The crawfish incident reveals: The mystery of Huff disease has not been cracked for more than 80 years

The mystery of “Huff’s disease” has not been resolved after more than 80 years of illness in patients with aquatic products, and it is suspected that the self-contained toxins in aquatic products are disclosed in a joint press conference held yesterday by the China CDC and the Nanjing Food Safety Commission Office. The suspected cases of crayfish in Nanjing appear to belong to Haff disease.

So what kind of disease is Huff disease? According to Wu Yongning, a researcher at the Institute for Nutrition and Food Safety at the Chinese Center for Disease Control and Prevention, in the summer and autumn of 1924, there was an epidemic of acute toxic muscle disease in the Hav waterfront in the Baltic Sea. It manifested as sudden and severe muscle stiffness and pain without central nervous system. Abnormalities, fever, and hepatosplenomegaly, some patients have brownish urine, the clinical manifestations are very different. Most patients quickly returned to normal, with only a few severe deaths. In the following 9 years, approximately 1000 patients were found in the same season and in the same area, and these patients were found to be related to draught products.

What is the disease of Huff disease?

High incidence in summer and autumn, crayfish, squid, squid, and other diseases can be caused yesterday, the Health Department of Jiangsu Province, the website specifically introduced Huff disease. The website stated that in 1924, the case of rhabdomyolysis syndrome of unknown origin caused by the consumption of aquatic products in foreign countries was reported for the first time in the world. It occurred in the Huff region along the Baltic Sea and was called Haff disease. The disease is suspected of being associated with an unidentified toxin. The typical clinical manifestation of Huff disease is a sudden onset of rhabdomyolysis, with muscle tenderness, stiffness, soy sauce, urine, and the like.

On August 29 of this year, a member of the Scientific Squirrel Association and a Master of Science in Biology wrote an article in the media entitled "Huff disease or "myositosis" behind the scenes". The article pointed out that the Nanjing "crayfish caused rhabdomyolysis" incident and The relatively concentrated rhabdomyolysis cases that occurred in the United States in the late 1990s are extremely similar.

Between March and August 1997, 6 cases of severe soreness such as muscle soreness occurred after eating largemouth bass. After the outbreak of the epidemic, the US Food and Drug Administration (FDA), the local health and environment departments participated in the investigation and research, and finally locked the "backstage behind the scenes" of the outbreak to Huff disease.

Huff disease is a disease of doubt. Summer and autumn are the high incidence of Huff disease. Freshwater salmon, squid, pike, crayfish and so on all have pathogenic records. The affected areas include Sweden, the Soviet Union, the United States, Brazil and Germany. In early August 2000, patients with Huff disease caused by eating paralysis appeared in Beijing. The specific pathogenic factors of Huff disease are still unknown, and only know that it is related to ingestion of aquatic products.

“Haf disease is currently caused by the consumption of aquatic products. According to foreign reports, it will seriously cause renal failure. The patient admitted to our hospital has not yet experienced one case of kidney failure, mainly muscle soreness, and back muscle aches and pains. "Xing Changying, chief physician of the People's Hospital of Jiangsu Province, pointed out that the current cases found in this hospital are relatively lighter than foreign reports.

What is the cause of Huff disease?

It is not yet clear that the suspect may be "Anemone Toxin"

Since the first outbreak of Huff disease in 1924, the cause of the disease has been discussed in various countries and no exact cause has been found. Then, what investigations did American investigators do on 6 cases?

In the article, Yu Shengzhi pointed out that the history shows that the patient had consumed aquatic products within 24 hours before the onset of illness. The two people vomited after eating, the vomiters had milder symptoms, and the biochemical tests were also lower, so the possibility of food-borne toxins was more likely. At the same time, investigators also analyzed the patient's food. The source, how to clean it, and how to cook it are also in progress. As a result, it was found that some of the six people who ate large mouthed herring were from supermarkets and some from the market, but they all cooked at high temperatures. Toxins from the corruption of fish were eliminated.

Subsequently, environmental regulators began to search for the source of food and to investigate the location and number of large-mouthed fish. They tested other fish samples from these fish fishing areas and eliminated most of the known toxins.

Finally, the researchers conducted toxicological tests of unknown ingredients. Raw fish and cooked fish were extracted with three different solvents, and then the extracts were administered to rats and injected into their abdominal cavity. As a result, an extract of cooked fish caused muscle damage and similar symptoms such as soy sauce urine. The researchers finally concluded that what caused Huff disease was an unknown toxin that was soluble in nonpolar lipids. The toxin remained stable at high temperatures and could not be eliminated by cooking. At present, researchers believe that the chief "suspected offenders" are sea turtle toxins (palytoxin) and similar toxins in freshwater fish.

After this investigation, researchers have a deeper understanding of Huff disease. In 2001, within 30 miles of Louisiana in the United States, rhabdomyolysis occurred within 9 to 7 days after eating 9 crayfish within 3 to 16 hours. The doctor quickly judged Huff disease according to the results of previous studies and quickly gave symptomatic treatment.

Concerned about rhabdomyolysis after strenuous exercise can also cause "muscle lysis"

Reporters learned that Nanjing treats patients with rhabdomyolysis every year, but the incidence is not high, but mostly based on dissemination. Huang Yilong, deputy director of the Nanjing Municipal Bureau of Health, once said that because the incidence of rhabdomyolysis is not high and it is not included in the monitoring category, it is not easy to judge whether this year's patients have risen sharply. However, clinicians in Nanjing generally reported that patients with rhabdomyolysis this year are particularly concentrated and many are family members.

Strenuous exercise, strong physical labor, or traumatic compression, long-term use of antihypertensive drugs, asthma drugs, or psychotropic drugs may also cause rhabdomyolysis. In 2002, two recruits developed rhabdomyolysis after a 5 km trail running. In the same way, clinically there have been some small white-collar workers who usually do not love sports and blitz on the holidays. A young man once bet on someone and was forced to do more than 400 push-ups in a row. He was overexerted and the result was "dissolved" muscles.

Similarly, before the "lobster gate", crushing and crushing were also important causes of rhabdomyolysis. Experts point out that the body caused by any reason, especially the pressure on the limb, can cause rhabdomyolysis. There are also doctors who have seen rhabdomyolysis in drug users.

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