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3 results

  • Farm animal exposure setting impacts hemolytic uremic syndrome risk among Shiga toxin-producing Escherichia coli cases: Minnesota, 2010–2019

  • Madhura S. Vachon, Joshua Rounds, Kirk Smith, Carlota Medus, Craig W. Hedberg, Carrie Klumb, Gillian A. M. Tarr
  • Journal:
    Epidemiology & Infection / Volume 152 / 2024
    Published online by Cambridge University Press:
    16 May 2024, e96
    • Article
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  • Shiga toxin-producing Escherichia coli (STEC) transmission occurs in ruminant contact settings and can lead to post-diarrheal hemolytic uremic syndrome (HUS). We investigated whether exposure setting (ruminant exposure from living or working on a farm, visiting a farm or animal contact venue, or both) influenced HUS development among individuals with laboratory-confirmed STEC infections using Minnesota surveillance data from 2010 to 2019. Logistic regression was performed to determine whether exposure setting was associated with HUS independent of age, gender, stx2 gene detection, and county ruminants per capita. Among confirmed STEC cases, ruminant exposure only from living or working on a farm was not significantly associated with HUS compared to cases without any ruminant exposure (OR: 1.25; 95% CI: 0.51, 3.04). However, ruminant exposure only from visiting a farm or public animal contact venue was associated with HUS (OR: 2.53; 95% CI: 1.50, 4.24). Exposure from both settings was also associated with HUS (OR: 3.71; 95% CI: 1.39, 9.90). Exposure to ruminants when visiting farms or animal contact venues is an important predictor of HUS, even among people who live or work on farms with ruminants. All people, regardless of routine ruminant exposure, should take care in settings with ruminants to avoid infection with STEC.

  • 66 - Overdoses

  • from Section 11 - Environmental emergencies
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 431-450

  • Summary

    This chapter discusses the diagnosis, evaluation and management of disseminated intravascular coagulation and thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS). The classic presentation of TTP involves a pentad of symptoms that include fever, neurological signs, anemia, thrombocytopenia, and renal dysfunction. This collection of symptoms is only seen in 20-30% of cases and it is strongly recommended to suspect the condition and manage it as such if a patient exhibits three or more of those features. HUS is most commonly seen in children and often follows an infectious illness, usually diarrhea. Morbidity and mortality in patients with TTP/HUS are usually attributed to thrombosis rather than anemia and bleeding. Patients with TTP can present with neurological symptoms that can be life threatening themselves or complicated by a life-threatening event. Patients (usually children) presenting with HUS may have significant renal dysfunction requiring dialysis.