Materiały źródłowe

• #1 Hemolytic-Uremic Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/779218-overview

  Hemolytic-uremic syndrome (HUS) is the most common cause of acute kidney injury in children and is increasingly recognized in adults. […] Stx-HUS occurs with a frequency of 0.5-2.1 cases per 100,000 population per year, with a peak incidence in children younger than 5 years, in whom the incidence is 6.1 cases per 100,000 population per year. In 2015, 274 cases of HUS were reported in the United States, 122 of them in children 1-4 years of age. […] NonStx-HUS accounts for 5-10% of all cases of HUS, and the incidence in children is about one-tenth of that of Stx-HUS. This rate corresponds to about 2 cases per 100,000 population per year. […] In children younger than 15 years, typical HUS occurs at a rate of 0.91 cases per 100,000 population in Great Britain, 1.25 cases per 100,000 population in Scotland, and 1.44 cases per 100,000 population in Canada.

• #1 Hemolytic–uremic syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Hemolytic%E2%80%93uremic_syndrome

  Hemolytic-Uremic Syndrome (HUS) shows marked geographic variation, with annual incidence rates ranging from 0.07 cases per 100,000 person-years in Australia to 2.7 cases per 100,000 in the United States, while European countries report intermediate rates around 0.62-2.1 cases per 100,000 person-years. […] Children under five years of age consistently show the highest incidence rates across all regions, with reported rates of 3.9 cases per 100,000 children per year in the United States and up to 7.9 cases per 100,000 children in Argentina, suggesting a particular vulnerability in this age group. […] The condition demonstrates a slight female predominance in adult cases, though gender distribution is equal in pediatric populations, and studies indicate that rural populations generally have higher incidence rates than urban areas, possibly due to increased exposure to Shiga toxin producing E. coli (STEC) infections. […] It is also likely that some regions (such as China) have high numbers of unreported cases of HUS, due to healthcare providers in those regions lacking understanding of the syndrome.

• #1 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children […] Background/Objectives: Hemolytic uremic syndrome (HUS) is a known cause of acute kidney injury in children, but there are few recent reports on its epidemiology and outcome. We aimed to investigate trends in the incidence and the long-term outcomes of both Shiga toxin-producing Escherichia coli -HUS (STEC-HUS) and atypical HUS (aHUS) in Poland over the last 12 years (2012–2023), based on the Polish Pediatric HUS and Pediatric Renal Replacement Therapy (RRT) Registries. […] The incidence of HUS varies in different geographical regions, with an estimated incidence from 6.3 to 14.2/million age-related population/year (marp) for STEC-HUS and CM-HUS combined. In Europe, the reported incidence of STEC-HUS is 5.6 to 7.8/marp/year, although an increasing trend has been observed in recent years. The highest rates of 60-120/marp are noted in Argentina, mainly in children aged <5 years. The incidence of CM-HUS, reported to be 0.23–2/marp/year, has been relatively constant in recent years.

• #1 Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management

  https://www.mdpi.com/2072-6651/13/5/306

  They mainly rely on pediatric centers for active surveillance, along with passive surveillance from laboratories. […] Thus, STEC-HUS incidence as reported in the adult population might be underestimated and should be interpreted very cautiously. […] The incidence of STEC-associated infections is estimated on a regular basis in the USA by the FoodNet annual reports. […] In 2018, it stood at 62.6 per 1,000,000 person-years with an incidence of STEC-HUS of 6.0 per 1,000,000 person-years. […] In Europe, the global incidence of STEC-HUS was assessed in Germany around 1.1 per 1,000,000 person-years in 2008 to 2012. […] The interpretation of these results is rendered dubious by the fact that only five out of 21 adults had a confirmed STEC infection, while severe ADAMTS13 deficiency was documented in two cases, suggesting a final diagnosis of TTP.

• #1 FoodNet Fast | CDC

  https://wwwn.cdc.gov/foodnetfast/HUS

  HUS is a serious condition that can lead to kidney failure, permanent health problems, and even death. HUS is most often triggered by Shiga toxin-producing Escherichia coli (STEC) infection, in particular by a type of STEC called O157. About 80% of pediatric patients (children younger than 18) who develop HUS have STEC infection. […] FoodNet conducts active surveillance for physician-diagnosed, pediatric HUS cases. […] Data are routinely reported to the FoodNet active surveillance database and summaries of these data are uploaded to FoodNet Fast each year. […] Founded in 1995, FoodNet now has sites in 10 states, covering 15% of the U.S. population. […] HUS by Year Incidence per 100,000 of post-diarrheal HUS in children by year for FoodNet sites. […] Percentage of pediatric, post-diarrheal HUS patients by month for FoodNet sites. […] Evidence of STEC includes all HUS cases that have tested positive for STEC by one or more methods of testing. […] Incidence per 100,000 children of HUS and confirmed STEC O157 and non-O157 infections by year for FoodNet sites.

• #1 Hemolytic Uremic Syndrome (HUS) – FL Health CHARTS – Florida Department of Health

  https://www.flhealthcharts.gov/ChartsDashboards/rdPage.aspx?rdReport=NonVitalIndNoGrpCounts.Dataviewer&cid=8612

  Most diarrhea-associated Hemolytic uremic syndrome (HUS) is caused by Shiga toxin-producing Escherichia coli, most commonly E. coli O157. HUS is characterized by the acute onset of anemia, renal injury, and low platelet count. Most cases of HUS occur after an acute gastrointestinal illness (usually diarrheal). […] HUS is monitored to prevent and control outbreaks. […] This disease became reportable on November 1, 1994. The first full year of data collection is 1995. Cases occurring in previous years may have been retrospectively identified after becoming reportable. Counts and rates include confirmed and probable cases of Hemolytic Uremic Syndrome (HUS). […] Data presented here are from Merlin, Florida’s web-based reportable disease surveillance system. Note that any data prior to 1992 are not maintained in Merlin and should be interpreted with caution.

• #1 Hemolytic Uremic Syndrome (HUS) Surveillance Tool Guide | FoodNet | CDC

  https://www.cdc.gov/foodnet/data/hus-surveillance.html

  FoodNet Fast’s HUS Surveillance Tool lets you see how rates of HUS have changed in FoodNet’s surveillance area since 1997, and how these rates compare with rates of Shiga toxin-producing E. coli (STEC) infection. […] FoodNet conducts surveillance for physician-diagnosed pediatric post-diarrheal HUS cases. […] FoodNet tracks the incidence of infections and HUS to assess the effectiveness of measures aimed at preventing infections and to monitor progress toward national health goals. […] The review of hospital charts in FoodNets surveillance area can take one to two years to complete. FoodNet staff at CDC review all HUS data submitted, which also takes time. For these reasons, HUS data typically lag a year behind other FoodNet data releases.

• #1 Hemolytic uremic syndrome (HUS) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hemolytic-uremic-syndrome/symptoms-causes/syc-20352399

  Anyone can get hemolytic uremic syndrome. But it’s most common in young children. Most often, infection with certain strains of Escherichia coli (E. coli) bacteria is the cause. […] The most common cause of hemolytic uremic syndrome is infection with certain strains of E. coli bacteria. This is especially true for children under age 5. Some of the E. coli strains make a toxin called Shiga toxin. These strains are called Shiga toxin-producing E. coli (STEC). […] The risk of getting hemolytic uremic syndrome is highest for: Children 5 or younger. People who have weakened immune systems. People with certain gene changes.

• #1 Hemolytic Uremic Syndrome: An Emerging Health Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p991.html

  Hemolytic uremic syndrome primarily occurs in children one to 10 years of age, with an average annual incidence of one to three cases per 100,000 children and a survival rate of nearly 95 percent. […] Some studies indicate that rural populations are more at risk than urban populations, and the incidence is higher in warmer months, peaking from June to September. […] Occurrences may be sporadic or present as an outbreak. […] Three to 15 percent of persons who have STEC with diarrhea can develop hemolytic uremic syndrome. […] Young children and older persons with altered immune response, as well as persons who have been in contact with infected farm animals, are particularly vulnerable. […] In addition to age, risk factors associated with hemolytic uremic syndrome include bloody diarrhea, fever, and elevated white blood cell count and C-reactive protein levels. […] The use of antibiotics or antimotility/antidiarrheal and antimicrobial agents in the early stages of diarrhea has been shown to increase the risk of hemolytic uremic syndrome because the gut is exposed to a greater number of toxins for a longer period as intestinal motility slows.

• #1 Incidence and cost of haemolytic uraemic syndrome in urban China: a national population-based analysis | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-022-02746-2

  Haemolytic uraemic syndrome (HUS) is a severe syndrome that causes a substantial burden for patients and their families and is the leading cause of acute kidney injury in children. However, data on the epidemiology and disease burden of HUS in Asia, including China, are limited. We aimed to estimate the incidence and cost of HUS in China. […] The crude incidence of HUS was 0.66 per 100,000 person-years (95% CI: 0.35 to 1.06), and the standardized incidence was 0.57 (0.19 to 1.18). […] This is the first population-based study on the incidence of HUS in urban China. […] The national incidence of HUS was 0.66 cases per 100,000 person-years (95% CI:0.35 to 1.06) in 2016. […] The incidence rate of HUS was 0.66 cases per 100,000 person-years, with a peak incidence in children younger than 1 year old (5.08 cases per 100,000 person-years), and the incidence in males was slightly higher than that in females. […] The total cost per patient per year was 2.15 thousand US dollars, which was higher than the national average annual medical care cost for urban residents (250 US dollars per patient). […] In conclusion, this is the first population-based study of the incidence of HUS in urban China.

• #1 RIDRM Hemolytic Uremic Syndrome

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-hemolytic-uremic-syndrome

  Hemolytic uremic syndrome (HUS) is a potentially life-threatening complication of infection with Shiga toxin-producing Escherichia coli (STEC). HUS is a type of kidney failure, and anyone with HUS should be hospitalized. Although most people with HUS recover within a few weeks, there is a potential for permanent health issues or death. Of people diagnosed with STEC, approximately 5-10% will develop HUS. […] HUS is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). […] The DPH, through FoodNet/FoodCORE, will interview all cases. Interviews include food and travel histories in an attempt to identify a source of infection and to identify individuals in high-risk occupations or settings (food handler, health care worker with direct patient contact, day care setting). The DPH will notify the LHD if a person is in a high-risk setting.

• #1 Hemolytic Uremic Syndrome (HUS) – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/hemolytic-uremic-syndrome-hus/

  HUS is a rare disease but is more common in children than adults, especially children less than five years of age. HUS is the leading cause of acute kidney failure in children. […] Preventing infection by bacteria, especially E. coli O157:H7, is key to preventing HUS. The health department will give advice on each situation in which a person with Shiga toxin-producing E. coli infection is a food handler, healthcare worker, or childcare worker or attendee. Some people might not be allowed to go back to childcare or work in a high risk setting until two stool specimens test negative for the bacteria.

• #1 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  Despite the observed improvement in the prognosis for children with HUS, it should be emphasized that it remains a life-threatening disease. During the acute phase, it is primarily associated with a risk of death, often due to central nervous system involvement. In the study group, 6 deaths were recorded among children with STEC-HUS, all during the acute episode, and 5 deaths were recorded among children with aHUS, 2 of them during the acute phase, while there were no deaths among patients actively treated with eculizumab. […] The incidence of STEC-HUS in children has increased in Poland over the last decade; however, the long-term outcome has improved, with a decreasing number of children with permanent kidney damage being observed, probably due to the better intensive symptomatic treatment given during the acute phase.

• #1 Hemolytic uremic syndrome due to Shiga toxin-producing Escherichia coli infection

  https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-infectieuses-d-origine-alimentaire/syndrome-hemolytique-et-uremique/hemolytic-uremic-syndrome-due-to-shiga-toxin-producing-escherichia-coli-infection

  The leading cause of hemolytic uremic syndrome (HUS) in children is Shiga toxin-producing Escherichia coli (STEC) infection, which has a major outbreak potential. […] Since the early 2010s, STEC epidemiology is characterized by a decline of the historically predominant O157 serogroup and the emergence of non-O157 STEC, especially O26 and O80 in France. […] HUS is observed in 5-15% of STEC infection cases, defined by the triad of mechanical hemolytic anemia, thrombocytopenia, and acute renal injury. […] Clinical and bacteriological STEC-HUS surveillance needs to be continued.

• #1 Frontiers | Short- and Long-Term Renal Outcome of Hemolytic-Uremic Syndrome in Childhood

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00220/full

  Mortality rate was low for STEC-HUS (1.3%) and Non-STEC-HUS-group (6.3%) and declined compared to historical group (9.5%) as better treatment options, especially for Non-STEC-HUS, are available. […] In conclusion, our report points at the fact that all patients, irrespective of their HUS origin, strictly should be followed on a long-term basis because of the high impact of renal sequelae for their further life.

• #2

  https://link.springer.com/article/10.1007/s00467-008-0935-6

  Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in childhood and the reason for chronic renal replacement therapy. […] HUS caused by infectious agents is a common cause of acute renal failure in children and leads to significant morbidity and mortality during the acute phase. […] Epidemiologic studies in outbreaks of hemorrhagic colitis and D+ HUS have clearly shown that some patients develop hemolytic anemia and/or thrombocytopenia with little evidence of renal involvement, whereas other children develop substantial renal disease with normal platelet count and/or minimal hemolysis. […] HUS mortality is reported to be between 3% and 5%, and death due to HUS is nearly always associated with severe extrarenal disease, including severe central nervous system (CNS) involvement.

• #2 Incidence and cost of haemolytic uraemic syndrome in urban China: a national population-based analysis | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-022-02746-2

  Haemolytic uraemic syndrome (HUS) is a severe syndrome that causes a substantial burden for patients and their families and is the leading cause of acute kidney injury in children. However, data on the epidemiology and disease burden of HUS in Asia, including China, are limited. We aimed to estimate the incidence and cost of HUS in China. […] The crude incidence of HUS was 0.66 per 100,000 person-years (95% CI: 0.35 to 1.06), and the standardized incidence was 0.57 (0.19 to 1.18). […] This is the first population-based study on the incidence of HUS in urban China. […] The national incidence of HUS was 0.66 cases per 100,000 person-years (95% CI:0.35 to 1.06) in 2016. […] The incidence rate of HUS was 0.66 cases per 100,000 person-years, with a peak incidence in children younger than 1 year old (5.08 cases per 100,000 person-years), and the incidence in males was slightly higher than that in females. […] The total cost per patient per year was 2.15 thousand US dollars, which was higher than the national average annual medical care cost for urban residents (250 US dollars per patient). […] In conclusion, this is the first population-based study of the incidence of HUS in urban China.

• #2 Haemolytic uremic syndrome surveillance in children less than 15 years in Belgium, 2009–2015 | Archives of Public Health | Full Text

  https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-018-0289-x

  The Haemolytic Uremic Syndrome (HUS) is the most severe manifestation of infection with Shiga toxin-producing Escherichia coli (STEC). In Belgium, the surveillance of paediatric HUS cases is conducted by a sentinel surveillance network of paediatricians called Pedisurv. In this article, we present the main findings of this surveillance from 2009 to 2015 and we describe an annual incidence of HUS. […] From 2009 to 2015, 110 cases were notified to the Pedisurv network with a mean annual notification rate of 0.8/100,000 in children 15 years. The mean annual incidence based on the hospital discharge data was 3.2/100,000 in children 15 years and 4.5/100,000 in children 5 years. […] The incidence of paediatric HUS in Belgium is high compared to other European countries. Its surveillance in Belgium is quite comprehensive and, although less effective than monitoring all STEC infections to detect the emergence of outbreaks, is important to better monitor circulation of the most pathogenic STEC strains.

• #2 Hemolytic Uremic Syndrome: An Emerging Health Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p991.html

  Hemolytic uremic syndrome primarily occurs in children one to 10 years of age, with an average annual incidence of one to three cases per 100,000 children and a survival rate of nearly 95 percent. […] Some studies indicate that rural populations are more at risk than urban populations, and the incidence is higher in warmer months, peaking from June to September. […] Occurrences may be sporadic or present as an outbreak. […] Three to 15 percent of persons who have STEC with diarrhea can develop hemolytic uremic syndrome. […] Young children and older persons with altered immune response, as well as persons who have been in contact with infected farm animals, are particularly vulnerable. […] In addition to age, risk factors associated with hemolytic uremic syndrome include bloody diarrhea, fever, and elevated white blood cell count and C-reactive protein levels. […] The use of antibiotics or antimotility/antidiarrheal and antimicrobial agents in the early stages of diarrhea has been shown to increase the risk of hemolytic uremic syndrome because the gut is exposed to a greater number of toxins for a longer period as intestinal motility slows.

• #2 Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management

  https://www.mdpi.com/2072-6651/13/5/306

  In adults, the incidence of both STEC infections and STEC-HUS tended to be higher in older people, compared to adults aged 18 to 59 in FoodNet reports. […] Geographical disparity is important, with contrasting figures even across Europe. […] The highest incidence of STEC-HUS was observed in Argentina in 2002, with 122 per 1,000,000 person-years. […] There has been a constant increase of worldwide STEC infection incidence observed over the last decade, although these results have not been substantiated by data deriving from the USA, suggesting regional disparities. […] Overall, the diversity of transmission modes is a major contributor to geographical disparity, and local consumption habits must be taken into account when investigating the origin of an outbreak.

• #2 Hemolytic Uremic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556038/

  Hemolytic uremic syndrome (HUS) is a rare but potentially serious condition, often due to infection and less commonly to genetic predisposition or other underlying conditions. […] HUS and aHUS are most often associated with children younger than 10, with most cases in those younger than 5. […] Globally, STEC causes 43 acute illnesses per 100,000 person-years and 3890 cases of HUS. […] STEC-HUS incidence is estimated at 0.57 cases per 100,000 children, and in the highest risk group—children aged 6 months to 2 years—the incidence is as high as 3 per 100,000 children. […] In contrast to HUS, aHUS is notably less frequent; nevertheless, aHUS exhibits substantially elevated morbidity and mortality rates. […] Like typical HUS, atypical HUS affects young children, predominantly those younger than 5, and prevalence is estimated at 2 to 9 cases per million people aged 20 years or younger.

• #2 Haemolytic uraemic syndrome (HUS) | Australian Government Department of Health and Aged Care

  https://www.health.gov.au/diseases/haemolytic-uraemic-syndrome-hus

  Patients with haemolytic uraemic syndrome (HUS) have acute renal failure, a low red blood cell count (anaemia) low blood platelets (thrombocytopenia). This condition occurs in a small number of patients who are infected with Shiga toxin-producing E. coli (STEC). […] HUS is a nationally notifiable disease. […] We monitor cases through the National Notifiable Disease Surveillance System.

• #2 Haemolytic uremic syndrome surveillance in children less than 15 years in Belgium, 2009–2015 | Archives of Public Health | Full Text

  https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-018-0289-x

  Surveillance of HUS is important to detect outbreaks, strains of STEC associated with severe outcomes, to detect the emergence of new strains of STEC and to find incriminated products. […] In Belgium, HUS is monitored specifically by the sentinel surveillance network of paediatricians (Pedisurv). The objective of the monitoring via Pedisurv is to highlight the burden of disease of HUS on the Belgian children and collect epidemiological, clinical and microbiological data for cases of paediatric HUS. […] The overall incidence of HUS in Belgium estimated with the hospital discharge data is higher than in other European countries and the United States. […] Monitoring of HUS and STEC infections in Belgium is considered to be comprehensive as it is currently done through mandatory notification, the NRC and a network of laboratories monitoring STEC and the Pedisurv network for paediatric HUS.

• #2 Epidemiology of Atypical Hemolytic Uremic Syndrome: A Systematic Liter | CLEP

  https://www.dovepress.com/epidemiology-of-atypical-hemolytic-uremic-syndrome-a-systematic-litera-peer-reviewed-fulltext-article-CLEP

  In general, incidence estimates were similar across all the studies; however, prevalence data were found to be more variable. […] Due to the rarity of the disease, global aHUS disease epidemiology is not well known. […] Although population-based estimates exist for some countries, there are gaps in global aHUS incidence and prevalence. […] This systematic review provided a comprehensive overview of currently available incidence and prevalence estimates globally of aHUS. Incidence was found to range between 0.23 and 1.9 per million population annually, depending on region and age group. Prevalence figures ranged from around two to ten per million population, also depending on region and age. […] Noticeable evidence gaps include inconsistent case definitions for aHUS and a dearth of epidemiological estimates of prevalence and incidence for aHUS outside of Europe.

• #2 Hemolytic Uremic Syndrome (HUS)

  https://www.health.ny.gov/diseases/communicable/e_coli/fact_sheet.htm

  Hemolytic Uremic Syndrome (HUS) is a rare but serious disease that affects the kidneys and blood clotting functions of infected people. HUS occurs as a complication of a diarrheal infection (usually E.coli O157:H7 infection). The disease occurs more commonly in children under 5 years of age than in other age groups. […] Anyone infected with E. coli O57:H7 or another Shiga toxin-producing E. coli(STEC) strain can get HUS. Children who are less than 5 years old, people with weakened immune systems (such as those with cancer, HIV/AIDS, or a transplant), or persons with a family history of HUS are more at risk to develop the disease. Only a small fraction of people diagnosed with E.coli O57:H7 (or STEC) infection develop HUS.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hemolytic-Uremic-Syndrome-Epidemiology.aspx

  Among those infected with STEC and who develop diarrheal illness, only 3-15% will progress to HUS. Those at risk for HUS in this group include: Young children, Immunocompromised individuals, Those in contact with infected farm animals, Those with bloody diarrhea, Those with fever associated with STEC infection, Those with a high white cell count and CRP levels, Those exposed to antibiotics, or antidiarrheals in early acute infection perhaps because of prolonged exposure of the gut to the bacterial toxins. […] In most parts of the world where HUS occurs, the E. coli serotype O157:H7 is commonly associated with HUS. This includes: North America, Japan, Western Europe, South America, Africa. […] Sporadic disease is the most common form of D+HUS, but endemic outbreaks, often traced to cattle or sheep reservoirs of the bacterium, have occurred. These are often because of the consumption of food which has come into contact with animal feces in some way, and become contaminated with the organism.

• #2 The Prevalence and Incidence of Hemolytic Uremic Syndrome: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10284565/

  The overall cost per patient per year was 2.15 thousand US dollars, which was also ostensibly more expensive than the country’s average for urban residents’ medical care expenses. […] The prevalence of HUS in this new scenario becomes a critical signal for healthcare planning. […] This systematic review summarizes the global incidence and prevalence estimates of HUS that are currently available. […] Numerous epidemiological assessments on the frequency and incidence of HUS outside the majority of European countries are lacking, and there are various case definitions for the disease.

• #2 Misconceptions Regarding Hemolytic Uremic Syndrome | Pediatric Emergency Medicine

  https://www.acep.org/pediatrics/education/education-articles/hemolytic-uremic-syndrome

  Children diagnosed with HUS should be transferred to a pediatric facility to be evaluated by a pediatric nephrologist and hospitalized. Management is supportive and includes intravenous (IV) fluid hydration, blood pressure management, red blood cell transfusions, and dialysis. […] Early diagnosis and initiation of IV fluids decreases dialysis and long-term renal complications. Hospitalization and close monitoring for dialysis needs is mandatory.

• #2 Hemolytic Uremic Syndrome

  https://www.tn.gov/health/cedep/reportable-diseases/hemolytic-uremic-syndrome.html

  Hemolytic Uremic Syndrome (HUS) is a serious sequela of enteric infection with Shiga toxin-producing E. coli (most commonly STEC O157). Children under 5 years of age, the elderly and immunocompromised persons are at greatest risk of developing HUS. About 8% of children (and a small percentage of adults) with STEC O157 diarrhea develop HUS. HUS is diagnosed by microangiopathic hemolytic anemia, thrombocytopenia and renal failure. HUS is usually preceded by a prodromal gastrointestinal illness, or less commonly, an upper respiratory illness. The prodrome is nonspecific and may include malaise and diarrhea, which may be bloody, within 10 days of diagnosis. If patients have no laboratory evidence of hemolysis, thrombocytopenia or nephropathy 3 days after resolution of diarrhea, their risk of developing HUS is low. Up to 5% of pediatric HUS results in death, and 12% of patients will have severe sequelae such as renal impairment, neurological injury or hypertension.

• #2 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  The incidence of aHUS is relatively constant. Following the introduction of eculizumab for the treatment of aHUS, the long-term prognosis has improved significantly. No patients receiving anti-C5 antibodies have required maintenance kidney replacement therapy to date, and fewer patients have developed hypertension, proteinuria, or chronic kidney disease. […] The majority of children with HUS, both STEC-HUS and aHUS, recovered during the observation period, but some of them achieved full recovery even 5 years after onset, suggesting that their kidney status should be systematically followed.

• #2 Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/haemolytic-uraemic-syndrome-in-children-england-wales-northern-ireland-and-ireland-a-prospective-cohort-study/6359ED929A30D92597957B06AFD0D1EE

  Our study also aimed to identify changes in incidence in the decade since the previous BPSU-HUS study and to establish characteristics of the condition, and current clinical management approaches used to treat HUS. […] The crude incidence of paediatric HUS was 0.78 per 100,000 person-years, although this varied by country, age, gender, and ethnicity. […] The annual incidence of 0.78/100,000 was comparable to reported rates elsewhere, and there had been no notable changes in England, Wales, or Northern Ireland to previous estimates. In Ireland, however, incidence was estimated to have increased three-fold, and the exact reasons for this are unknown but coincide with an increase in reported STEC infections. […] Due to the high morbidity of HUS in children, the continued monitoring and control of STEC remains a high public health priority. Strengthening existing surveillance systems, including maximising diagnosis of STEC from stool specimens, will enable the relative contribution to severe disease by serogroup and Stx type to be better understood and improve outcomes.

• #2 RIDRM Hemolytic Uremic Syndrome

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-hemolytic-uremic-syndrome

  Hemolytic uremic syndrome (HUS) is a potentially life-threatening complication of infection with Shiga toxin-producing Escherichia coli (STEC). HUS is a type of kidney failure, and anyone with HUS should be hospitalized. Although most people with HUS recover within a few weeks, there is a potential for permanent health issues or death. Of people diagnosed with STEC, approximately 5-10% will develop HUS. […] HUS is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). […] The DPH, through FoodNet/FoodCORE, will interview all cases. Interviews include food and travel histories in an attempt to identify a source of infection and to identify individuals in high-risk occupations or settings (food handler, health care worker with direct patient contact, day care setting). The DPH will notify the LHD if a person is in a high-risk setting.

• #3 The Prevalence and Incidence of Hemolytic Uremic Syndrome: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10284565/

  A hemolytic uremic syndrome is an uncommon but severe condition brought on by an overactive alternative complement system, typically involving a hereditary component. […] A systematic review was conducted to evaluate the incidence and prevalence estimates of hemolytic uremic syndrome (HUS) internationally. […] HUS had an annual crude incidence of 0.66 per 100,000 people and a standard annual incidence of 0.57 per 100,000 people. […] Patients under 20 years old were the age group where HUS was most common. […] It was concluded that several variables, including the region, the age group affected, and the frequency of the underlying bacterial infection, determine the prevalence and incidence of HUS. […] HUS is often more common in children than adults and is more common in some nations.

