a Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health , Southeast University , Nanjing , China.
b Nanjing Municipal Center for Disease Control and Prevention , Nanjing , Jiangsu , China.
Clin Toxicol (Phila). 2019 May;57(5):331-337. doi: 10.1080/15563650.2018.1529318. Epub 2018 Nov 17.
This paper reports a detailed epidemiological investigation of a large Haff disease outbreak in Nanjing, China, including laboratory analysis of water, river sediment, and fish.
Structured questionnaires were administered to all case-patients. An unmatched case-control study was conducted to identify the factors affecting the incidence of Haff disease. Thirteen samples of crayfish, together with four samples of water and four samples of sediment were collected and sent for laboratory analysis.
The disease onset of 494 patients occurred between 2 am on 30 June 2016 and 3 am on 29 August 2016. The median incubation time for onset of symptoms after crayfish ingestion was 7.1 hours (range: 1-20 hours). All patients presented with or developed local or diffuse myalgia. However, no kidney injury was observed. Serum creatinine kinase was elevated in all patients (mean: 4614 U/L, median: 2000 U/L, range: 81-55200 U/L). The average number of crayfish consumed by patients on the day of illness was 20 (2-80). The case-control study revealed that eating a large quantity of crayfish, drinking alcohol, and eating the crayfish head and/or intestines were associated with an increased risk of disease. Chemical analysis of crayfish, river water and sediment did not identify known or novel toxins including anticoccidiosis drugs, niclosamide, organophosphorus pesticides, and microcystins.
An outbreak of Haff Disease was associated with consumption of crayfish from the Yangtze River and its surrounding water system. Eating a large quantity of crayfish, eating the head and/or intestines, and consuming alcohol with the crayfish were associated with the development of Haff Disease.
本文报道了中国南京一起大规模哈夫病暴发的详细流行病学调查，包括对水、河底沉积物和鱼类的实验室分析。
对所有病例进行了结构化问卷调查。采用病例对照研究来确定影响哈夫病发病率的因素。共采集了 13 只小龙虾样本，以及 4 份水样和 4 份底泥样本进行实验室分析。
494 名患者的发病时间为 2016 年 6 月 30 日 2 时至 8 月 29 日 3 时。食入小龙虾后症状出现的中位潜伏期为 7.1 小时（范围：1-20 小时）。所有患者均出现局部或弥漫性肌痛，但未见肾损伤。所有患者的血清肌酸激酶均升高（均值：4614 U/L，中位数：2000 U/L，范围：81-55200 U/L）。发病当日患者平均食用小龙虾 20 只（2-80 只）。病例对照研究显示，大量食用小龙虾、饮酒以及食用小龙虾头和/或虾肠与发病风险增加相关。对小龙虾、河水和底泥的化学分析未发现已知或新型毒素，包括抗球虫病药物、硝氯酚、有机磷农药和微囊藻毒素。
哈夫病暴发与食用长江及其周边水系的小龙虾有关。大量食用小龙虾、食用头和/或虾肠、以及与小龙虾一起饮酒与哈夫病的发生有关。
