Next Article in Journal
Snake Genome Sequencing: Results and Future Prospects
Previous Article in Journal
Indoxyl Sulfate—Review of Toxicity and Therapeutic Strategies
Review

The Emergence and Epidemiology of Haff Disease in China

1
Division of Clinical Pharmacology and Drug and Poisons Information Bureau, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
2
Centre for Food and Drug Safety, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
3
Prince of Wales Hospital Poison Treatment Centre, Hong Kong, China
Academic Editor: Vítor Vasconcelos
Toxins 2016, 8(12), 359; https://doi.org/10.3390/toxins8120359
Received: 18 October 2016 / Revised: 23 November 2016 / Accepted: 28 November 2016 / Published: 1 December 2016
(This article belongs to the Section Marine and Freshwater Toxins)
Haff disease is a rare syndrome of unexplained myalgia and rhabdomyolysis occurring within 24 h of consumption of certain types of cooked freshwater fish or crustacean. It is caused by a yet unidentified heat-stable toxin. In the present review of published case studies and official press releases, the main objective is to report the emergence and epidemiology of Haff disease in China. Haff disease first occurred in Beijing in 2000 and in Lianzhou and Liannan, Guangdong Province in 2009. Subsequent outbreaks mostly occurred in the Jiangsu Province—Nanjing, Yangzhou, Huai’an, and Yancheng. Isolated outbreaks occurred in other cities since 2010—Shijiazhuang, Yueyang, Shanghai, Wuhu, Baoding, Shenzhen, and Hong Kong (imported cases from Shenzhen). Outbreaks occurred predominately in the summer. Crayfish accounted for almost all the outbreaks. Two large outbreaks occurred in Lianzhou and Liannan in 2009 (n = 54) after eating pomfrets and in Nanjing in 2010 (n = 42) after eating crayfish. Other reports or outbreaks involved only 1–9 subjects (median 2 subjects). Variability in individual susceptibility and attack rates were noted, with many subjects remaining asymptomatic despite sharing the same seafood meal as the index cases. Adults were predominately involved. Symptoms occurred within 3–20 h of seafood ingestion, including myalgia, weakness, and, less frequently, nausea, vomiting, abdominal pain, and diarrhea. Myalgia and muscle weakness should normally subside within 2–3 days. Serum creatine phosphokinase became normal within 5–6 days. Abnormal renal function was uncommon. Serious complications (renal failure, multi-organ failure, and prolonged myopathy) and death were rare. In any subjects with unexplained myalgia and rhabdomyolysis, seafood consumption should be included in the history. All suspected cases of Haff disease, including milder presentations, should be reported to public health authorities. View Full-Text
Keywords: Haff disease; rhabdomyolysis; crayfish; China Haff disease; rhabdomyolysis; crayfish; China
Show Figures

Figure 1

MDPI and ACS Style

Chan, T.Y.K. The Emergence and Epidemiology of Haff Disease in China. Toxins 2016, 8, 359. https://doi.org/10.3390/toxins8120359

AMA Style

Chan TYK. The Emergence and Epidemiology of Haff Disease in China. Toxins. 2016; 8(12):359. https://doi.org/10.3390/toxins8120359

Chicago/Turabian Style

Chan, Thomas Y.K. 2016. "The Emergence and Epidemiology of Haff Disease in China" Toxins 8, no. 12: 359. https://doi.org/10.3390/toxins8120359

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop