Haff disease

Overview
Haff disease is the development of rhabdomyolysis (swelling and breakdown of skeletal muscle, with a risk of acute kidney failure) within 24 hours of ingesting fish.

History
It was first described in 1924 in the vicinity of Königsberg on the Baltic coast, in people staying around the haff (German: lagoon).

Over the subsequent fifteen years, about 1000 cases were reported in people, birds and cats, usually in the summer and fall, and a link was made with the consumption of fish (burbot, eel and pike). Since that time, only occasional reports have appeared of the condition, mostly from the Soviet Union and Germany.

In 1997, six cases of Haff disease were reported in California and Missouri, all after the consumption of buffalo fish (Ictiobus cyprinellus). The source of the fish was traced by the Centers for Disease Control and Prevention, and studies of other fish from the same sources showed a hexane-soluble (and hence non-polar lipid) substance that induced similar symptoms in mice; other food-borne poisons commonly found in fish could not be detected.

Poison
The exact nature of the poison is still unclear. It cannot be inactivated by cooking, as all six CDC cases had consumed cooked or fried fish.

Palytoxin has been proposed as a disease model.

It has been suggested that the toxin may have thiaminase activity (i.e. it degrades thiamine, also known as vitamin B1).