Hemolytic Uremic Syndrome (HUS)
Hemolytic uremic syndrome (HUS) is a life-threatening illness that affects the red blood cells and kidneys. It is a rare condition, but is more common in children, especially those younger than five years of age. HUS often occurs after a gastrointestinal infection with Escherichia coli O157:H7, a type of Shiga-Toxin Producing E. coli (STEC), but other pathogens, such as Campylobacter jejunii can cause HUS. About five to ten percent of people diagnosed with STEC develop HUS. The condition has also been linked to other bacterial pathogens known to cause gastrointestinal infections, including Shigella and Salmonella.
Transmission
HUS cannot be spread from person to person. However, STEC, Shigella and other organisms that can cause HUS can be spread through eating or drinking contaminated food or water or contact with an ill person.
HUS may recur in a person if they are exposed to STEC, Shigella, or other organisms.
Symptoms
Post-diarrheal HUS usually occurs one to two weeks following the onset of diarrhea, when diarrhea is improving. Symptoms of HUS may include:
- Fever
- Fatigue
- Irritability
- Blood in urine
- Decreased frequency of urination to no urination
- Anemia (low red blood cell count that causes pale complexion and weakness)
- Low platelet count (cells in the bloodstream that help blood clot)
- Decreased kidney function may occur
Diagnosis
A health care provider can diagnosis HUS based on clinical signs symptoms and several laboratory tests, including kidney function, blood clotting factors, and blood count.
Treatment
Someone who is diagnosed with HUS will need to be hospitalized
- Supportive care including management of patient’s fluids and electrolytes
- Blood transfusion may be necessary if the patient is severely anemic
- Dialysis may also be required if the patient’s kidneys fail
For more information about the treatment of HUS contact your health care provider or visit Signs of Hemolytic Uremic Syndrome | E. coli infection | CDC.
Prevention
HUS can be prevented by taking the following precautions against getting disease such as STEC, Shigellosis and other gastrointestinal infections.
- Wash hands thoroughly after
- Using the bathroom
- Changing diapers
- Before preparing food
- Contact with animals and their environments (farms, petting zoos, fairs, and your backyard)
- Cook meats thoroughly, especially beef and meat that has been tenderized, such as hamburger
- Cook to an internal temperature of at least 160°F
- Color is not a reliable indicator of the meat being done
Exclusion Guidance
Individuals with HUS likely will not be able to attend work, school or child care, general exclusions apply.
For additional information about HUS,
contact North Dakota Health and Human Services’ Public Health Division at 800.472.2180.
Resources
1. Kimberlin, D. W., Barnett, E. D., Lynfield, R., Sawyer, M. H. (2021) Red Book: 2021- Report of the Committee on Infectious Diseases. 31st ed. American Academy of Pediatrics. [Management and Prevention of Infectious Diseases] [322-328].
2. Kimberlin, D. W., Barnett, E. D., Lynfield, R., Sawyer, M. H. (2021) Red Book: 2021- Report of the Committee on Infectious Diseases. 31st ed. American Academy of Pediatrics. [Management and Prevention of Infectious Diseases] [1041-1047].
3. U.S National Library of Medicine. (2022, January 25). NIH – Hemolytic-uremic syndrome. Medline Plus. Retrieved May 24, 2023, from https://medlineplus.gov/ency/article/000510.htm
4. Centers for Disease Control and Prevention. (2014, December 1). CDC – E. coli (Escherichia coli). Centers for Disease Control and Prevention. Retrieved May 24, 2023, from https://www.cdc.gov/ecoli/ecoli-symptoms.html