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Diarrhoea in close contacts as a risk factor for childhood haemolytic uraemic syndrome

Published online by Cambridge University Press:  15 May 2009

P. C. Rowe ,
E. Orrbine ,
H. Lior ,
G. A. Wells  and
P. N. McLaine
P. C. Rowe
Affiliation:
Canadian Pediatric Kidney Disease Reference Centre, Ottawa, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
E. Orrbine
Affiliation:
Canadian Pediatric Kidney Disease Reference Centre, Ottawa, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
H. Lior
Affiliation:
Canadian Pediatric Kidney Disease Reference Centre, Ottawa, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
G. A. Wells
Affiliation:
Canadian Pediatric Kidney Disease Reference Centre, Ottawa, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
P. N. McLaine*
Affiliation:
Canadian Pediatric Kidney Disease Reference Centre, Ottawa, and the National Laboratory for Enteric Pathogens, Laboratory Centre for Disease Control, Ottawa, Canada
*
*Dr Peter N. McLaine. Director. Canadian Pediatric Kidney Disease Reference Centre, 401 Smyth Road, Ottawa, Ontario. Canada K1H 8L1.
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Summary

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To determine whether the risk factors for childhood haemolytic uraemic syndrome (HUS) are similar to risk factors previously reported for Escherichia coli O 157. H7 gastroenteritis, we conducted a case-control study at eight paediatric hospitals in the summer of 1990. Thirty-four consecutive children with HUS were prospectively enrolled; all had diarrhoea and 88% had laboratory evidence of exposure to verotoxin-producing E. coli (VTEC). The 102 controls were otherwise healthy children with minor acute injuries. Parents of all subjects responded to a questionnaire about each child's exposure to various foods, methods of food preparation, sources of water, travel, and individuals with diarrhoea.

Children with HUS were significantly more likely than controls to have had close contact with an individual with diarrhoea in the 2 weeks before the onset of illness (74 υ. 29%, P < 0.00001; odds ratio 7·0. 95% CI 2.7–18.5). The onset of diarrhoea in the contacts occurred a median of 6 days (range, 1− > 14 days) before the onset of diarrhoea in the HUS patients. Exposure to undercooked ground meat was not significantly more common in the patients with HUS (15 υ. 8%; P=0.05). These data provide evidence consistent with person-to-person transmission of VTEC in a substantial proportion of episodes of childhood HUS.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 1 , February 1993 , pp. 9 - 16
Copyright
Copyright © Cambridge University Press 1993

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