholoma flavovirens, commonly known as the man on horseback or yellow knight is a widely eaten but arguably toxic fungus of the genus Tricholoma that forms ectomycorrhiza with pine trees.
Dioctophyme renale, commonly referred to as the giant kidney worm, is a parasitic nematode (roundworm) whose mature form is found in the kidneys of mammals. D. renale is distributed worldwide, but is less common in Africa and Oceania. It affects fish eating mammals, particularly mink and dogs. Human infestation is rare, but results in kidney destruction, usually of one kidney and hence not fatal. A 2019 review listed a total of 37 known human cases of dioctophymiasis in 10 countries with the highest number (22) in China. Upon diagnosis through tissue sampling, the only treatment is surgical excision.
The longfin yellowtail, also known as the almaco or silvercoat jack, deep-water, falcate, European or highfin amberjack, rock salmon, longfin or yellow kingfish, is a game fish of the family Carangidae; they are in the same family as yellowtail and amberjack. They are carnivorous and feed, both day and night, on other, smaller fish, such as baitfish, small squid, octopus, crab and shrimp. The flesh is thick and dense, like tuna, and easily may be passed off for white albacore if prepared as sushi.
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Trachurus lathami is a species of fish in the family Carangidae and the genus Trachurus, the jack mackerels. Common names include rough scad and horse mackerel in English, as well as chinchard frappeur (French), chicharro garretón (Spanish), jurel, and carapau, garaçuma, surel, and xixarro. It is native to parts of the western Atlantic Ocean, including seas off the eastern coasts of North and South America and the Gulf of Mexico.
Exertional rhabdomyolysis (ER) is the breakdown of muscle from extreme physical exertion. It is one of many types of rhabdomyolysis that can occur, and because of this, the exact prevalence and incidence are unclear.
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