The Mississippi State Department of Health recently confirmed three cases of Haff disease, a rare illness caused by an unidentified toxin. The toxin was found in buffalo fish that were caught on the Yazoo River, said Liz Sharlot, director of communications for the Mississippi State Department of Health.

The three cases are members of one family who purchased the fish. Sharlot said the location where the fish was sold was not pertinent to the story.

Cooking of the fish does not reduce the risk of the disease, which can cause rhabdomyolysis. Rhabdomyolsis is a muscle injury syndrome that causes pain, stiffness and, rarely, kidney damage, the state Department of Health said.

The Department of Health said symptoms usually occur within 12 hours of consuming the fish. Symptoms include muscle weakness, pain, dry mouth, chest pain, nausea, vomiting, confusion, and dark urine. Severe symptoms typically resolve quickly though some patients complain of fatigue for months following the onset of the acute symptoms.

These were the first cases of Haff disease in Mississippi and not much is known about the toxin or its connection with the fish, Sharlot said.

Dr. Donald Jackson, a professor of fisheries with Mississippi State University, said buffalo fish are primarily found in Mississippi River drainage. Buffalo fish are caught mostly for commercial reasons and are popular to catch in the spring, Jackson said.

Buffalo fish are also found in Pearl River drainage.

Haff Disease first appeared in the United States in 1984 and there have been about 30 confirmed cases since that time, the Department of Health said.

According to a 1998 article by the Center for Disease Control, in 1997 alone, there were six cases of Haff disease in the United States among people who ate buffalo fish. Four cases were identified in California and two in Missouri.

A study published in April 2000 by the CDC said Haff Disease was first identified in 1924 near the Königsberger Haff shores along the Baltic coast where physicians recognized an outbreak of an illness that was characterized by sudden, severe muscular rigidity. In the nine years that followed, similar outbreaks mostly occurring in the summer and fall, affected an estimated 1,000 people along the coast of the Königsberger Haff. The species of fish that were commonly eaten by those affected along that coast were burbot, eel and pike.

The study said between 1934 and 1984, cases were seen in Sweden and the Soviet Union. In June 1984, the first two cases in the United States were reported. Both cases occurred in Texas. From 1984 until 1996, only four more cases were reported. Two cases were reported during that span of time were in Los Angeles and two in San Francisco. The six cases that occurred in 1997 in California and Missouri prompted an investigation by the CDC to describe the epidemiology of the 1997 U.S. cases.

The study said in regards to the 1997 cases, “All patients were hospitalized, none died, and the median hospital stay was 3 days. Clinically, five of six patients had rapid onset of generalized muscular pain and rigidity, so severe that in one case ventilation was required.”

In three of the incidents, the buffalo fish were caught commercially by fisherman from rivers in Louisiana and in one incident, the fish were caught by fishermen in rivers and lakes near St. Louis, Missouri. No specific bodies of water were identified as the origin of the implicated fish and no fish or unusual animal death rates were found in the areas where the buffalo fish were caught, the study said.

Sharlot said the three individuals from Mississippi are now doing well.

The state Department of Health advises anyone who experiences the symptoms of the disease after consuming buffalo fish harvested in Mississippi or nearby waters to seek immediate medical attention.