Epidemiology

Shiga toxin-producing Escherichia coli (STEC) HUS is most common in young children (<5 years), but it can be seen at any age, with decreasing frequency in older children and adults.[7] Although large outbreaks have been reported, it is more commonly seen in small clusters or sporadically.[8][9][10] The annual incidence in the US in children <5 years is 2 to 3 per 100,000.[11] In Europe, the prevalence of atypical or recurrent HUS is 3.3 per million children <18 years of age.[12] HUS is diagnosed in approximately 15% of children with STEC infections, approximately 5 to 10 days after the onset of diarrhoea.[8][9][13][14] In England, 539 confirmed cases involving Escherichia coli O157 infections were reported in 2019.[15] Of these, 29% required hospitalisation and 3% developed HUS.

Other forms of HUS are much less common. It is difficult to estimate their incidence because of the overlap in diagnostic criteria with other thrombotic microangiopathies, especially thrombotic thrombocytopenic purpura (TTP).

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