title: Strategies for surveillance of pediatric hemolytic uremic syndrome: Foodborne Diseases Active Surveillance Network (FoodNet), 2000-2007.
abstract: BACKGROUND
  Postdiarrheal hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure among US children. The Foodborne Diseases Active Surveillance Network (FoodNet) conducts population-based surveillance of pediatric HUS to measure the incidence of disease and to validate surveillance trends in associated Shiga toxin-producing Escherichia coli (STEC) O157 infection.
  
  
  METHODS
  We report the incidence of pediatric HUS, which is defined as HUS in children <18 years. We compare the results from provider-based surveillance and hospital discharge data review and examine the impact of different case definitions on the findings of the surveillance system.
  
  
  RESULTS
  During 2000-2007, 627 pediatric HUS cases were reported. Fifty-two percent of cases were classified as confirmed (diarrhea, anemia, microangiopathic changes, low platelet count, and acute renal impairment). The average annual crude incidence rate for all reported cases of pediatric HUS was 0.78 per 100,000 children <18 years. Regardless of the case definition used, the year-to-year pattern of incidence appeared similar. More cases were captured by provider-based surveillance (76%) than by hospital discharge data review (68%); only 49% were identified by both methods.
  
  
  CONCLUSIONS
  The overall incidence of pediatric HUS was affected by key characteristics of the surveillance system, including the method of ascertainment and the case definitions. However, year-to-year patterns were similar for all methods examined, suggesting that several approaches to HUS surveillance can be used to track trends.
authors.affiliation: Atlanta Research and Education Foundation, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Kanyin L
authors.initials: KL
authors.lastname: Ong
authors.forename: Mirasol
authors.initials: M
authors.lastname: Apostal
authors.forename: Nicole
authors.initials: N
authors.lastname: Comstock
authors.forename: Sharon
authors.initials: S
authors.lastname: Hurd
authors.forename: Tameka Hayes
authors.initials: TH
authors.lastname: Webb
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mickelson
authors.forename: Joni
authors.initials: J
authors.lastname: Scheftel
authors.forename: Glenda
authors.initials: G
authors.lastname: Smith
authors.forename: Beletshachew
authors.initials: B
authors.lastname: Shiferaw
authors.forename: Effie
authors.initials: E
authors.lastname: Boothe
authors.forename: L Hannah
authors.initials: LH
authors.lastname: Gould
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D011159:Population Surveillance / Q000379:methods*; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*; D014481:United States / Q000453:epidemiology