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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

Girl with E. coli still hospitalized with Hemolytic Uremic Syndrome (HUS)

What is Hemolytic Uremic Syndrome (HUS)?

Hemolytic Uremic Syndrome (HUS) (see www.about-hus.com) is a severe, life-threatening complication of an E. coli O157:H7 bacterial infection (see www.about-ecoli.com). Although most people recover from an E. coli O157:H7 infection, about 5-10% of infected individuals goes on to develop HUS.

Hemolytic Uremic Syndrome was first described in 1955, and is now recognized as the most common cause of kidney failure in childhood. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. In fact, some researchers now believe that E. coli O157:H7 is the only cause of HUS in children.

HUS develops when the toxin from E. coli bacteria, known as Shiga-like toxin (SLT) [1,2], enters the circulation by binding to special receptors. These Shiga-toxin receptors, known as Gb3 receptors [1], are probably heterogeneously distributed in the major body organs allowing disparate thrombotic (blood clotting) impacts in different HUS victims, although the greatest receptor concentration appears to be in the kidneys, especially in children. As the inflammatory reaction process accelerates, red blood cells are destroyed and cellular debris aggregates within the microvasculature while the body’s inherent clot breaking mechanisms are disrupted. The result is formation of microthrombi within particularly susceptible organs such as the kidneys and brain. Because there exists no way to halt the progression of HUS, doctors are left to support the HUS victim while the acute process runs its course.

Some organs appear more susceptible than others to the damage caused by these toxins, possibly due to the presence of increased numbers of toxin-receptors. These organs include the kidney, pancreas, and brain.

Dave McKibben, Los Angeles Times Staff Writer reported today that:

The 12-year-old, one of seven diners who became ill after eating in a Lake Forest restaurant, remains in intensive care with complications.  A 12-year-old girl remained in intensive care Wednesday after being infected with the E. coli bacteria at a Lake Forest restaurant, hospital and health officials said.  After being diagnosed with the most serious complication of E. coli Wednesday afternoon, the girl was transferred from Children’s Hospital of Orange County at Mission Hospital in Mission Viejo to the CHOC facility in Orange. The girl, whose name has not been released because of privacy issues, was admitted to the hospital Friday.  Two others hospitalized after dining at the Foothill Ranch restaurant have been released. One person over age 70 was discharged Tuesday or Wednesday. An 8-year-old boy was discharged Tuesday.  Denise Almazan, a CHOC spokeswoman, said the 12-year-old girl, a dancer, was in excellent health before she became ill.  Almazan said the girl was diagnosed with hemolytic uremic syndrome, which occurs in less than 10% of those infected with E. coli, usually those younger than 5 or the elderly. People with HUS may develop kidney failure and anemia, and 3% to 5% die.