Childhood hemolytic uremic syndrome, United Kingdom and Ireland.
We conducted prospective surveillance of childhood hemolytic uremic syndrome (HUS) from 1997 to 2001 to describe disease incidence and clinical, epidemiologic and microbiologic characteristics. We compared our findings, where possible, with those of a previous study conducted from 1985 to 1988. The average annual incidence of HUS for the United Kingdom and Ireland (0.71/100,000) was unchanged from 1985 to 1988. The overall early mortality had halved, but the reduction in mortality was almost entirely accounted for by improved outcome in patients with diarrhea-associated HUS. The principal infective cause of diarrhea-associated HUS was Shiga toxin-producing Escherichia coli O157 (STEC O157), although in the 1997-2001 survey STEC O157 phage type (PT) 21/28 had replaced STEC O157 PT2 as the predominant PT. The risk of developing diarrhea-associated HUS was significantly higher in children infected with STEC O157 PT 2 and PT 21/28 compared with other PTs. Hypertension as a complication of HUS was greatly reduced in patients with diarrhea-associated HUS.
Lynn
Richard M
RM
Royal College of Paediatrics and Child Health, London, United Kingdom.
O'Brien
Sarah J
SJ
Taylor
C Mark
CM
Adak
Goutam K
GK
Chart
Henrik
H
Cheasty
Tom
T
Coia
John E
JE
Gillespie
Iain A
IA
Locking
Mary E
ME
Reilly
William J
WJ
Smith
Henry R
HR
Waters
Aoife
A
Willshaw
Geraldine A
GA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology