Steve Doyle ("Mr. E. coli") of the Huntsville Times continues to cover the story:
3 with E. coli still in hospital but improving
Three people sickened in an E. coli outbreak linked to Little Rosie’s remain hospitalized with kidney failure. They are suffering from either HUS or TTP. See www.about-hus.com and www.about-ttp.com for a complete discussion of these illnesses.
- Five-year-old Samuel Coggin of Meridianville is undergoing dialysis at Vanderbilt Children’s Hospital to flush the toxic [produced from the] E. coli O157:H7 bacteria from his kidneys.
- Hampton Cove resident Regina Lassiter, 69, is also slowly improving, although she remains on a ventilator at Memorial Mission Hospital in Asheville, N.C.
- The other hospitalized E. coli victim, a 48-year-old woman whose name has not been released, was in serious condition Monday in Huntsville Hospital’s medical intensive care unit. She had been in critical condition.
Hemolytic Uremic Syndrome (HUS) is a severe, life-threatening complication of an E. coli O157:H7 bacterial infection. Although most people recover from an E. coli O157:H7 infection, about 5-10% of infected individuals goes on to develop HUS.
What is Thrombotic Thrombocytopenic Purpura?
At the outset, it is important to note there are two basic types of TTP, having nothing to do with each other. Thrombotic thrombocytopenic purpura (TTP) is a rare blood condition characterized by the formation of small clots (thrombi) within the circulation, which results in the consumption of platelets and thus a low platelet count (thrombocytopenia). A different TTP-like syndrome, more properly called hemolytic uremic syndrome (HUS) or “adult-HUS,” is caused by the specific bacterium E. coli O157:H7. HUS is a rare complication of E. coli O157:H7 infections and usually occurs in young children. But when it occurs in adults, doctors often refer to it as TTP or TTP/HUS because of its resemblance to TTP.
The most important aspect of the treatment of patients with Hemolytic Uremic Syndrome remains excellent supportive care, which includes: close observation in a tertiary care facility; meticulous attention to fluid, electrolyte, and metabolic balance; optimal nutrition; and careful blood pressure control. Blood product transfusions may be necessary several times during the course of the active stage of HUS. Dialysis, or interventional therapy, such as plasma exchange (plasmapheresis), may be necessary for patients at risk for a bad outcome.
There is no known therapy to halt the progression of Hemolytic Uremic Syndrome. The active stage of the disease usually lasts one to two weeks, during which a variety of complications are possible. HUS is a frightening illness that even in the best American medical facilities has a mortality rate of about 5%. By comparison, the mortality rate in the developing world is much higher. About 50% of patients require dialysis due to kidney failure, 25% develop pancreatitis, 25% experience seizures, and 5% suffer from diabetes mellitus. The majority of Hemolytic Uremic Syndrome patients requires transfusion of blood products and develops complications common to the critically ill. The illness is a living nightmare for the patients and families, and leaves a painful memory that lingers long after the acute illness had passed.
Among survivors of HUS, about five percent will eventually develop end stage kidney disease, with the resultant need for dialysis or transplantation, and another five to ten percent experience neurological or pancreatic problems which significantly impair quality of life. Since the longest available follow-up studies of HUS are about twenty (20) years, an accurate lifetime prognosis is not available, and as such, medical follow-up is indicated for even the mildest affected cases.