Haemolytic uraemic syndrome (HUS)

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What is HUS?

Haemolytic uraemic syndrome (HUS) is a rare but serious illness that can be life-threatening and is caused by a bacterial infection. HUS causes inflammation and the blood vessels to clot in the kidneys. This prevents the kidneys from working properly. HUS also causes changes to your blood, including anaemia and low platelet count.

You can get HUS at any age but it’s most common in children under the age of 5 years. Young children and older adults are at greater risk of severe disease.

What are the symptoms of HUS?

Your early symptoms depend on the cause of your HUS.

The most common cause of HUS is an infection from a type of E.coli bacteria. Your first symptoms may include about 5 to 10 days of:

  • severe stomach pain and cramps
  • bloody diarrhoea
  • fever and vomiting (less common)

Whatever causes your HUS, later symptoms can include:

  • pale skin and easy bruising
  • jaundice (yellowing of your skin and whites of your eyes)
  • bleeding from your nose and mouth
  • passing less urine than usual or bloody urine (wee)
  • swelling in your legs and arms
  • high blood pressure
  • confusion

What causes HUS?

The most common cause of HUS is a type of bacterium called Shiga toxin-producing E.coli (STEC). It is commonly found in cow and sheep faeces (poo).

You can catch STEC if you:

  • eat undercooked meat
  • drink unpasteurised (‘raw’) milk or juice
  • drink or swim in contaminated water
  • touch cows and sheep, or their faeces, then put your hand in your mouth
  • eat unwashed vegetables that were in contact with animal faeces

You can also catch STEC through close contact with someone who has the infection or with surfaces they’ve touched, such as toys, nappies, taps or toilet flushes. The STEC bacterium produces toxins (poisonous substances) that damage your digestive tract (gut) and can cause HUS. This happens in a small number of the people infected with the bacterium, but most people infected with STEC don’t develop HUS.

Other less common causes of HUS include other infections and medicines (such as some drugs for cancer, autoimmune diseases and a complication of pregnancy).

When should I see my doctor?

HUS is a serious disease and if you have symptoms, see a doctor immediately.

HUS is a notifiable disease. This means that your doctor must tell the Australian Government’s Department of Health and Aged Care if you’re diagnosed with HUS. The Department needs to monitor and track all cases of HUS to find outbreaks and improve healthcare responses.

How is HUS diagnosed?

If your doctor thinks that you have HUS, they will ask about your symptoms and examine you. Blood, urine and stool tests can help them make a diagnosis.

How is HUS treated?

If you have HUS, you may need intensive care in hospital, generally for about 1 to 2 weeks. You may need intravenous fluids (IV) and a blood transfusion. If your kidneys aren’t working properly, you may need dialysis.

Can HUS be prevented?

You can reduce the chance that you and your children get HUS by taking care to eat properly cooked and washed foods, washing your hands often (including before eating), avoiding unpasteurised milk (also known as raw milk) and juices, and only drinking treated water (such as Australian tap water and other chemically treated water, boiled water or purified water).

What are the complications of HUS?

Long-term complications of HUS can include kidney failure, high blood pressure and seizures. If you have not passed urine for around 10 to 14 days, or need a long period of dialysis, you have a greater risk of long-term kidney problems.

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