According to a study published in the May issue of Clinical Infectious Diseases, hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure in children in the United States. FoodNet, the Foodborne Disease Active Surveillance network, was the source of the statistics. Surveillance is difficult because there is no single diagnostic test to diagnose HUS.
The study examined pediatric HUS cases from 2000 to 2007 and found that in 627 cases, more than 90% occurred after a diarrheal illness and most were caused by infections of Shiga toxin-producing E. coli 0157:H7 (STEC). An average of 78 cases were reported every year; most (66%) occurred in children less than than five years old; of those cases, 64% were in children less than two years old.
About 93,000 Americans are sickened with STEC infections every year. Six percent of those patients will develop hemolytic uremic syndrome; of those cases, five percent are fatal.
HUS can also cause long-term health complications, including neurologic dysfunction, kidney failure, and hypertension. If a patient receives good supportive care quickly, outcomes improve.
The study found that most cases were captured by provider-based surveillance (76%) than by hospital discharge data review (68%). FoodNet contacts a network of pediatric nephrologists and hospital infection control practitioners to identify patients with diagnosed HUS, and they review hospital discharge data. Researchers suggest that health departments should consider which strategy to use when choosing a reporting method.
