Haff disease in the pandemic COVID-19 period in Brazil

Gabriella De Almeida Campos,Carmem Lúcia Carneiro Leão De Biase,Valtuir Barbosa Felix,Euclides Maurício Trindade-Filho,Sabrina Jurema Da Rocha Dantas,Emanuel Guilherme De Almeida Carvalho,Magnúcia De Lima Leite,Sura Amélia Barbosa Felix Leão,Andrezza Thaís Da Silva Lino,Elvys Blayne Sales De Souza,Rafael Vinicius De Almeida Tabosa,José Claudio Da Silva

doi:10.33448/rsd-v10i14.22175

Abstract

Objective: This study describes and characterize the cases of Haff disease reported in Brazil during the COVID-19 pandemic period. Descriptive and cross-sectional study using public data from the National Center for Strategic Information and Response in Health Surveillance nacional. The Risk Communication number 17 of 09/15/2021 was accessed. The description of suspected cases was extended to all Brazilian states where notifications occurred, from January 1, 2020, to September 15, 2021. There was an increase in cases of Haff's disease in Brazil, from 2020 onwards, with 46 in the Northeast region of Brazil. Eighty-five cases and three deaths were reported between January and September 2021 in the North, Northeast, South and Midwest regions. Most cases occurred in regions of greater heat such as the coastal region of the Northeast and around regions of the Amazon River Basin. A critical period for coping with the SARS-CoV-2 virus pandemic in Brazil, cases of disease of Haff could be reported in various regions of country. Despite the etiological suspicions, studies, and follow-up of the cases, it is still not possible to affirm that the disease is caused by biomolecules of the Palytoxin-Like Toxins group. The possible identification of the responsible toxin(s) will be essential for a complete understanding of the etiopathogenic mechanism of the disease and adequate development of prevention, treatment, and cure measures.

Highlights

For the first time an outbreak of an unknown disease that occurred along the Baltic coast and near the coast of Königsberg Haff ( Kaliningrad, Russia) in the year 1924 was recognized
This study describes and characterize the cases of Haff disease reported in Brazil during the COVID-19 pandemic period
During the period of the COVID-19 pandemic, there was a growing increase in cases of Haff disease in Brazil, starting in 2020 with 51 cases reported to CIEVS Nacional, from the northeast region of Brazil, with 5 of them subsequently discarded; and 85 notified between January and September 2021, totaling 131 cases in less than 2 years

Summary

Introduction

For the first time an outbreak of an unknown disease that occurred along the Baltic coast and near the coast of Königsberg Haff ( Kaliningrad, Russia) in the year 1924 was recognized. A second outbreak occurred a few years later around the shore of the Königsberg lagoon in which about a thousand people developed symptoms of Haff's disease. Fever, splenomegaly or hepatomegaly are generally not observed (Jeddeloh e Haffkrankheit, 1939; Júnior et al, 2013; dos Santos et al., 2009). In addition to being common in Haff's disease, known as “black urine disease”, rhabdomyolysis can have other causes such as: intense physical activity, use of medications and drugs, infectious diseases, electrolyte changes, etc (Rosa et al, 2005; Qian e Sha, 2018; Yang et al, 2018)

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