Haff disease
Encyclopedia
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
.
, Germany
(now Kaliningrad
, Russia) on the Baltic coast
, in people staying around the haff (German: lagoon
).
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
). Since that time, only occasional reports have appeared of the condition, mostly from the Soviet Union
and Germany.
In 1997, six cases of Haff disease were reported in California
and Missouri
, all after the consumption of buffalo fish
(Ictiobus cyprinellus).
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 were victims of Haff disease.
The most recent US outbreak was reported in Brooklyn, NY on 18 November 2011, when two household members were stricken by the syndrome after eating Buffalo fish.
, 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. It cannot be inactivated by cooking, as all six CDC cases had consumed cooked or fried fish. Palytoxin
has been proposed as a disease model. It has also been suggested that the toxin may have thiaminase
activity (i.e. it degrades thiamine
, also known as vitamin B1).
Rhabdomyolysis
Rhabdomyolysis is a condition in which damaged skeletal muscle tissue breaks down rapidly. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure...
(swelling and breakdown of skeletal muscle
Skeletal muscle
Skeletal muscle is a form of striated muscle tissue existing under control of the somatic nervous system- i.e. it is voluntarily controlled. It is one of three major muscle types, the others being cardiac and smooth muscle...
, with a risk of acute kidney failure
Acute renal failure
Acute kidney injury , previously called acute renal failure , is a rapid loss of kidney function. Its causes are numerous and include low blood volume from any cause, exposure to substances harmful to the kidney, and obstruction of the urinary tract...
) within 24 hours of ingesting fish
Fish
Fish are a paraphyletic group of organisms that consist of all gill-bearing aquatic vertebrate animals that lack limbs with digits. Included in this definition are the living hagfish, lampreys, and cartilaginous and bony fish, as well as various extinct related groups...
.
History
It was first described in 1924 in the vicinity of KönigsbergKönigsberg
Königsberg was the capital of East Prussia from the Late Middle Ages until 1945 as well as the northernmost and easternmost German city with 286,666 inhabitants . Due to the multicultural society in and around the city, there are several local names for it...
, Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
(now Kaliningrad
Kaliningrad
Kaliningrad is a seaport and the administrative center of Kaliningrad Oblast, the Russian exclave between Poland and Lithuania on the Baltic Sea...
, Russia) on the Baltic coast
Baltic Sea
The Baltic Sea is a brackish mediterranean sea located in Northern Europe, from 53°N to 66°N latitude and from 20°E to 26°E longitude. It is bounded by the Scandinavian Peninsula, the mainland of Europe, and the Danish islands. It drains into the Kattegat by way of the Øresund, the Great Belt and...
, in people staying around the haff (German: lagoon
Lagoon
A lagoon is a body of shallow sea water or brackish water separated from the sea by some form of barrier. The EU's habitat directive defines lagoons as "expanses of shallow coastal salt water, of varying salinity or water volume, wholly or partially separated from the sea by sand banks or shingle,...
).
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
Burbot
The burbot is the only gadiform fish inhabiting freshwaters. It is also known as mariah, the lawyer, and eelpout. It is closely related to the marine common ling and the cusk...
, eel
Eel
Eels are an order of fish, which consists of four suborders, 20 families, 111 genera and approximately 800 species. Most eels are predators...
and pike
Esox
Esox is a genus of freshwater fish, the only living genus in the family Esocidae — the esocids which were endemic to North America, Europe and Eurasia during the Paleogene through present.The type species is E. lucius, the northern pike...
). Since that time, only occasional reports have appeared of the condition, mostly from the Soviet Union
Soviet Union
The Soviet Union , officially the Union of Soviet Socialist Republics , was a constitutionally socialist state that existed in Eurasia between 1922 and 1991....
and Germany.
In 1997, six cases of Haff disease were reported in California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
and Missouri
Missouri
Missouri is a US state located in the Midwestern United States, bordered by Iowa, Illinois, Kentucky, Tennessee, Arkansas, Oklahoma, Kansas and Nebraska. With a 2010 population of 5,988,927, Missouri is the 18th most populous state in the nation and the fifth most populous in the Midwest. It...
