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Sesab (Ministry of Health of the State of Bahia) registered a new case of Haff’s disease on Friday (13), totaling 13 notifications in 2020. Since August of this year, inhabitants of the municipalities of Entre Ríos, Salvador, Camaçari and, now Dias D’Ávila has been diagnosed with the disease.
The Secretariat confirmed that there were reports of fish intake. In the first three cases, the patients consumed a fish known as a manatee, and about seven hours later, they began to show symptoms of severe body pain, dizziness, nausea and weakness.
Although the exact origin of Haff’s disease is not yet known, the researchers observed that all people diagnosed consumed some animal that lives in water, often fresh. It is believed that the food eaten has been contaminated with some toxin, which has not been identified. As herbivorous fish are often associated with cases, toxins can be found in vegetation, algae, or other microorganisms.
Experts raised the possibility of a bacteria, but it was considered unlikely, as the fish was cooked or fried, processes by which the microorganism would not survive. However, CDC (Center for Disease Control and Prevention) studies have shown that one substance (nonpolar lipid) induces similar symptoms in rats and is not inactivated by cooking.
“There are also some theories about the toxin that causes aggression to the muscles. paliotoxin. It is an intense vasoconstrictor and is considered one of the most poisonous non-protein substances. It is found in corals, dinoflagellates and, by accumulation through food, in various river and marine fish, such as the pacu, the manatee and the grouper. It can also be found in crawfish, crawfish and crawfish, “he says. Vidal Haddad, associate professor at the Unesp School of Medicine (Paulista State University) of Botucatu.
According to him, paliotoxin is produced by certain bacteria, but it has not been identified in patients. “The facts lead to this, as all the animals mentioned have already been associated with Haff in Brazil and around the world. However, as long as the toxin is not isolated, there is a theory that an enterovirus could cause the disease.”
Brown urine
Symptoms of Haff disease usually appear between two and 24 hours after eating cooked fish or shellfish. Patients experience extreme muscle pain and stiffness, chest pain, shortness of breath, numbness, and loss of strength throughout the body, in addition to brown urine.
Muscles, when injured, apparently release a substance called myoglobin into the blood, which turns urine a dark color and can damage the kidneys; people can also have kidney failure.
To arrive at a diagnosis, doctors can order tests. However, because it is not known exactly what causes the disease, the most important thing will be to listen to the patient’s history. Because it is little known, identifying the problem can be difficult, but the recommendation is that a healthcare professional is sought as soon as symptoms appear.
Treatment is based on the consequences of the disease, relieving symptoms such as pain and shortness of breath and assisting the kidneys with devices when necessary. In milder cases, the signs of the syndrome disappear in a few days, without the need for hospitalization or the use of medical devices. However, even so, medical evaluation is important. As the disease progresses rapidly and can cause kidney failure, if not treated properly, it can lead to death.
Since December 2016, when the first cases emerged, Bahia registered a single death from Haff’s disease, which occurred in 2017.
* With information from an article published on 10/04/18
