Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study.

Publisher: Cambridge University Press Country of Publication: England NLM ID: 8703737 Publication Model: Electronic Cited Medium: Internet ISSN: 1469-4409 (Electronic) Linking ISSN: 09502688 NLM ISO Abbreviation: Epidemiol Infect Subsets: MEDLINE

Original Publication: Cambridge Eng : Cambridge University Press

Escherichia coli Infections*/epidemiology ; Escherichia coli Infections*/diagnosis ; Hemolytic-Uremic Syndrome*/epidemiology ; Shiga-Toxigenic Escherichia coli*; Child ; Child, Preschool ; Female ; Humans ; Infant ; Diarrhea/epidemiology ; England/epidemiology ; Northern Ireland/epidemiology ; Prospective Studies ; Wales/epidemiology ; Male

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. Between 2011 and 2014, 288 HUS patients were included in the study, of which 256 (89.5%) were diagnosed as typical HUS. 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 majority of typical HUS cases were 1 to 4 years old (53.7%) and female (54.0%). Clinical symptoms included diarrhoea (96.5%) and/or bloody diarrhoea (71.9%), abdominal pain (68.4%), and fever (41.4%). Where STEC was isolated (59.3%), 92.8% of strains were STEC O157 and 7.2% were STEC O26. Comparison of the HUS case ascertainment to existing STEC surveillance data indicated an additional 166 HUS cases were captured during this study, highlighting the limitations of the current surveillance system for STEC for monitoring the clinical burden of STEC and capturing HUS cases.

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111815 United Kingdom DH_ Department of Health

Keywords: E. coli; Shiga-like toxin-producing; epidemiology; medical microbiology; paediatrics; surveillance

Date Created: 20230901 Date Completed: 20231006 Latest Revision: 20231028

20240829

PMC10600734

10.1017/S0950268823001413

37655611