Haff disease is a syndrome of painful muscle stiffness and rhabdomyolysis, often accompanied by myoglobinuria, following the consumption of cooked freshwater and brackish water fish.
Since Haff disease is characterized by vomiting and myalgia without fever following mean incubation periods of 8 hours, a heat-stable toxin has always been suspected as the cause.
Internet search engines including Pub Med, Medline, Ovid, Google[R], and Google Scholar[R] were queried with the key words, "Haff disease, seafood poisoning, and rhabdomyolysis", in order to identify all reports of Haff disease in the US with the first two cases reported in 1984 and the last two cases reported in 2014.
Health officials in Chicago and Cook County are reporting two people who consumed the fish have been seen at the hospital for suspected cases of Haff disease.
Haff disease is a swelling and breakdown of skeletal muscle thought to be caused by a toxin sometimes found in buffalo fish in the Mississippi River.
Outbreaks resembling Haff disease were described in Sweden and the Soviet Union between 1934 and 1984 (2, 3).
Outbreaks of Haff disease have never been reported in Brazil.
A third report concerned Haff disease
, which has a case-fatality rate of 1% (9).
Haff disease is a syndrome of unexplained rhabdomyolysis following consumption of certain types of fish, it is caused by an unidentified toxin.
The first reported case of Haff disease in the United States occurred in Texas in 1984 (M Tormey, Los Angeles Department of Health Services, personal communication, 1997), five additional cases were reported in California during 1984-1986 All U S cases have been associated with eating buffalo fish.
Although Haff disease is traditionally an epidemic foodborne illness, these six cases occurred in two clusters and as one sporadic case.
Among these was arsenic poisoning (4), which is still cited in modern medical dictionaries as the cause of Haff disease (5).