Amazons register 44 cases and one death

Amazon health authorities are on the alert after the increase in the number of cases of rhabdomyolysis — associated with the Disease of haff, known as “black urine disease” — in the state. Altogether, there are 44 reported cases, one of which resulted in death, since the 21st of August. The information is from the Amazonas Health Surveillance Foundation.

The municipalities that register cases are Itacoatiara (34 cases and one death), Silves (four cases), Manaus and Parintins (with two cases each), Caapiranga and Autazes, with one case in each. Of the total number of patients, ten are still hospitalized. All are from Itacoatiara.

The only death confirmed by the disease so far was that of a 51-year-old woman, who had been hospitalized since Friday (27) at the José Mendes Regional Hospital, from Vila do Novo Remanso, also in Itacoatiara. She died on Saturday.

According to the director-president of the foundation, Cristiano Fernandes, the epidemiological investigation of the cases is being reinforced. “All reported cases may be associated with fish ingestion. There is still no consensus in the scientific community about the toxin that contaminates fish. Surveillance is focusing on early detection of cases and monitoring so that there is adequate clinical management for patients “, explains.

Rhabdomyolysis is a clinical-laboratory syndrome that results from muscle injury with the release of intracellular substances into the bloodstream. It usually occurs in healthy people, following trauma, excessive physical activity, seizures, consumption of alcohol and other drugs, infections and ingestion of contaminated food, including fish.

What is Haff disease?

Its exact origin is still mysterious, but researchers found unanimity: all patients, even outside Brazil, consumed some animal that lives in water, often fresh water.

Some experts have raised the suspicion that it is caused by bacteria, but this is considered unlikely. The most accepted hypothesis is that the disease is caused by some type of toxin, not yet identified, that contaminates the food and remains active in raw food or even after being cooked, fried or roasted.


Symptoms of Haff’s disease usually appear between two and 24 hours after eating fish or shellfish.

In addition to the discomfort felt by the body and the dark color of urine, the condition can cause kidney failure. This is because the muscles, when injured, release a substance called myoglobin into the blood, which can damage the kidneys (and is also responsible for black pee).

The most serious sequelae, however, usually only happen if the patient does not have fast and efficient care. Other common sensations are shortness of breath, numbness and loss of body strength.

Tests can be ordered to confirm the diagnosis, but as it is not known exactly what causes the disease, the most important thing will be to hear the patient’s history. As it is rare, identifying the disease can be difficult, but the recommendation is that a health professional be sought as soon as symptoms appear.