Last week a woman bought fish from a Brooklyn market and prepared it for herself and her mother. The next day the younger woman, who ate more of the fish, vomited and experienced muscle pain severe enough that she made a visit to a nearby hospital. Laboratory tests showed muscle enzyme levels 300 times normal, evidence of rhabdomyolysis, the release of the muscle protein myoglobin into the bloodstream. She had none of the usual risk factors for rhabdomyolysis such as extreme muscle overuse, trauma, muscle compression or drugs. Within a few hours her mother presented to the same hospital with similar, but less severe symptoms. Both women were treated and are expected to make full recoveries. No additional cases have occurred.
First reported in 1924, Haff disease gets its name from the Koenigsberg Haff, a brackish inlet of the Baltic Sea where the syndrome was first described. The syndrome is characterized by the sudden onset of severe rhabdomyolysis with nausea, vomiting, chest pain, shortness of breath, and pain with light touch. In Europe Haff disease has been associated with consumption of burbot, eel, and pike. In the United States 23 cases have been reported since 1984 and have followed the consumption of Buffalo fish, crayfish, and salmon. Like paralytic shellfish and ciguatera poisoning, a heat-stabile toxin is suspected but has yet to be identified.
The Buffalo Fish (Ictiobus cyprinellus) is a fresh-water fish and was reported to have been eaten by the two NYC Haff disease cases. Samples of fish from the market have been sent for testing and a temporary embargo has been placed while a trace-back to the source is underway.
No comments:
Post a Comment