• #3 The Epidemiology of Hemolytic Uremic Syndrome: Clinical Presentation, Laboratory Findings, Management and Outcomes

  https://symbiosisonlinepublishing.com/hematology/hematology19.php

  The Epidemiology of Hemolytic Uremic Syndrome: Clinical Presentation, Laboratory Findings, Management and Outcomes […] Hemolytic-uremic syndrome (HUS) is a disease that has been described as a triad of hemolytic anemia, thrombocytopenia and renal impairment. […] HUS remains a leading cause of acute renal injury in children and is increasingly recognized as a cause of renal failure in adults. […] The annual incidence of HUS in the United States is approximately 2.2 cases per 100,000 population, as well as in Europe. […] There was no study done in Oman and very limited from the whole region about HUS. […] The study results showed that HUS populations were mostly due to Shiga toxin producing Escherichia Coli (STEC). […] It showed that HUS population were young, mostly male and only 25% have known medical comorbidities at time of presentation. […] The majority presented with AKI requiring dialysis, of which PD was main stay of therapy. […] Previous studies showed that the average annual incidence for HUS of 0.71 per 100,000 children in Germany while it was 0.7 cases/100,000 and 0.6 cases/100,000 in France and Australia, respectively. […] The highest HUS incidence worldwide occurs in Argentina, although exact incidence rates are unclear. […] Our study results were in concordance with the world-wide pattern of the disease’s young age incidence, with mean age (SD) 10.68 (14.07) years. […] We also found that there was relatively higher incidence of the disease in males (58.33 %) which is similar to what was found by other researchers in our region, Saudi Arabia and Kuwait. […] In the present study, the total white cell count was very high with a mean (SD) 15.2 (9.1) and neutrophilic leukocytosis of 8.99 (7.7) at time of presentation. […] The important role of leukocytes in the pathogenesis of HUS and its endothelial dysfunction leading to HUS was also noted to be of vital role. […] AKI is a common manifestation of TMAs, although rarely a severe feature of TTP. […] In our study we found that 64% of patients had AKI, 50 % with gastrointestinal symptoms, 25% with HTN, 16.67% with seizure, 5.56% with confusion and 2.78% with cerebrovascular accident (CVA). […] In the present study, two third (63.9 %) of patients needed RRT, of which the majority were on PD (69.5%). […] Most centers in Germany and Austria start dialysis on the day of admission if oliguria or anuria is present. […] This study found that the mean duration of RRT was 33.2 SD (31.8) days while the mean time to recovery was 36 SD (33.7) days. […] While we had a low mortality of 2.78%, which is similar to a Saudi report of 3% mortality rate. […] Our results were in a concordance with the world-wide pattern of the disease’s young age incidence and disease presentation and complications with lower mortality rates.

• #3 Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/haemolytic-uraemic-syndrome-in-children-england-wales-northern-ireland-and-ireland-a-prospective-cohort-study/6359ED929A30D92597957B06AFD0D1EE

  Haemolytic uraemic syndrome (HUS) caused by infection with Shiga toxin-producing Escherichia coli (STEC) is a relatively rare but potentially fatal multisystem syndrome clinically characterised by acute kidney injury. This study aimed to provide robust estimates of paediatric HUS incidence in England, Wales, Northern Ireland, and the Republic of Ireland by using data linkage and case reconciliation with existing surveillance systems, and to describe the characteristics of the condition. […] The crude incidence of paediatric typical HUS was 0.78 per 100,000 person-years, although this varied by country, age, gender, and ethnicity. […] The British Paediatric Surveillance Unit (BPSU) enables surveillance of rare childhood illnesses in the UK and Ireland. This methodology has been used to conduct two previous prospective surveillance studies on paediatric HUS in the UK and Ireland, one from 1985 to 1988, and the other from 1997 to 2001.

• #3 Hemolytic uremic syndrome due to Shiga toxin-producing Escherichia coli infection

  https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-infectieuses-d-origine-alimentaire/syndrome-hemolytique-et-uremique/hemolytic-uremic-syndrome-due-to-shiga-toxin-producing-escherichia-coli-infection

  The leading cause of hemolytic uremic syndrome (HUS) in children is Shiga toxin-producing Escherichia coli (STEC) infection, which has a major outbreak potential. […] Since the early 2010s, STEC epidemiology is characterized by a decline of the historically predominant O157 serogroup and the emergence of non-O157 STEC, especially O26 and O80 in France. […] HUS is observed in 5-15% of STEC infection cases, defined by the triad of mechanical hemolytic anemia, thrombocytopenia, and acute renal injury. […] Clinical and bacteriological STEC-HUS surveillance needs to be continued.

• #3 Hemolytic Uremic Syndrome (HUS) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/ecoli/husbasics.html

  In some persons, particularly children under 5 years of age and the elderly, a shiga toxin-producing E. coli infection can also cause a severe complication called hemolytic uremic syndrome (HUS). […] About 2%-7% of E. coli O157:H7 infections lead to HUS. […] In the United States, HUS is the principal cause of acute kidney failure in children, and most cases of hemolytic uremic syndrome are caused by E. coli O157:H7.

• #3 Hemolytic Uremic Syndrome (HUS) Surveillance Tool Guide | FoodNet | CDC

  https://www.cdc.gov/foodnet/data/hus-surveillance.html

  FoodNet Fast’s HUS Surveillance Tool lets you see how rates of HUS have changed in FoodNet’s surveillance area since 1997, and how these rates compare with rates of Shiga toxin-producing E. coli (STEC) infection. […] FoodNet conducts surveillance for physician-diagnosed pediatric post-diarrheal HUS cases. […] FoodNet tracks the incidence of infections and HUS to assess the effectiveness of measures aimed at preventing infections and to monitor progress toward national health goals. […] The review of hospital charts in FoodNets surveillance area can take one to two years to complete. FoodNet staff at CDC review all HUS data submitted, which also takes time. For these reasons, HUS data typically lag a year behind other FoodNet data releases.

• #3 RIDRM Hemolytic Uremic Syndrome

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-hemolytic-uremic-syndrome

  Hemolytic uremic syndrome (HUS) is a potentially life-threatening complication of infection with Shiga toxin-producing Escherichia coli (STEC). HUS is a type of kidney failure, and anyone with HUS should be hospitalized. Although most people with HUS recover within a few weeks, there is a potential for permanent health issues or death. Of people diagnosed with STEC, approximately 5-10% will develop HUS. […] HUS is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). […] The DPH, through FoodNet/FoodCORE, will interview all cases. Interviews include food and travel histories in an attempt to identify a source of infection and to identify individuals in high-risk occupations or settings (food handler, health care worker with direct patient contact, day care setting). The DPH will notify the LHD if a person is in a high-risk setting.

• #3 Misconceptions Regarding Hemolytic Uremic Syndrome | Pediatric Emergency Medicine

  https://www.acep.org/pediatrics/education/education-articles/hemolytic-uremic-syndrome

  Hemolytic uremic syndrome (HUS) is a type of thrombotic microangiopathy that can be seen after diarrheal illness in young children and consists of the triad of thrombocytopenia, nonimmune hemolytic anemia, and azotemia. […] HUS is traditionally caused by exposure to Shiga toxin producing E. coli (STEC-HUS) from pet, farm, or zoo animals. However, 75% of STEC-HUS cases are sporadic and an exposure is unknown 37% of the time. […] According to the Centers for Disease Control and Prevention (CDC), there has been an increase of reported STEC infections within the past 20 years. A shift in epidemiology occurred in the 2000s, and non-O157 serotypes are now more commonly found in North America and Europe. […] By the time HUS is diagnosed, stool cultures are less likely to be positive for E. coli.

• #3 Haemolytic uraemic syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/haemolytic-uraemic-syndrome

  Children under five years are most vulnerable to HUS. […] HUS can lead to permanent kidney damage or death. […] About 10 per cent of patients with EHEC develop HUS. […] HUS can lead to: Mild, chronic kidney damage occurs in about 50 per cent of cases. […] Kidney failure occurs in five per cent of cases. […] About five per cent of children who develop HUS will die. […] Children under one year or older than five years are at the greatest risk of death. […] Verotoxin producing E. coli (VTEC), Infectious Diseases Epidemiology and Surveillance (Blue Book), Department of Health, Victorian Government.

• #3 Hemolytic Uremic Syndrome: An Emerging Health Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p991.html

  Hemolytic uremic syndrome primarily occurs in children one to 10 years of age, with an average annual incidence of one to three cases per 100,000 children and a survival rate of nearly 95 percent. […] Some studies indicate that rural populations are more at risk than urban populations, and the incidence is higher in warmer months, peaking from June to September. […] Occurrences may be sporadic or present as an outbreak. […] Three to 15 percent of persons who have STEC with diarrhea can develop hemolytic uremic syndrome. […] Young children and older persons with altered immune response, as well as persons who have been in contact with infected farm animals, are particularly vulnerable. […] In addition to age, risk factors associated with hemolytic uremic syndrome include bloody diarrhea, fever, and elevated white blood cell count and C-reactive protein levels. […] The use of antibiotics or antimotility/antidiarrheal and antimicrobial agents in the early stages of diarrhea has been shown to increase the risk of hemolytic uremic syndrome because the gut is exposed to a greater number of toxins for a longer period as intestinal motility slows.

• #3 Hemolytic Uremic Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22741

  HUS and aHUS are most often associated with children younger than 10, with most cases in those younger than 5. Globally, STEC causes 43 acute illnesses per 100,000 person-years and 3890 cases of HUS. STEC-HUS is one of the most common causes of pediatric renal replacement therapy. A large retrospective study showed that 15% of children (younger than 18) who presented to the emergency department with bloody diarrhea developed STEC-HUS. […] STEC-HUS incidence is estimated at 0.57 cases per 100,000 children, and in the highest risk group—children aged 6 months to 2 years—the incidence is as high as 3 per 100,000 children. Incidence directly coordinates with environmental exposure and agricultural practices, such as cattle raising, and most patients are diagnosed between April and September when cattle show higher colonization of STEC.

