Haemolytic uraemic syndrome 2

This study aimed to monitor trends in the aetiology of childhood HUS in the UK and to identify general outbreaks of infection. The main objectives of this study were to ensure that appropriate clinical specimens are collected for detailed microbiological analysis by designated reference laboratories. To collect standardised clinical and epidemiological data on all cases of childhood HUS presenting to nephrologists based in collaborating specialist paediatric units in the UK. Additionally, the team wished to develop and maintain a confidential database incorporating clinical, epidemiological and microbiological data collected from paediatric nephrology units and reference laboratories.

By bpsu · February 1, 1997

Lead investigator

Dr G K Adak

About the study

When this study was undertaken, Verocytotoxin-producing Escherichia coli (VTEC) infection was the most common cause of childhood haemolytic uraemic syndrome (HUS) in the United Kingdom and the Republic of Ireland. Data from the PHLS Laboratory of Enteric Pathogens (LEP) and the Scottish VTEC Reference Laboratory indicated that VTEC O157 infection accounts for 90% of VTEC-associated childhood HUS cases in the UK. However, other VTEC serogroups predominate in Denmark and Australia. In Italy, VTEC O26 has overtaken VTEC O157 as the most common VTEC serogroup. At that time, laboratory testing of clinical specimens for non-O157 VTEC could only be conducted by specialist laboratories. Therefore, laboratory report surveillance was not a suitable instrument for monitoring trends in the incidence of these pathogens or for identifying outbreaks of infection. However, it had been demonstrated in Australia that clinical surveillance of childhood HUS was an effective instrument for detecting outbreaks of infection caused by non-O157 VTEC in the absence of appropriate laboratory-based surveillance systems. Given rising levels of food imports, there was a public health need to maintain and improve the surveillance of non-O157 VTEC in the UK. Clinical surveillance of childhood HUS through paediatric nephrologists (supported by detailed microbiological investigation) remained the most effective surveillance mechanism currently available.

Aims:

To monitor trends in the aetiology of childhood HUS in the UK.
To identify general outbreaks of infection.

Duration

February 1997 – February 2001

Published papers

Lynn RM, O’Brien SJ, Taylor CM, Adak GK, Chart H, Cheasty T, Coia JE, Gillespie IA, Locking ME, Reilly WJ, Smith HR, Waters A, Willshaw GA. Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis. 2005 Apr;11(4):590-6. doi: 10.3201/eid1104.040833. PMID: 15829199; PMCID: PMC3320351.

BPSU 15th Annual report 2000-2001

Support Group

Haemolytic Uraemic Syndrome Support (HUSH)
Web: http://www.ecoli-uk.com