EPIDEMIOLOGY OF THE POST-DIARRHEA HEMOLYT IC-UREMIC SYNDROME IN CHILDREN FROM 4 FRENCH DEPARTMENTS

Background. - Epidemiology of the hemolytic uremic syndrome (HUS) is b est known in the English-speaking countries than in France. Population and methods. - The attack rate of the HUS following acute gastro-ente ritis in children was studied between 1982 and 1993 in four French dep artments (total population: 1,758,000). Investigations were performed with the cooperation of all the pediatric hospitals in each department . The pediatric population (0-4 Bears of age) remained stable at 4.8 t o 5.3% during the study. Forty-nine children (22 girls, 27 bogs) were included in this retrospective study. Results. - All patients had hemo lytic anemia with schizocytosis; thrombocytopenia was observed in 46/4 9 cases. Acute renal failure occurred in 48 cases. Twenty-fire childre n required peritoneal dialysis (cumulative duration = 339 days). Four children (8.1%) died One patient is still in chronic renal failure aft er 3 years. Age at disease was less than 1 year in 18 cases 1-2 years in 13, 2-3 fears in nine, 3-4 years in six and 4-10 years in three The attack rate for the 1982-1993 period for the patients less than 5 yea rs of age was 51.7/100,000 (50.2-54). The mean. of annual attack rate in the same group was 4.61/100,000 (range: 1.1-11.3), higher than the annual attack rate of acute HUS in Greet Britain (3.1/100,000) Canada (3.1/100,000) and USA (2.7/100,000). Conclusions. - The attack rate of HUS was similar inside each department even though country vs city dw ellers and liverstock were unequally distributed.