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Haff Disease After Eating Salmon

Ricky L. Langley, MD, MPH, William H. Bobbitt, III, MD
Volume: 100 Issue: 11 November, 2007

Abstract:

While fish consumption is considered a component of a heart-healthy diet, many illnesses have been associated with eating contaminated fish. The authors describe two cases of muscle weakness and rhabdomyolysis that occurred after eating salmon. Cases of rhabdomyolysis and muscle weakness after consumption of fresh water fish have rarely been reported in the United States but have been frequently reported from the Baltic region. This illness is known as Haff disease. While the etiology is unknown, it is felt to be a toxin. Palytoxin, found in marine fish, has been associated with rhabdomyolysis, and may serve as a model for further study of the suspected toxin responsible for rhabdomyolysis after consumption of fresh water fish. If a case of Haff disease is suspected, contact the Centers for Disease Control and Prevention and collect any uneaten fish, which may be sent for laboratory analysis.

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References:

1. Mozaffarian D, Rimm E. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006;296:1885–1899.
 
2. Marszalek JR, Lodish HF. Docosahexaenoic acid, fatty acid-interacting proteins, and neuronal function: breastmilk and fish are good for you. Annu Rev Cell Dev Biol 2005;21:633–657.
 
3. Ahmed F, ed. Seafood Safety. Washington, DC, National Academy Press, 1991.
 
4. Powell P. Minimata disease story of mercury's malevolence. South Med J 1991;84:1352–1358.
 
5. Hallegraeff G. Harmful algal blooms: a global overview. In: Hallegreff G, Anderson D, Cembella A, eds.Manual on Harmful Marine Microalgae. Paris, UNESCO Publishing, 2003, pp 25–49.
 
6. Landsberg JH, Hall S, Johannessen JN, et al. Saxitoxin puffer fish poisoning in the United States, with the first report of Pyrodinium bahamense as the putative toxin source. Environ Health Perspect2006;114:1502–1507.
 
7. Centers for Disease Control and Prevention. Haff disease associated with eating buffalo fish-United States, 1997. MMWR Morb Mortal Wkly Rep 1998;47:1091–1093.
 
8. Buchholz U, Mouzin E, Dickey R, et al. Haff disease: from the Baltic Sea to the US shore. Emerg Infect Dis 2000;6:192–195.
 
9. Krishna N, Wood J. It looked like a myocardial infarction after eating crawfish . . . ever heard of Haff disease? Louisiana Morbidity Report May-June 2001;12:1–2.
 
10. Aassmann H, Bielenstein H, Habs H, et al. Beobachtungenund Untersuchungen bei der Haffkrankheit 1932 (Observations and investigations about Haff disease 1932). Dtsch Med Wochenschr1933;1:122–126.
 
11. Zu Jeddeloh B. Haffkrankheit (Haff disease) Ergebnisse in der innren Medizen. 1939;57:138–182.
 
12. Lentz O. Uber die Haffkrankheit (About Haff disease). Med Klin 1925;1:4–8.
 
13. DiNubile M, Hokama Y. The ciguatera poisoning syndrome from farm-raised salmon. Ann Intern Med1995;122:113–114.
 
14. Okano H, Masouka M, Kamei S, et al. Rhabdomyolysis and myocardial damage induced by palytoxin, a toxin of blue humphead parrotfish. Intern Med 1998;37:330–333.
 
15. Taniyama S, Mahmud Y, Terada M, et al. Occurrence of a food poisoning incident by palytoxin from a serranid Epinephelus sp in Japan. J Nat Toxins 2002;11:277–282.
 
16. Kodama A, Hokama Y, Yasumoto T, et al. Clinical and laboratory findings implicating palytoxin as cause of ciguatera poisoning due to Decapterus macrosoma (mackerel). Toxicon 1989;27:1051–1053.
 
17. Alcala A, Alcala L, Garth J, Yasumura D, et al. Human fatality due to ingestion of the crab Demania reynaudii that contained a palytoxin-like toxin. Toxicon 1988;26:105–107.
 
18. Kasuhara K, Nishiura R, Yazawa S, et al. Rhabdomyolysis induced by ostraciid fish poisoning.Nippon Nakia Gakkai Zasshi 2005;94:750–752.
 
19. Blanco J, Zabalaza M, Salcedo J. Rhabdomyolysis of infectious and noninfectious causes. South Med J 2002;95:542–544.

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