, all after the consumption of buffalo fish
Bigmouth buffalo
The bigmouth buffalo, Ictiobus cyprinellus, also known as the gourd head, redmouth buffalo, buffalo fish, bernard buffalo, roundhead, or brown buffalo, is a large species of the Catostomidae or "sucker" family....
(Ictiobus cyprinellus).
In July and August 2010, dozens of people contracted rhabdomyolysis
Rhabdomyolysis
Rhabdomyolysis is a condition in which damaged skeletal muscle tissue breaks down rapidly. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure...
after eating Procambarus clarkii
Procambarus clarkii
Procambarus clarkii is a freshwater crayfish species, native to the Southeastern United States, but found also on other continents, where it is often an invasive pest. It is known variously as the red swamp crawfish, red swamp crayfish, Louisiana crawfish, Louisiana crayfish or mudbug.-Range and...
in Nanjing
Nanjing
' is the capital of Jiangsu province in China and has a prominent place in Chinese history and culture, having been the capital of China on several occasions...
, China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
. A month later, the Chinese authorities claimed they were victims of Haff disease.
The most recent US outbreak was reported in Brooklyn, NY on 18 November 2011, when two household members were stricken by the syndrome after eating Buffalo fish.
Poison
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 PreventionCenters for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
, and studies of other fish from the same sources showed a hexane
Hexane
Hexane is a hydrocarbon with the chemical formula C6H14; that is, an alkane with six carbon atoms.The term may refer to any of four other structural isomers with that formula, or to a mixture of them. In the IUPAC nomenclature, however, hexane is the unbranched isomer ; the other four structures...
-soluble (and hence non-polar
Chemical polarity
In chemistry, polarity refers to a separation of electric charge leading to a molecule or its chemical groups having an electric dipole or multipole moment. Polar molecules interact through dipole–dipole intermolecular forces and hydrogen bonds. Molecular polarity is dependent on the difference in...
lipid
Lipid
Lipids constitute a broad group of naturally occurring molecules that include fats, waxes, sterols, fat-soluble vitamins , monoglycerides, diglycerides, triglycerides, phospholipids, and others...
) substance that induced similar symptoms in mice
Mouse
A mouse is a small mammal belonging to the order of rodents. The best known mouse species is the common house mouse . It is also a popular pet. In some places, certain kinds of field mice are also common. This rodent is eaten by large birds such as hawks and eagles...
; other food-borne poisons commonly found in fish could not be detected. It cannot be inactivated by cooking, as all six CDC cases had consumed cooked or fried fish. Palytoxin
Palytoxin
Palytoxin is a very dangerous toxin; it is considered to be one of the most toxic non-peptide substances known, second only to maitotoxin in terms of toxicity in mice...
has been proposed as a disease model. It has also been suggested that the toxin may have thiaminase
Thiaminase
Thiaminase is an enzyme that metabolizes or breaks down thiamine into two molecular parts.The old name was "Aneurinase".There are two types: -Sources:Source include:* Bracken , Nardoo and other plants.* Some fish including carp and goldfish....
activity (i.e. it degrades thiamine
Thiamine
Thiamine or thiamin or vitamin B1 , named as the "thio-vitamine" is a water-soluble vitamin of the B complex. First named aneurin for the detrimental neurological effects if not present in the diet, it was eventually assigned the generic descriptor name vitamin B1. Its phosphate derivatives are...
, also known as vitamin B1).
Secondary sources
- Jürgen W. Schmidt: Die "Haffkrankheit" in Ostpreussen im Herbst 1932, in: Preussenland - Mitteilungen der Historischen Kommission für Ost- und Westpreussische Landesforschung und aus dem Geheimen Staatsarchiv Preussischer Kulturbesitz Heft 2/2009 (47. Jg.) pp. 57-60