Amazonas state suffers from outbreak of ‘black urine disease’

The northern Brazilian state of Amazonas recorded a further 11 cases of rhabdomyolysis, known locally as “black urine disease” — not to be confused with alkaptonuria, which is given the same nickname. So far, 44 cases were confirmed over a 10-day period in five Amazonas cities, with the municipality of Itacoatiara seeing 34 cases and the first death caused by the disease. 

Rhabdomyolysis is a potentially life-threatening syndrome characterized by the destruction of muscle fibers. It usually occurs in healthy people, following trauma, excessive physical activity, seizures, consumption of alcohol and other drugs, infections, and the ingestion of contaminated food. 

When the syndrome appears after the consumption of fish and shellfish, it is associated with Haff disease, which is still poorly understood. In the cases registered in Amazonas state, the affected patients had reportedly consumed popular local fish such as pirarucu, tambaqui, and pirapitinga. 

Among the main symptoms of rhabdomyolysis are muscle and chest pain, shortness of breath, nausea, dizziness, and weakness, as well as characteristically coffee-colored urine.

Another six cases of the disease were recorded last month in Bahia. The Northeast state suffered an outbreak of the disease last year, with 40 confirmed cases.

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