title: An outbreak of diarrhea-associated childhood hemolytic uremic syndrome: the Walkerton epidemic.
abstract: In Canada, the majority of cases of childhood hemolytic uremic syndrome (HUS) are associated with a diarrheal illness (D+) due to verotoxin-producing Escherichia coli (VTEC). Although the ingestion of undercooked beef is an important cause, we report on the largest outbreak of E. coli illness due to a contaminated supply of municipal water. We describe the clinical features and short-term outcomes of 22 children who simultaneously developed D+HUS.
authors.affiliation: Division of Nephrology, British Columbia Children's Hospital, Vancouver, British Columbia, Canada. dmastsell@cw.bc.ca
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Matsell
authors.forename: Colin T
authors.initials: CT
authors.lastname: White
mesh_terms: D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D004196:Disease Outbreaks; D017707:Erythrocyte Transfusion; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D019453:Escherichia coli O157 / Q000302:isolation & purification* / Q000472:pathogenicity; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008372:Manure / Q000382:microbiology; D009864:Ontario / Q000453:epidemiology; D010289:Parenteral Nutrition, Total; D010530:Peritoneal Dialysis; D017713:Platelet Transfusion; D013997:Time Factors; D016896:Treatment Outcome; D014871:Water Microbiology; D018508:Water Purification; D014881:Water Supply
chemical_list: D008372:Manure