Haemolytic uraemic syndrome and E coli 0157BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7185.684 (Published 13 March 1999) Cite this as: BMJ 1999;318:684
Prevention rests with sound public health measures
- Margaret Fitzpatrick, Consultant paediatric nephrologist
- St James's University Hospital, Leeds LS9 7TF
Deaths from renal failure after outbreaks of acute gastroenteritis in Scotland in 1996, which were traced back to poor hygiene in butchers‘ shops, focused attention on Escherichia coli 0157 and its links with the haemolytic uraemic syndrome. Although in the Scottish outbreak deaths occurred mainly in elderly people, haemolytic uraemic syndrome associated with diarrhoea generally affects children and is the commonest cause of acute renal failure in children in Europe and North America.
Haemolytic uraemic syndrome is the most important complication of infection by verocytotoxin producing E coli—usually of the serotype 0157:H7, though other serotypes are also implicated. 1 2 It is characterised by the sudden onset of haemolytic anaemia with fragmentation of red blood cells, thrombocytopenia, and acute renal failure after a prodromal illness of acute gastroenteritis often with bloody diarrhoea. The gastrointestinal disease may be severe, with haemorrhagic colitis, and the central nervous system, pancreas, lungs and heart may also be affected. Fortunately more than 95% of people affected with this condition do recover from the acute illness, and …