• #3

  https://link.springer.com/article/10.1007/s00467-008-0935-6

  Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in childhood and the reason for chronic renal replacement therapy. […] HUS caused by infectious agents is a common cause of acute renal failure in children and leads to significant morbidity and mortality during the acute phase. […] Epidemiologic studies in outbreaks of hemorrhagic colitis and D+ HUS have clearly shown that some patients develop hemolytic anemia and/or thrombocytopenia with little evidence of renal involvement, whereas other children develop substantial renal disease with normal platelet count and/or minimal hemolysis. […] HUS mortality is reported to be between 3% and 5%, and death due to HUS is nearly always associated with severe extrarenal disease, including severe central nervous system (CNS) involvement.

• #3 Frontiers | Short- and Long-Term Renal Outcome of Hemolytic-Uremic Syndrome in Childhood

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00220/full

  Mortality rate was low for STEC-HUS (1.3%) and Non-STEC-HUS-group (6.3%) and declined compared to historical group (9.5%) as better treatment options, especially for Non-STEC-HUS, are available. […] In conclusion, our report points at the fact that all patients, irrespective of their HUS origin, strictly should be followed on a long-term basis because of the high impact of renal sequelae for their further life.

• #3 Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/haemolytic-uraemic-syndrome-in-children-england-wales-northern-ireland-and-ireland-a-prospective-cohort-study/6359ED929A30D92597957B06AFD0D1EE

  Our study also aimed to identify changes in incidence in the decade since the previous BPSU-HUS study and to establish characteristics of the condition, and current clinical management approaches used to treat HUS. […] The crude incidence of paediatric HUS was 0.78 per 100,000 person-years, although this varied by country, age, gender, and ethnicity. […] The annual incidence of 0.78/100,000 was comparable to reported rates elsewhere, and there had been no notable changes in England, Wales, or Northern Ireland to previous estimates. In Ireland, however, incidence was estimated to have increased three-fold, and the exact reasons for this are unknown but coincide with an increase in reported STEC infections. […] Due to the high morbidity of HUS in children, the continued monitoring and control of STEC remains a high public health priority. Strengthening existing surveillance systems, including maximising diagnosis of STEC from stool specimens, will enable the relative contribution to severe disease by serogroup and Stx type to be better understood and improve outcomes.

• #3 Factsheets – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/gastroenteric/hus/factsheets/

  Haemolytic Uraemic Syndrome (HUS) refers to a group of clinical features (syndrome) that includes: […] The commonest cause of HUS is verocytotoxigenic E. coli (VTEC) gastroenteric infection; HUS is the commonest cause of kidney failure in children. […] HUS is notifiable in Ireland and each year about 30 cases of VTEC-related HUS are reported, mostly in children. […] Young children, elderly people and people with weakened immune systems are at highest risk of developing VTEC associated HUS. […] As HUS is almost always due to VTEC infection, it will be important to determine where this infection may have come from. […] If your child develops HUS, as well as being looked after by clinical physicians in the hospital, you will be contacted by Public Health physicians who investigate VTEC cases to work out how your child may have acquired their infection and how far it may have spread. […] Rapid intervention with fluids is crucial, so it is important to identify HUS as early as possible in all ages.

• #4 Epidemiology of Atypical Hemolytic Uremic Syndrome: A Systematic Liter | CLEP

  https://www.dovepress.com/epidemiology-of-atypical-hemolytic-uremic-syndrome-a-systematic-litera-peer-reviewed-fulltext-article-CLEP

  Atypical hemolytic uremic syndrome (aHUS) is a rare but severe disorder that frequently has a genetic component and results from the overactivation of the alternative complement pathway. […] Our objective was to conduct a systematic literature review to assess the incidence and prevalence estimates of aHUS globally. […] Regional epidemiologic estimates were obtained for Europe and Oceania. Country-specific data were available for France, Norway, Australia, and Italy. […] Four of the identified studies reported on the prevalence of aHUS, prevalence in the age group of 20 years or younger was ranging from 2.2 to 9.4 per million population, while the only study that reported prevalence in all ages showed a prevalence of 4.9 per million population. […] Six studies reported on the incidence of aHUS, annual incidence in the age group of 20 years or younger was ranging from 0.26 to 0.75 per million population, and for all ages, annual incidence was ranging from 0.23 to 1.9 per million population.

• #4 Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management

  https://www.mdpi.com/2072-6651/13/5/306

  In adults, the incidence of both STEC infections and STEC-HUS tended to be higher in older people, compared to adults aged 18 to 59 in FoodNet reports. […] Geographical disparity is important, with contrasting figures even across Europe. […] The highest incidence of STEC-HUS was observed in Argentina in 2002, with 122 per 1,000,000 person-years. […] There has been a constant increase of worldwide STEC infection incidence observed over the last decade, although these results have not been substantiated by data deriving from the USA, suggesting regional disparities. […] Overall, the diversity of transmission modes is a major contributor to geographical disparity, and local consumption habits must be taken into account when investigating the origin of an outbreak.

• #4 Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/haemolytic-uraemic-syndrome-in-children-england-wales-northern-ireland-and-ireland-a-prospective-cohort-study/6359ED929A30D92597957B06AFD0D1EE

  Our study also aimed to identify changes in incidence in the decade since the previous BPSU-HUS study and to establish characteristics of the condition, and current clinical management approaches used to treat HUS. […] The crude incidence of paediatric HUS was 0.78 per 100,000 person-years, although this varied by country, age, gender, and ethnicity. […] The annual incidence of 0.78/100,000 was comparable to reported rates elsewhere, and there had been no notable changes in England, Wales, or Northern Ireland to previous estimates. In Ireland, however, incidence was estimated to have increased three-fold, and the exact reasons for this are unknown but coincide with an increase in reported STEC infections. […] Due to the high morbidity of HUS in children, the continued monitoring and control of STEC remains a high public health priority. Strengthening existing surveillance systems, including maximising diagnosis of STEC from stool specimens, will enable the relative contribution to severe disease by serogroup and Stx type to be better understood and improve outcomes.

• #4 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  The mean age-standardised annual incidence for STEC-HUS between 2014 and 2022 was 3.9 cases/marp (range 1.0–7.4/marp), while for aHUS it was 1.8 cases/marp (range 1.2–3.8/marp). Throughout the study period, there was a trend of increasing incidence of STEC-HUS in children, at marginal statistical significance (p for trend 0.059), whereas there was little variability in aHUS (p for trend 0.2). The incidence varied significantly according to the age of the children. […] The incidence of CKD5 due to HUS analysed in the same period revealed a statistically significant trend of decreasing incidence (p for trend 0.04). The incidence of CKD5 due to STEC-HUS was 0.04 case/marp, which indicates that 1% of children with HUS-STEC developed permanent kidney damage requiring KRT. No STEC-HUS patient has started KRT in the last 5 years (2018–2022). The incidence of CKD5 due to aHUS was 0.26/marp in the pre-eculizumab era.

• #4 Hemolytic Uremic Syndrome (HUS) | Florida Department of Health

  https://www.floridahealth.gov/diseases-and-conditions/e-coli-o157-h7/hemolytic-uremic-syndrome.html

  Hemolytic Uremic Syndrome (HUS) is a reportable medical condition in the State of Florida. […] According to the Centers for Disease Control and Prevention, approximately 2%-7% of E. coli O157:H7 infections lead to HUS.

• #4 FoodNet Fast | CDC

  https://wwwn.cdc.gov/foodnetfast/HUS

  HUS is a serious condition that can lead to kidney failure, permanent health problems, and even death. HUS is most often triggered by Shiga toxin-producing Escherichia coli (STEC) infection, in particular by a type of STEC called O157. About 80% of pediatric patients (children younger than 18) who develop HUS have STEC infection. […] FoodNet conducts active surveillance for physician-diagnosed, pediatric HUS cases. […] Data are routinely reported to the FoodNet active surveillance database and summaries of these data are uploaded to FoodNet Fast each year. […] Founded in 1995, FoodNet now has sites in 10 states, covering 15% of the U.S. population. […] HUS by Year Incidence per 100,000 of post-diarrheal HUS in children by year for FoodNet sites. […] Percentage of pediatric, post-diarrheal HUS patients by month for FoodNet sites. […] Evidence of STEC includes all HUS cases that have tested positive for STEC by one or more methods of testing. […] Incidence per 100,000 children of HUS and confirmed STEC O157 and non-O157 infections by year for FoodNet sites.

• #4 FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance – OMB 0920-0978

  https://omb.report/icr/201808-0920-022/doc/85719101

  FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance […] FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance […] If a case is captured through HDD and was previously identified through the network of practitioners, sites should check that the abstracted information from active surveillance is current and complete. […] Is this case epidemiologically linked to a confirmed or probable Shiga toxin-producing E.coli (STEC) case? […] Is this case outbreak related?

• #4 Hemolytic–uremic syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Hemolytic%E2%80%93uremic_syndrome

  Hemolytic-Uremic Syndrome (HUS) shows marked geographic variation, with annual incidence rates ranging from 0.07 cases per 100,000 person-years in Australia to 2.7 cases per 100,000 in the United States, while European countries report intermediate rates around 0.62-2.1 cases per 100,000 person-years. […] Children under five years of age consistently show the highest incidence rates across all regions, with reported rates of 3.9 cases per 100,000 children per year in the United States and up to 7.9 cases per 100,000 children in Argentina, suggesting a particular vulnerability in this age group. […] The condition demonstrates a slight female predominance in adult cases, though gender distribution is equal in pediatric populations, and studies indicate that rural populations generally have higher incidence rates than urban areas, possibly due to increased exposure to Shiga toxin producing E. coli (STEC) infections. […] It is also likely that some regions (such as China) have high numbers of unreported cases of HUS, due to healthcare providers in those regions lacking understanding of the syndrome.

