E Mouzin, MD, Pasteur Institute, Paris, France. Although the etiology was not determined, epidemiologic investigations linked illness to ingestion of fish, especially burbot. All U.S. cases have been associated with eating buffalo fish. Haff disease typically presents as a paroxysm of rhabdomyolysis, with accompanying muscle tenderness, rigidity, and dark brown urine. However, as in patient 3, milder presentations also occur.
Diagnosis is based on a compatible clinical history.
Possible complications include electrolyte disturbances, renal failure, and disseminated intra-vascular coagulation. Symptoms usually resolve within 2-3 days. Clinicians and public health practitioners are encountering an increasing variety of foodborne illnesses, in part because of a diversification of food preparation and eating habits. International travelers, members of ethnic groups with unique cuisines, and consumers of both imported and domestic specialty food items may be at risk for foodborne illnesses that are rare or have not been reported previously in the United States. Clinicians should be aware of food exposures that pose a risk to their patients and routinely obtain food histories, even from those patients whose illness may not appear to be food-related.