Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance
Summary: Background: From late 2016 to early 2021, cases of Haff disease, a rare cause of rhabdomyolysis, possibly due to poisoning by palytoxin-like compounds in seafood, were detected in Salvador, Brazil. Surveillance was established to detect additional cases aiming at describing the clinical ch...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Elsevier
2022
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/9fb41ce3a3f64ddaa044f5faa8990327 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:9fb41ce3a3f64ddaa044f5faa8990327 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:9fb41ce3a3f64ddaa044f5faa89903272021-12-02T05:04:38ZHaff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance2667-193X10.1016/j.lana.2021.100092https://doaj.org/article/9fb41ce3a3f64ddaa044f5faa89903272022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667193X21000880https://doaj.org/toc/2667-193XSummary: Background: From late 2016 to early 2021, cases of Haff disease, a rare cause of rhabdomyolysis, possibly due to poisoning by palytoxin-like compounds in seafood, were detected in Salvador, Brazil. Surveillance was established to detect additional cases aiming at describing the clinical characteristics of the cases, identifying associated factors, estimating disease attack rate, and investigating the presence of biotoxins and trace metals in selected fish specimens obtained from cases. Method: Between December/2016-January/2021, surveillance investigated Haff disease suspected cases, and obtained clinical and fish samples to test. Findings: Of 65 cases investigated during the 2016-2017 outbreak, 43 (66%) had high creatine phosphokinase (CPK) levels. Among those with laboratory-confirmed rhabdomyolysis, 38 (88%) were hospitalized, 11 (26%) required intensive care, and three (7%) dialysis. Ingestion of marine fish 24h before disease onset was reported by 74% of the cases with elevated CPK and by 41% of those without CPK measurement (P=0·02). Attack rate for individuals who ate fish related to the outbreak was 55%. Following this outbreak, surveillance identified 12 suspected cases between 2017-2019, and a second outbreak in 2020-2021, with 16 laboratory-confirmed rhabdomyolysis patients (five required intensive care; one died). No traces of ciguatoxins and metals were detected in fish specimens obtained in 2016, found to be Seriola rivoliana. Some fish samples from 2020 were screened for palytoxin (PlTX)-like compounds and contained detectable levels of molecule fragments characteristics of isobaric PlTX, ovatoxin-a (OVTX-a), OVTX-b and OVTX-d. Interpretation: These findings support the hypothesis that compounds related to PlTX accumulated in marine fish may be the toxic agent causing the disease. Haff disease is a life-threatening condition, requiring clinical suspicion for patients with sudden-onset myalgia following fish ingestion. Suspected cases should be reported to health authorities for investigation.Cristiane Wanderley CardosoMonaise Madalena Oliveira e SilvaAntônio Carlos BandeiraRenan Bispo SilvaAna Paula Pitanga Barbuda PratesÊnio Silva SoaresJosé Jorge Moreno SilvaLázaro José Rodrigues de SouzaMirela Maisa da Silva SouzaMarcela Almeida MuhanaRosildete Silva Santos PiresJosé Fernando Araujo NetoManuela Sampaio Souza SantosLuiz Laureno Mafra JuniorThiago Pereira AlvesMathias Alberto SchrammGuilherme Sousa RibeiroElsevierarticleRhabdomyolysisHaff diseasefoodborne diseasepalytoxinpublic healthglobal healthPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Americas, Vol 5, Iss , Pp 100092- (2022) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Rhabdomyolysis Haff disease foodborne disease palytoxin public health global health Public aspects of medicine RA1-1270 |
| spellingShingle |
Rhabdomyolysis Haff disease foodborne disease palytoxin public health global health Public aspects of medicine RA1-1270 Cristiane Wanderley Cardoso Monaise Madalena Oliveira e Silva Antônio Carlos Bandeira Renan Bispo Silva Ana Paula Pitanga Barbuda Prates Ênio Silva Soares José Jorge Moreno Silva Lázaro José Rodrigues de Souza Mirela Maisa da Silva Souza Marcela Almeida Muhana Rosildete Silva Santos Pires José Fernando Araujo Neto Manuela Sampaio Souza Santos Luiz Laureno Mafra Junior Thiago Pereira Alves Mathias Alberto Schramm Guilherme Sousa Ribeiro Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| description |