• #4 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hemolytic-Uremic-Syndrome-Epidemiology.aspx

  Among those infected with STEC and who develop diarrheal illness, only 3-15% will progress to HUS. Those at risk for HUS in this group include: Young children, Immunocompromised individuals, Those in contact with infected farm animals, Those with bloody diarrhea, Those with fever associated with STEC infection, Those with a high white cell count and CRP levels, Those exposed to antibiotics, or antidiarrheals in early acute infection perhaps because of prolonged exposure of the gut to the bacterial toxins. […] In most parts of the world where HUS occurs, the E. coli serotype O157:H7 is commonly associated with HUS. This includes: North America, Japan, Western Europe, South America, Africa. […] Sporadic disease is the most common form of D+HUS, but endemic outbreaks, often traced to cattle or sheep reservoirs of the bacterium, have occurred. These are often because of the consumption of food which has come into contact with animal feces in some way, and become contaminated with the organism.

• #4

  https://link.springer.com/article/10.1007/s00431-015-2642-1

  Despite the severity of HUS and the fact that it represents a leading cause of acute kidney injury in children, the general epidemiology of HUS is all but well documented. […] We systematically reviewed the files concerning patients with STEC-HUS and atypical HUS (aHUS) over a 10-year observation period (January 2003-December 2012). […] We identified 101 cases of HUS during the 10 years. The overall mean annual incidence was 6.3 cases/million children aged 18 years (range 1.9-11.9), and 15.7/million of age-related population (MARP) among subjects aged 5 years; aHUS accounted for 11.9 % of the cases (mean incidence 0.75/MARP). The overall case fatality rate was 4.0 % (3.4 % STEC-HUS, 8.3 % aHUS). […] Given the public health impact of HUS, this study provides recent, population-based epidemiological data useful for healthcare planning and particularly for estimating the financial burden that healthcare providers might have to face in treating HUS, whose incidence rate seems to increase in Northern Italy. […] Comprehensive, population-based epidemiological data concerning both typical and atypical HUS based on a long observational period.

• #4 The Epidemiology of Hemolytic Uremic Syndrome: Clinical Presentation, Laboratory Findings, Management and Outcomes

  https://symbiosisonlinepublishing.com/hematology/hematology19.php

  The Epidemiology of Hemolytic Uremic Syndrome: Clinical Presentation, Laboratory Findings, Management and Outcomes […] Hemolytic-uremic syndrome (HUS) is a disease that has been described as a triad of hemolytic anemia, thrombocytopenia and renal impairment. […] HUS remains a leading cause of acute renal injury in children and is increasingly recognized as a cause of renal failure in adults. […] The annual incidence of HUS in the United States is approximately 2.2 cases per 100,000 population, as well as in Europe. […] There was no study done in Oman and very limited from the whole region about HUS. […] The study results showed that HUS populations were mostly due to Shiga toxin producing Escherichia Coli (STEC). […] It showed that HUS population were young, mostly male and only 25% have known medical comorbidities at time of presentation. […] The majority presented with AKI requiring dialysis, of which PD was main stay of therapy. […] Previous studies showed that the average annual incidence for HUS of 0.71 per 100,000 children in Germany while it was 0.7 cases/100,000 and 0.6 cases/100,000 in France and Australia, respectively. […] The highest HUS incidence worldwide occurs in Argentina, although exact incidence rates are unclear. […] Our study results were in concordance with the world-wide pattern of the disease’s young age incidence, with mean age (SD) 10.68 (14.07) years. […] We also found that there was relatively higher incidence of the disease in males (58.33 %) which is similar to what was found by other researchers in our region, Saudi Arabia and Kuwait. […] In the present study, the total white cell count was very high with a mean (SD) 15.2 (9.1) and neutrophilic leukocytosis of 8.99 (7.7) at time of presentation. […] The important role of leukocytes in the pathogenesis of HUS and its endothelial dysfunction leading to HUS was also noted to be of vital role. […] AKI is a common manifestation of TMAs, although rarely a severe feature of TTP. […] In our study we found that 64% of patients had AKI, 50 % with gastrointestinal symptoms, 25% with HTN, 16.67% with seizure, 5.56% with confusion and 2.78% with cerebrovascular accident (CVA). […] In the present study, two third (63.9 %) of patients needed RRT, of which the majority were on PD (69.5%). […] Most centers in Germany and Austria start dialysis on the day of admission if oliguria or anuria is present. […] This study found that the mean duration of RRT was 33.2 SD (31.8) days while the mean time to recovery was 36 SD (33.7) days. […] While we had a low mortality of 2.78%, which is similar to a Saudi report of 3% mortality rate. […] Our results were in a concordance with the world-wide pattern of the disease’s young age incidence and disease presentation and complications with lower mortality rates.

• #4 Haemolytic uraemic syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/haemolytic-uraemic-syndrome

  Children under five years are most vulnerable to HUS. […] HUS can lead to permanent kidney damage or death. […] About 10 per cent of patients with EHEC develop HUS. […] HUS can lead to: Mild, chronic kidney damage occurs in about 50 per cent of cases. […] Kidney failure occurs in five per cent of cases. […] About five per cent of children who develop HUS will die. […] Children under one year or older than five years are at the greatest risk of death. […] Verotoxin producing E. coli (VTEC), Infectious Diseases Epidemiology and Surveillance (Blue Book), Department of Health, Victorian Government.

• #4 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  The study provides prospective population-based information on the epidemiology and outcome of HUS in childhood in Poland from 2012 to 2023, taking into account the availability of eculizumab for aHUS and the current treatment strategy for the acute phase of STEC-HUS. The average incidence of STEC-HUS in children in Poland was 3.9/marp, which is slightly lower than the reported incidence for other European countries—5.6 for the northern Italian region, and 7.8/marp for UK and Ireland. However, it should be noted that an increase in the incidence of STEC-HUS, at marginal statistical significance, was observed in the Polish population during the study period. […] The average incidence for aHUS during the observed period was 1.8/marp, not significantly different from that previously reported for pediatric populations, 0.5–2/marp, although it was higher than that reported by Ardissino in Italy between 2002 and 2012. Only a slight variation in incidence was observed in Poland during the period evaluated.

• #4 Hemolytic Uremic Syndrome (HUS) – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/hemolytic-uremic-syndrome-hus/

  HUS is a rare disease but is more common in children than adults, especially children less than five years of age. HUS is the leading cause of acute kidney failure in children. […] Preventing infection by bacteria, especially E. coli O157:H7, is key to preventing HUS. The health department will give advice on each situation in which a person with Shiga toxin-producing E. coli infection is a food handler, healthcare worker, or childcare worker or attendee. Some people might not be allowed to go back to childcare or work in a high risk setting until two stool specimens test negative for the bacteria.

• #5 Epidemiology of Atypical Hemolytic Uremic Syndrome: A Systematic Liter | CLEP

  https://www.dovepress.com/epidemiology-of-atypical-hemolytic-uremic-syndrome-a-systematic-litera-peer-reviewed-fulltext-article-CLEP

  In general, incidence estimates were similar across all the studies; however, prevalence data were found to be more variable. […] Due to the rarity of the disease, global aHUS disease epidemiology is not well known. […] Although population-based estimates exist for some countries, there are gaps in global aHUS incidence and prevalence. […] This systematic review provided a comprehensive overview of currently available incidence and prevalence estimates globally of aHUS. Incidence was found to range between 0.23 and 1.9 per million population annually, depending on region and age group. Prevalence figures ranged from around two to ten per million population, also depending on region and age. […] Noticeable evidence gaps include inconsistent case definitions for aHUS and a dearth of epidemiological estimates of prevalence and incidence for aHUS outside of Europe.

• #5 The Prevalence and Incidence of Hemolytic Uremic Syndrome: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10284565/

  Since Shiga toxin-producing E. coli (STEC) infections are the most frequent cause of HUS and are frequently epidemic, there is a good chance that the incidence of HUS and STEC infections are connected. […] HUS incidence rates have been reported to be lower than our findings in Australia (0.07 cases per 100,000 person-years) and Iran (0.28 cases per 100,000 person-years). […] In this study, females had a little greater incidence than males, although the difference was not statistically significant. […] Children had the greatest incidence rate, with 5.08 per 100,000 person-years annually. […] The national average hospitalization cost per patient for the same time period was 1.30 thousand US dollars; however, the average hospitalization cost for each HUS patient was 1.75 thousand US dollars, which is much higher.

• #5 Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/haemolytic-uraemic-syndrome-in-children-england-wales-northern-ireland-and-ireland-a-prospective-cohort-study/6359ED929A30D92597957B06AFD0D1EE

  Our study also aimed to identify changes in incidence in the decade since the previous BPSU-HUS study and to establish characteristics of the condition, and current clinical management approaches used to treat HUS. […] The crude incidence of paediatric HUS was 0.78 per 100,000 person-years, although this varied by country, age, gender, and ethnicity. […] The annual incidence of 0.78/100,000 was comparable to reported rates elsewhere, and there had been no notable changes in England, Wales, or Northern Ireland to previous estimates. In Ireland, however, incidence was estimated to have increased three-fold, and the exact reasons for this are unknown but coincide with an increase in reported STEC infections. […] Due to the high morbidity of HUS in children, the continued monitoring and control of STEC remains a high public health priority. Strengthening existing surveillance systems, including maximising diagnosis of STEC from stool specimens, will enable the relative contribution to severe disease by serogroup and Stx type to be better understood and improve outcomes.

