Hemolytic Uremic Syndrome (HUS)

Updated: March 2023

What is hemolytic uremic syndrome?

HUS is a rare but serious disease that affects the kidneys and blood clotting functions of infected people. Infection with HUS causes destruction of red blood cells, which can then cause kidney failure. HUS occurs as a complication of a diarrheal infection (usually Shiga toxin-producing E.coli (STEC) infection). The disease occurs more commonly in children under 5 years of age than in other age groups.

Who gets hemolytic uremic syndrome?

Anyone infected with Shiga toxin-producing E. coli (STEC) can get HUS. Children under 5 years of age, people with weakened immune systems (such as those with cancer, HIV/AIDS, or a transplant), or persons with a family history of HUS are more at risk to develop the disease. Only a small fraction of people diagnosed with STEC infection develop HUS.

How does Shigatoxin-producing E.coli (STEC) spread?

People become infected with STEC when they ingest any product contaminated with the bacteria, including raw (or undercooked) meat, lettuce, alfalfa sprouts, salami, or raw (unpasteurized) milk, juice, or cider. Infected people can spread E. coli to other people if they do not wash their hands after using the toilet.

What are the symptoms of hemolytic uremic syndrome?

Symptoms of HUS include vomiting, bloody diarrhea (loose stool/poop), stomach pain, fever, chills, and headache. As infection progresses, persons may experience fatigue, weakness, fainting, bruising, and paleness. Complications may occur leading to high blood pressure, seizures, blood-clotting problems, kidney disease, stroke, or coma.

How is hemolytic uremic syndrome diagnosed?

HUS cannot be diagnosed with one single test or indicator, but rather a panel of tests and evaluations. These tests and evaluations include a medical and family history, physical exam, urine test, blood test, stool test, and/or kidney biopsy.

What is the treatment for hemolytic uremic syndrome?

Treatment for HUS infection typically involves hospitalization, and may include special diets, blood transfusions, and kidney dialysis. Most people recover completely from HUS, but in some cases, it can be fatal.

What can be done to help prevent Shigatoxin-producing E.coli (STEC) infection?

  1. Always handle raw meat, especially ground beef, accordingly:
    • Wrap fresh meats in plastic bags at the market to prevent blood and juices from dripping on to other foods. Refrigerate promptly; do not store at room temperature.
    • Never place cooked food on an unwashed plate that previously held raw beef, poultry, pork, fish, or seafood.
    • Cutting boards and counters used for beef, poultry, pork, fish, or seafood preparation should be washed immediately after use to prevent cross contamination with other foods.
    • Avoid eating raw or undercooked meats. While the juice color will usually change from red to gray when the meat is fully cooked, it is not a reliable test to assure it is safe to eat.
    • Always check the temperature of cooked foods with a meat thermometer. Foods that reach the temperatures listed below (or higher) are considered fully cooked.
      Food Temperature
      Chicken 165° F
      Hamburger 160° F
      Pork 150° F
      Hot dogs 140° F
      Leftovers 165° F
      Eggs 145° F
      Other foods 140° F
  2. Avoid drinking raw (unpasteurized) milk, juices and ciders.

  3. Wash fruits and vegetables thoroughly, especially those that will be eaten raw.

  4. Wash hands with soap and hot water before and after food preparation, as well as, before eating.

  5. Wash hands with soap and hot water after using the toilet, changing diapers, and after any animal contact (at home, farms, petting zoos, etc.).

  6. Do not drink water from untreated sources (including roadside springs) and avoid swallowing water from recreational water sources (including lakes, streams, and swimming pools).