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A Dias D’Ávila resident who is hospitalized in a private hospital in Salvador is the thirteenth reported case of Haff’s disease in Bahia this year, as reported on Friday (13) by the Secretary of Health of the State of Bahia (Sesab), which registered the new case today. Three cases they had already registered yesterday.
Haff’s disease is an unexplained rhabdomyolysis syndrome (ruptured muscle cells) and its symptoms are sudden onset of extreme muscle pain and stiffness, chest pain, shortness of breath, numbness and loss of strength throughout the body, as well as Brown-colored urine, associated with elevated serum CPK enzyme, related to fish intake. The disease can progress rapidly with kidney failure and, if left untreated, can lead to death.
The disease can affect the kidney because the CPK enzyme leaves the muscle fiber and enters the bloodstream, explains the director of Epidemiological Surveillance of the Department of Health of the State of Bahia, Márcia São Pedro. When symptoms appear, it is necessary to go to the health unit so that the patient can be hydrated in the first 48 to 72 hours.
In August 2020, the municipality of Entre Ríos registered the occurrence of three suspected cases of Haff’s disease with reports of fish consumption. Five people from the same family ate the “bull’s eye” fish and about seven hours later, the first, a 53-year-old man, developed symptoms of severe body pain, dizziness, nausea and weakness. Other members of the family had similar symptoms.
In Salvador, in September and October, two hospital units reported the occurrence of six cases of Haff’s disease. In the capital, three patients were hospitalized. In November, three cases were registered in Camaçari and today (13), one case in Dias D’Ávila.
According to the director of Epidemiological Surveillance, the three cases of the disease registered in Camaçari corresponded to people from the same family who reported having eaten the bull. The patients were admitted, but they are fine.
Since December 2016, when the first cases appeared, Bahia registered a single death from Haff’s disease, which occurred in 2017. Salvador even registered an outbreak of the disease, with 65 cases investigated and included in the outbreak.
In addition to fish, the disease is also related to the ingestion of crustaceans, according to the director. “With the notification of the cases, we look for food, which is seized and taken for analysis at the Central Public Health Laboratory (Lacen) to find out what caused the disease. In the case of fish, the disease may be related to an algae with toxins that it ingests ”, he explains.
Food seized in connection with cases of the disease in 2020 is still being analyzed by Lacen da Bahia and other states. In previous cases, the disease was found to be related to algae that the bull’s eye fish ingested.
In a note, Bahía Pesca claims to be in direct contact with Sesab to monitor the development of the problem and update Bahia fishermen and consumers regarding any news. We are awaiting the determinations of the competent bodies, in charge of determining the safety of fish consumption, ”says the entity.
recommendations
Sesab warns that at the first symptoms, the person should look for a health unit immediately and identify other people who may have consumed the same fish or crustacean to detect possible new cases of the disease.
Health professionals should observe the color of the urine (dark) as a warning sign and the development of rhabdomyolysis, as in this case, the patient must hydrate quickly for 48 to 72 hours. Anti-inflammatory drugs are contraindicated. In case of suspicion, the recommendation is an examination for the measurement of creatine phosphokinase (CPK), GOT and monitoring of renal function.
São Pedro asks health professionals to be vigilant to report cases of Haff’s disease in the state. With the notification, the sanitary surveillance analyzes the places where the patients have eaten or bought the food to carry out the apprehension and analysis of the fish.
On November 3, Sesab and the Salvador Municipal Health Secretariat (SMS) issued a technical note to alert health professionals about the occurrence of Haff’s disease cases so that new cases can be identified and investigated in less weather. The document cautions that images with compatible symptoms should be reported even without the possibility of performing a CPK exam.