• #5 FoodNet Fast | CDC

  https://wwwn.cdc.gov/foodnetfast/HUS

  HUS is a serious condition that can lead to kidney failure, permanent health problems, and even death. HUS is most often triggered by Shiga toxin-producing Escherichia coli (STEC) infection, in particular by a type of STEC called O157. About 80% of pediatric patients (children younger than 18) who develop HUS have STEC infection. […] FoodNet conducts active surveillance for physician-diagnosed, pediatric HUS cases. […] Data are routinely reported to the FoodNet active surveillance database and summaries of these data are uploaded to FoodNet Fast each year. […] Founded in 1995, FoodNet now has sites in 10 states, covering 15% of the U.S. population. […] HUS by Year Incidence per 100,000 of post-diarrheal HUS in children by year for FoodNet sites. […] Percentage of pediatric, post-diarrheal HUS patients by month for FoodNet sites. […] Evidence of STEC includes all HUS cases that have tested positive for STEC by one or more methods of testing. […] Incidence per 100,000 children of HUS and confirmed STEC O157 and non-O157 infections by year for FoodNet sites.

• #5 Haemolytic uraemic syndrome (HUS) | Australian Government Department of Health and Aged Care

  https://www.health.gov.au/diseases/haemolytic-uraemic-syndrome-hus

  Patients with haemolytic uraemic syndrome (HUS) have acute renal failure, a low red blood cell count (anaemia) low blood platelets (thrombocytopenia). This condition occurs in a small number of patients who are infected with Shiga toxin-producing E. coli (STEC). […] HUS is a nationally notifiable disease. […] We monitor cases through the National Notifiable Disease Surveillance System.

• #5

  https://step2.medbullets.com/heme/120243/hemolytic-uremic-syndrome-hus

  Most commonly in children […] Exposed to E. coli […] Risk factors […] use of antimotility agents in EHEC diarrhea […] use of antibiotics in EHEC diarrhea.

• #5 Haemolytic uraemic syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/haemolytic-uraemic-syndrome

  Children under five years are most vulnerable to HUS. […] HUS can lead to permanent kidney damage or death. […] About 10 per cent of patients with EHEC develop HUS. […] HUS can lead to: Mild, chronic kidney damage occurs in about 50 per cent of cases. […] Kidney failure occurs in five per cent of cases. […] About five per cent of children who develop HUS will die. […] Children under one year or older than five years are at the greatest risk of death. […] Verotoxin producing E. coli (VTEC), Infectious Diseases Epidemiology and Surveillance (Blue Book), Department of Health, Victorian Government.

• #5 Misconceptions Regarding Hemolytic Uremic Syndrome | Pediatric Emergency Medicine

  https://www.acep.org/pediatrics/education/education-articles/hemolytic-uremic-syndrome

  Children diagnosed with HUS should be transferred to a pediatric facility to be evaluated by a pediatric nephrologist and hospitalized. Management is supportive and includes intravenous (IV) fluid hydration, blood pressure management, red blood cell transfusions, and dialysis. […] Early diagnosis and initiation of IV fluids decreases dialysis and long-term renal complications. Hospitalization and close monitoring for dialysis needs is mandatory.

• #6 Hemolytic-Uremic Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/779218-overview

  Seasonal variation occurs, with cases peaking in the summer and fall. […] HUS occurs infrequently in blacks. Both sexes are affected equally with HUS. […] HUS occurs mainly in young children; however, adolescents and adults are not exempt. In young children, spontaneous recovery is common. In adults, the probability of recovery is low when HUS is associated with severe hypertension.

• #6 Misconceptions Regarding Hemolytic Uremic Syndrome | Pediatric Emergency Medicine

  https://www.acep.org/pediatrics/education/education-articles/hemolytic-uremic-syndrome

  Hemolytic uremic syndrome (HUS) is a type of thrombotic microangiopathy that can be seen after diarrheal illness in young children and consists of the triad of thrombocytopenia, nonimmune hemolytic anemia, and azotemia. […] HUS is traditionally caused by exposure to Shiga toxin producing E. coli (STEC-HUS) from pet, farm, or zoo animals. However, 75% of STEC-HUS cases are sporadic and an exposure is unknown 37% of the time. […] According to the Centers for Disease Control and Prevention (CDC), there has been an increase of reported STEC infections within the past 20 years. A shift in epidemiology occurred in the 2000s, and non-O157 serotypes are now more commonly found in North America and Europe. […] By the time HUS is diagnosed, stool cultures are less likely to be positive for E. coli.

• #6 Hemolytic Uremic Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22741

  HUS and aHUS are most often associated with children younger than 10, with most cases in those younger than 5. Globally, STEC causes 43 acute illnesses per 100,000 person-years and 3890 cases of HUS. STEC-HUS is one of the most common causes of pediatric renal replacement therapy. A large retrospective study showed that 15% of children (younger than 18) who presented to the emergency department with bloody diarrhea developed STEC-HUS. […] STEC-HUS incidence is estimated at 0.57 cases per 100,000 children, and in the highest risk group—children aged 6 months to 2 years—the incidence is as high as 3 per 100,000 children. Incidence directly coordinates with environmental exposure and agricultural practices, such as cattle raising, and most patients are diagnosed between April and September when cattle show higher colonization of STEC.

• #6 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children […] Background/Objectives: Hemolytic uremic syndrome (HUS) is a known cause of acute kidney injury in children, but there are few recent reports on its epidemiology and outcome. We aimed to investigate trends in the incidence and the long-term outcomes of both Shiga toxin-producing Escherichia coli -HUS (STEC-HUS) and atypical HUS (aHUS) in Poland over the last 12 years (2012–2023), based on the Polish Pediatric HUS and Pediatric Renal Replacement Therapy (RRT) Registries. […] The incidence of HUS varies in different geographical regions, with an estimated incidence from 6.3 to 14.2/million age-related population/year (marp) for STEC-HUS and CM-HUS combined. In Europe, the reported incidence of STEC-HUS is 5.6 to 7.8/marp/year, although an increasing trend has been observed in recent years. The highest rates of 60-120/marp are noted in Argentina, mainly in children aged <5 years. The incidence of CM-HUS, reported to be 0.23–2/marp/year, has been relatively constant in recent years.

• #6

  https://step1.medbullets.com/hematology/109081/hemolytic-uremic-syndrome-hus

  Syndrome commonly seen in children […] most commonly in children […] exposed to E. coli […] raw or undercooked meat […] unwashed fruits/vegetables […] animals at petting zoo.

• #6 Haemolytic uraemic syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/haemolytic-uraemic-syndrome

  Children under five years are most vulnerable to HUS. […] HUS can lead to permanent kidney damage or death. […] About 10 per cent of patients with EHEC develop HUS. […] HUS can lead to: Mild, chronic kidney damage occurs in about 50 per cent of cases. […] Kidney failure occurs in five per cent of cases. […] About five per cent of children who develop HUS will die. […] Children under one year or older than five years are at the greatest risk of death. […] Verotoxin producing E. coli (VTEC), Infectious Diseases Epidemiology and Surveillance (Blue Book), Department of Health, Victorian Government.

• #7 Hemolytic-Uremic Syndrome

  https://fpnotebook.com/HemeOnc/ID/HmlytcUrmcSyndrm.htm

  Age: Children ages 1 to 10 years old most commonly affected. […] Incidence: 1-3 per 100,000. […] Peak timing: June to September in United States.

• #7 Hemolytic Uremic Syndrome: An Emerging Health Risk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p991.html

  Hemolytic uremic syndrome primarily occurs in children one to 10 years of age, with an average annual incidence of one to three cases per 100,000 children and a survival rate of nearly 95 percent. […] Some studies indicate that rural populations are more at risk than urban populations, and the incidence is higher in warmer months, peaking from June to September. […] Occurrences may be sporadic or present as an outbreak. […] Three to 15 percent of persons who have STEC with diarrhea can develop hemolytic uremic syndrome. […] Young children and older persons with altered immune response, as well as persons who have been in contact with infected farm animals, are particularly vulnerable. […] In addition to age, risk factors associated with hemolytic uremic syndrome include bloody diarrhea, fever, and elevated white blood cell count and C-reactive protein levels. […] The use of antibiotics or antimotility/antidiarrheal and antimicrobial agents in the early stages of diarrhea has been shown to increase the risk of hemolytic uremic syndrome because the gut is exposed to a greater number of toxins for a longer period as intestinal motility slows.

• #7 Haemolytic uremic syndrome surveillance in children less than 15 years in Belgium, 2009–2015 | Archives of Public Health | Full Text

  https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-018-0289-x

  The Haemolytic Uremic Syndrome (HUS) is the most severe manifestation of infection with Shiga toxin-producing Escherichia coli (STEC). In Belgium, the surveillance of paediatric HUS cases is conducted by a sentinel surveillance network of paediatricians called Pedisurv. In this article, we present the main findings of this surveillance from 2009 to 2015 and we describe an annual incidence of HUS. […] From 2009 to 2015, 110 cases were notified to the Pedisurv network with a mean annual notification rate of 0.8/100,000 in children 15 years. The mean annual incidence based on the hospital discharge data was 3.2/100,000 in children 15 years and 4.5/100,000 in children 5 years. […] The incidence of paediatric HUS in Belgium is high compared to other European countries. Its surveillance in Belgium is quite comprehensive and, although less effective than monitoring all STEC infections to detect the emergence of outbreaks, is important to better monitor circulation of the most pathogenic STEC strains.

