HEMOLYTIC-UREMIC SYNDROME IN CHILDHOOD - HOW IS IT CONTRACTED IN SWITZERLAND

Intestinal infections with shigatoxin-producing Escherichia coli or Sh igella dysenteriae type I play a major role in the pathogenesis of the hemolytic-uremic syndrome in childhood. Escherichia coli has been rep eatedly detected in the intestines of healthy cattle. Twenty-seven chi ldren with hemolytic-uremic syndrome were treated at our hospital betw een June 1990 and March 1997. Factors indicating a possible previous c ontact with bovine intestinal content were found in 18 out of the 27 p atients: parents stockbreeders (n=7), recent visit to a cowshed or con tact with cowdung or manure (n=5), residence in a rural cattle-breedin g area (n=5), or consumption of raw milk (n=1). The factors mentioned were found in 5 out of 27 control patients (p<0.01). Two children expe rienced hemolytic-uremic syndrome after a stay respectively in Egypt a nd Tunisia. Our results indicate an important source for acquisition o f hemolytic-uremic syndrome in childhood. Observing simple hygienic ru les such as washing of hands and pasteurization of milk is likely to h ave a positive influence on the incidence of this illness. There are a lso grounds to consider adding the hemolytic-uremic syndrome to the li st of travel-related diseases.