Summary: Background: From late 2016 to early 2021, cases of Haff disease, a rare cause of rhabdomyolysis, possibly due to poisoning by palytoxin-like compounds in seafood, were detected in Salvador, Brazil. Surveillance was established to detect additional cases aiming at describing the clinical characteristics of the cases, identifying associated factors, estimating disease attack rate, and investigating the presence of biotoxins and trace metals in selected fish specimens obtained from cases. Method: Between December/2016-January/2021, surveillance investigated Haff disease suspected cases, and obtained clinical and fish samples to test. Findings: Of 65 cases investigated during the 2016-2017 outbreak, 43 (66%) had high creatine phosphokinase (CPK) levels. Among those with laboratory-confirmed rhabdomyolysis, 38 (88%) were hospitalized, 11 (26%) required intensive care, and three (7%) dialysis. Ingestion of marine fish 24h before disease onset was reported by 74% of the cases with elevated CPK and by 41% of those without CPK measurement (P=0·02). Attack rate for individuals who ate fish related to the outbreak was 55%. Following this outbreak, surveillance identified 12 suspected cases between 2017-2019, and a second outbreak in 2020-2021, with 16 laboratory-confirmed rhabdomyolysis patients (five required intensive care; one died). No traces of ciguatoxins and metals were detected in fish specimens obtained in 2016, found to be Seriola rivoliana. Some fish samples from 2020 were screened for palytoxin (PlTX)-like compounds and contained detectable levels of molecule fragments characteristics of isobaric PlTX, ovatoxin-a (OVTX-a), OVTX-b and OVTX-d. Interpretation: These findings support the hypothesis that compounds related to PlTX accumulated in marine fish may be the toxic agent causing the disease. Haff disease is a life-threatening condition, requiring clinical suspicion for patients with sudden-onset myalgia following fish ingestion. Suspected cases should be reported to health authorities for investigation. |
| format |
article |
| author |
Cristiane Wanderley Cardoso Monaise Madalena Oliveira e Silva Antônio Carlos Bandeira Renan Bispo Silva Ana Paula Pitanga Barbuda Prates Ênio Silva Soares José Jorge Moreno Silva Lázaro José Rodrigues de Souza Mirela Maisa da Silva Souza Marcela Almeida Muhana Rosildete Silva Santos Pires José Fernando Araujo Neto Manuela Sampaio Souza Santos Luiz Laureno Mafra Junior Thiago Pereira Alves Mathias Alberto Schramm Guilherme Sousa Ribeiro |
| author_facet |
Cristiane Wanderley Cardoso Monaise Madalena Oliveira e Silva Antônio Carlos Bandeira Renan Bispo Silva Ana Paula Pitanga Barbuda Prates Ênio Silva Soares José Jorge Moreno Silva Lázaro José Rodrigues de Souza Mirela Maisa da Silva Souza Marcela Almeida Muhana Rosildete Silva Santos Pires José Fernando Araujo Neto Manuela Sampaio Souza Santos Luiz Laureno Mafra Junior Thiago Pereira Alves Mathias Alberto Schramm Guilherme Sousa Ribeiro |
| author_sort |
Cristiane Wanderley Cardoso |
| title |
Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| title_short |
Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| title_full |
Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| title_fullStr |
Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| title_full_unstemmed |
Haff Disease in Salvador, Brazil, 2016-2021: Attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| title_sort |
haff disease in salvador, brazil, 2016-2021: attack rate and detection of toxin in fish samples collected during outbreaks and disease surveillance |
| publisher |
Elsevier |
| publishDate |
2022 |
| url |
https://doaj.org/article/9fb41ce3a3f64ddaa044f5faa8990327 |
| work_keys_str_mv |
AT cristianewanderleycardoso haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT monaisemadalenaoliveiraesilva haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT antoniocarlosbandeira haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT renanbisposilva haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT anapaulapitangabarbudaprates haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT eniosilvasoares haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT josejorgemorenosilva haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT lazarojoserodriguesdesouza haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT mirelamaisadasilvasouza haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT marcelaalmeidamuhana haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT rosildetesilvasantospires haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT josefernandoaraujoneto haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT manuelasampaiosouzasantos haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT luizlaurenomafrajunior haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT thiagopereiraalves haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT mathiasalbertoschramm haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance AT guilhermesousaribeiro haffdiseaseinsalvadorbrazil20162021attackrateanddetectionoftoxininfishsamplescollectedduringoutbreaksanddiseasesurveillance |
| _version_ |
1718400610342010880 |