• #7 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hemolytic-Uremic-Syndrome-Epidemiology.aspx

  Among those infected with STEC and who develop diarrheal illness, only 3-15% will progress to HUS. Those at risk for HUS in this group include: Young children, Immunocompromised individuals, Those in contact with infected farm animals, Those with bloody diarrhea, Those with fever associated with STEC infection, Those with a high white cell count and CRP levels, Those exposed to antibiotics, or antidiarrheals in early acute infection perhaps because of prolonged exposure of the gut to the bacterial toxins. […] In most parts of the world where HUS occurs, the E. coli serotype O157:H7 is commonly associated with HUS. This includes: North America, Japan, Western Europe, South America, Africa. […] Sporadic disease is the most common form of D+HUS, but endemic outbreaks, often traced to cattle or sheep reservoirs of the bacterium, have occurred. These are often because of the consumption of food which has come into contact with animal feces in some way, and become contaminated with the organism.

• #7 Hemolytic Uremic Syndrome

  https://www.tn.gov/health/cedep/reportable-diseases/hemolytic-uremic-syndrome.html

  Hemolytic Uremic Syndrome (HUS) is a serious sequela of enteric infection with Shiga toxin-producing E. coli (most commonly STEC O157). Children under 5 years of age, the elderly and immunocompromised persons are at greatest risk of developing HUS. About 8% of children (and a small percentage of adults) with STEC O157 diarrhea develop HUS. HUS is diagnosed by microangiopathic hemolytic anemia, thrombocytopenia and renal failure. HUS is usually preceded by a prodromal gastrointestinal illness, or less commonly, an upper respiratory illness. The prodrome is nonspecific and may include malaise and diarrhea, which may be bloody, within 10 days of diagnosis. If patients have no laboratory evidence of hemolysis, thrombocytopenia or nephropathy 3 days after resolution of diarrhea, their risk of developing HUS is low. Up to 5% of pediatric HUS results in death, and 12% of patients will have severe sequelae such as renal impairment, neurological injury or hypertension.

• #8 Hemolytic Uremic Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22741

  HUS and aHUS are most often associated with children younger than 10, with most cases in those younger than 5. Globally, STEC causes 43 acute illnesses per 100,000 person-years and 3890 cases of HUS. STEC-HUS is one of the most common causes of pediatric renal replacement therapy. A large retrospective study showed that 15% of children (younger than 18) who presented to the emergency department with bloody diarrhea developed STEC-HUS. […] STEC-HUS incidence is estimated at 0.57 cases per 100,000 children, and in the highest risk group—children aged 6 months to 2 years—the incidence is as high as 3 per 100,000 children. Incidence directly coordinates with environmental exposure and agricultural practices, such as cattle raising, and most patients are diagnosed between April and September when cattle show higher colonization of STEC.

• #8 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hemolytic-Uremic-Syndrome-Epidemiology.aspx

  Among those infected with STEC and who develop diarrheal illness, only 3-15% will progress to HUS. Those at risk for HUS in this group include: Young children, Immunocompromised individuals, Those in contact with infected farm animals, Those with bloody diarrhea, Those with fever associated with STEC infection, Those with a high white cell count and CRP levels, Those exposed to antibiotics, or antidiarrheals in early acute infection perhaps because of prolonged exposure of the gut to the bacterial toxins. […] In most parts of the world where HUS occurs, the E. coli serotype O157:H7 is commonly associated with HUS. This includes: North America, Japan, Western Europe, South America, Africa. […] Sporadic disease is the most common form of D+HUS, but endemic outbreaks, often traced to cattle or sheep reservoirs of the bacterium, have occurred. These are often because of the consumption of food which has come into contact with animal feces in some way, and become contaminated with the organism.

• #8 Factsheets – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/gastroenteric/hus/factsheets/

  Haemolytic Uraemic Syndrome (HUS) refers to a group of clinical features (syndrome) that includes: […] The commonest cause of HUS is verocytotoxigenic E. coli (VTEC) gastroenteric infection; HUS is the commonest cause of kidney failure in children. […] HUS is notifiable in Ireland and each year about 30 cases of VTEC-related HUS are reported, mostly in children. […] Young children, elderly people and people with weakened immune systems are at highest risk of developing VTEC associated HUS. […] As HUS is almost always due to VTEC infection, it will be important to determine where this infection may have come from. […] If your child develops HUS, as well as being looked after by clinical physicians in the hospital, you will be contacted by Public Health physicians who investigate VTEC cases to work out how your child may have acquired their infection and how far it may have spread. […] Rapid intervention with fluids is crucial, so it is important to identify HUS as early as possible in all ages.

• #8 Haemolytic Uraemic Syndrome (Causes, Symptoms and Treatment)

  https://patient.info/doctor/haemolytic-uraemic-syndrome-pro

  In 2018, questionnaires were sent to a total of 607 confirmed cases of STEC O157 reported in England and Wales. 2% (14) were hospitalised for HUS. Most were under 5 years old (median age 3.7). […] The development of HUS may occur up to two weeks after the initial onset of symptoms and may develop after apparent recovery from the initial acute illness. Cases may be sporadic or occur as part of larger outbreaks. Scotland has one of the largest incidences of VTEC outbreaks in the world. These outbreaks are often traced to butchers. […] About 10% of HUS cases are atypical and are not caused by Shiga toxin-producing bacteria or streptococci. Patients without evidence of underlying infection should be fully investigated, in particular looking for complement gene mutations. […] HUS occurs worldwide but is less widely reported in countries with less developed medical services.

• #8 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  Despite the observed improvement in the prognosis for children with HUS, it should be emphasized that it remains a life-threatening disease. During the acute phase, it is primarily associated with a risk of death, often due to central nervous system involvement. In the study group, 6 deaths were recorded among children with STEC-HUS, all during the acute episode, and 5 deaths were recorded among children with aHUS, 2 of them during the acute phase, while there were no deaths among patients actively treated with eculizumab. […] The incidence of STEC-HUS in children has increased in Poland over the last decade; however, the long-term outcome has improved, with a decreasing number of children with permanent kidney damage being observed, probably due to the better intensive symptomatic treatment given during the acute phase.

• #9 Hemolytic Uremic Syndrome

  https://www.tn.gov/health/cedep/reportable-diseases/hemolytic-uremic-syndrome.html

  Hemolytic Uremic Syndrome (HUS) is a serious sequela of enteric infection with Shiga toxin-producing E. coli (most commonly STEC O157). Children under 5 years of age, the elderly and immunocompromised persons are at greatest risk of developing HUS. About 8% of children (and a small percentage of adults) with STEC O157 diarrhea develop HUS. HUS is diagnosed by microangiopathic hemolytic anemia, thrombocytopenia and renal failure. HUS is usually preceded by a prodromal gastrointestinal illness, or less commonly, an upper respiratory illness. The prodrome is nonspecific and may include malaise and diarrhea, which may be bloody, within 10 days of diagnosis. If patients have no laboratory evidence of hemolysis, thrombocytopenia or nephropathy 3 days after resolution of diarrhea, their risk of developing HUS is low. Up to 5% of pediatric HUS results in death, and 12% of patients will have severe sequelae such as renal impairment, neurological injury or hypertension.

• #9 Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management

  https://www.mdpi.com/2072-6651/13/5/306

  They mainly rely on pediatric centers for active surveillance, along with passive surveillance from laboratories. […] Thus, STEC-HUS incidence as reported in the adult population might be underestimated and should be interpreted very cautiously. […] The incidence of STEC-associated infections is estimated on a regular basis in the USA by the FoodNet annual reports. […] In 2018, it stood at 62.6 per 1,000,000 person-years with an incidence of STEC-HUS of 6.0 per 1,000,000 person-years. […] In Europe, the global incidence of STEC-HUS was assessed in Germany around 1.1 per 1,000,000 person-years in 2008 to 2012. […] The interpretation of these results is rendered dubious by the fact that only five out of 21 adults had a confirmed STEC infection, while severe ADAMTS13 deficiency was documented in two cases, suggesting a final diagnosis of TTP.

• #9 Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children

  https://www.mdpi.com/2077-0383/13/21/6499

  The incidence of aHUS is relatively constant. Following the introduction of eculizumab for the treatment of aHUS, the long-term prognosis has improved significantly. No patients receiving anti-C5 antibodies have required maintenance kidney replacement therapy to date, and fewer patients have developed hypertension, proteinuria, or chronic kidney disease. […] The majority of children with HUS, both STEC-HUS and aHUS, recovered during the observation period, but some of them achieved full recovery even 5 years after onset, suggesting that their kidney status should be systematically followed.

• #10 Haemolytic uraemic syndrome (STEC HUS) | Kidney Care UK

  https://kidneycareuk.org/kidney-disease-information/kidney-conditions/haemolytic-uraemic-syndrome-stec-hus/

  Haemolytic uraemic syndrome (HUS) is a rare condition that damages the small blood vessels inside the kidneys. […] STEC HUS affects around 1 in 100,000 people in the UK. There are about 100 new cases a year. It usually affects children under the age of ten. […] Not everyone who is infected with the bacteria will develop STEC HUS. Localised outbreaks may occur but in general, one in ten people infected by the bacteria will go on to develop STEC HUS. […] STEC HUS is classed as a notifiable disease so the local public health authority will be told in order to identify the cause of the outbreak and minimise further infection. Cases of STEC HUS in children should also be reported to the British Paediatric Surveillance Unit.

Zobacz więcej