E. coli, hemolytic uremic syndrome and a rising death toll

As more people in Europe fall ill from an especially dangerous strain of E. coli, the germ’s worst-case complication, hemolytic uremic syndrome, is grabbing headlines. The condition, which can shut down the kidneys, is potentially fatal—as evidenced by the mounting death toll.

Though most strains of E. coli are harmless, this particular outbreak appears to be caused by a virulent strain known as enterohemorrhagic E. coli. It leads to hemolytic uremic syndrome in about 8% of those infected, often children.

The syndrome develops when E. coli bacteria in the digestive tract release toxins that destroy red blood cells. The then-misshapen blood cells in turn clog blood vessels in the kidneys, rendering the organs less effective at filtering waste from the bloodstream--see this explainer on MedicineNet.com.

PubMed Health describes the symptoms:

“HUS often begins with vomiting and diarrhea, which may be bloody. Within a week, the person may become weak and irritable. Persons with this condition may urinate less than normal. Urine output may almost stop. Red blood cell destruction leads to symptoms of anemia.”

The syndrome can cause short-term or long-term kidney failure, partial removal of the bowel, seizures, stroke, or even death. The most common form of hemolytic uremic syndrome, involving diarrhea, kills 3% to 5% of people who have it, according to the Centers for Disease Control and Prevention. Older children and adults often fare the worst.

This is a serious condition, but not one that requires panic -- at least not in this country at this moment. The U.S. is inspecting potential sources of contaminated produce in this country, even as officials elsewhere attempt to identify the source of the illness.

Consumers should simply stay informed about the sources of E. coli outbreaks in general, according to Dr. Bruce Hirsh, an infectious diseases specialist at North Shore University Hospital in Manhasset, N.Y.

“The risk to a specific individual in good health is low. Out of the thousands of people exposed, very few will actually get sick,” said Dr. Hirsh in a phone interview.

But given that someone can become ill from only 100 bacteria, he says, consumers should avoid potential illness-carrying suspects until the actual source is identified. In this case, that means people in Europe should avoid, for now, cucumbers, tomatoes and lettuce.

healthkey@tribune.com

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