INCREASED INCIDENCE OF HEMOLYTIC-UREMIC S YNDROME DUE TO ENTEROHEMORRHAGIC ESCHERICHIA-COLI (EHEC) IN THE MUNSTERLAND EMSLAND PROVINCE OF GERMANY IN 1994/

Between 1985 and 1993 only 5 children per year were treated for HUS in the Pediatric Nephrology Unit in Munster, whereas 15 (9 girls and 6 b oys) were admitted between March to September 1994. 12 of 15 children were 1 to 3 years old. Few days before HUS developed all of them suffe red from haemorrhagic diarrhea, two showed CNS-affections, five hypert ension, and six suffered from severe pancreatitis. In four families EH EC-food infection was suspected. 2-5 days before diarrhea two children had drank raw milk, one child had consumed undercooked ground beef an d another one chicken. We suspect a counection between the increase in verotoxine-producing E. coli especially in cattle (therefore involvin g the contamination of meat and dairy products) and the increase of HU S. Evidence relating to the patients' histories, their environment, an d the incidence of infections in their families supports this hypothes is. In conclusion, to avoid EHEC-transmission, precise records of HUS- infected children must be kept including details of diet, family histo ry and surroundings. Parents should be informed of preventive measures such as boiling unpasteurised milk and thoroughly cooking meat.