Hemolytic Uremic Syndrome (HUS)

What is Hemolytic Uremic Syndrome (HUS)?

HUS is a serious disease that affects the kidneys and the body's ability to clot the blood. In severe cases, the red blood cells are destroyed, resulting in anemia and kidney failure. About 2%-7% of infections by the bacteria E. coli O157:H7 lead to HUS. In 2010, there were 5 cases reported in New York City residents.

Who gets HUS?

It is a rare disease, and it affects children more often than adults. In the United States, HUS is the principal cause of acute kidney failure in children. Most cases occur in the warmer months between April and October.

What causes HUS?

Most cases of HUS are caused by infection with the bacteria E. coli O157:H7. E. coli O157:H7 infections occur after eating contaminated food, such as undercooked meat or dairy products; or through contact with a person who has infectious diarrhea. One in ten children who have E. coli O157:H7 infection will go on to develop HUS. The bacterium (germ) releases a toxin that affects blood flow to the kidney and other vital organs including the brain, pancreas and liver, leading to impaired organ function. This can cause the sudden development of kidney failure, diabetes, hepatitis, and even heart failure.

What are the symptoms of HUS?

Five to ten days after exposure to E. coli O157:H7, some persons experience gastro-intestinal illness. Most commonly, the symptoms include diarrhea (with or without blood), fever, nausea, or vomiting. In some cases irritability, fatigue, extreme paleness, and a decrease in urine production may occur. Neurological symptoms (including drowsiness, unconsciousness, seizures, blindness, and coma) can be present when the disease starts, or develop during the course of illness.

How is HUS diagnosed?

If a doctor suspects HUS based on a patient's symptoms, he/she will request several lab tests to check kidney function, blood clotting factors, blood counts, and urine analysis.

What is the treatment of HUS?

There is no specific treatment for HUS in children; however dialysis is often required. Most children (90%) with HUS recover from the acute illness with no permanent damage to their kidneys if treated properly and on time. The following medical management of complications is recommended:

  • As with all types of diarrhea, it is important to avoid dehydration (loss of too much body fluid) by encouraging the patient to drink plenty of fluids, or providing intravenous fluids.
  • Efforts should be made to control blood pressure.
  • Kidney dialysis is often required; kidney transplant is occasionally necessary.
  • Blood transfusions may be needed.

How can HUS be prevented?

The following measures should be taken to prevent infection by E. coli O157:H7 bacteria:

Cook meat thoroughly.

  • Cook all ground beef and hamburger thoroughly.
  • Make sure the cooked meat is brown throughout (not pink), and the juices run clear.
  • Do not eat undercooked hamburger or other ground beef products at home, restaurants or outdoor barbecues.

Avoid unpasteurized foods and beverages.

  • Drink only pasteurized milk and milk products. Avoid raw milk.
  • Avoid unpasteurized apple cider.

Keep raw meats and their juices away from other foods.

  • Use separate cutting boards for raw meats and other foods.
  • Use separate shopping bags for raw meats while food shopping.
  • Wash counters and cooking tools with hot soapy water before and after preparing raw meats.

Wash your hands often.

  • Persons with diarrhea, especially children, should wash their hands carefully with soap and warm running water after using the toilet to reduce the risk of spreading the disease.
  • Always thoroughly your wash hands with soap and warm running water before feeding infants, touching food, after using the toilet or changing diapers, and after handling raw meat.
  • If you work in a child-care center where you change children's diapers, wash your hands carefully between changing each child's diapers. When using gloves, wash your hands and change gloves between each child.
  • If you take care of persons who have an E. coli O157:H7 infection, or persons who have diarrhea, wash your hands after bathing patients, emptying bedpans, changing soiled linen, or otherwise coming in contact with stool.

Stay home when sick.

  • Young children known to have E. coli O157:H7 infection should stay home from daycare/school until two stool cultures (obtained two days apart) have tested negative for the bacteria.

Last Updated March 2012