The states of Amazonas and Bahia have registered an increase in people with Haff syndrome, popularly known as ‘black urine disease’. There are already 25 cases under analysis, 19 in the city of Itacoatiara, which is 176 km from Manaus, and six in five municipalities in Bahia: Alagoinhas, Simões Filho, Maraú, Mata de São Jorge and Salvador. The health and epidemiological surveillance authorities of both places are investigating the origin of the outbreak.
The disease is usually caused after eating poorly preserved fish and shellfish. “It is a very rare disease, and it is caused by a toxin present in fish and crustaceans. This toxin causes an injury to the muscles, called rhabdomyolysis. This injury releases the myoglobin protein, which falls into the bloodstream and overloads the kidneys”, he explains infectologist Ana Senni Rodrigues.
According to the FVS -RCP (Amazon Health Surveillance Foundation – Dr. Rosemary Costa Pinto), rhabdomyolysis can also happen after trauma, excessive physical activity, seizures, consumption of alcohol and other drugs and infections.
In Amazonas, the suspicion of health surveillance is that those infected have consumed freshwater fish. Last Thursday (26), the FVS sent a technical team to Itacoatiara to monitor the patients. Of the 19 chaosa, eight are hospitalized, seven at the José Mendes Regional Hospital, in Itacoatiara, and one at the Doctor Heitor Vieira Dourado Tropical Medicine Foundation (FMT-HVD), in Manaus.
Symptoms and Treatment
Symptoms of the disease are: body aches, difficulty walking, body numbness, and change in urine color and quantity due to the release of myoglobin protein. The effects of ingesting the toxin appear two to 24 hours after eating.
“The toxin mainly affects the muscular system and, as a result, compromises the kidney. The urine is dark because of the protein called myoglobin that we have in the muscle, it has the same blood type, as a component of hemoglobin, and that is why it becomes dark “says Anna Senni.
There is no medicine that neutralizes the action of the toxin, so the treatment is clinical. “There is no specific treatment, so the patient is treated based on the pain and the problem he presents. If he has an altered kidney, he will treat with hemodialysis, hydrate. If he has muscle pain, he will take care of the pain”, stresses the infectologist.
Last year, Bahia had an outbreak of the syndrome. There were 40 confirmed cases in the cities of Salvador, Feira de Santana, Camaçari, Entre Rios, Dias D’Ávila and Candiba.