A national study of the epidemiology, clinical features and microbiology of the haemolytic uraemic syndromes
A national study of the epidemiology, clinical features and microbiology of the haemolytic uraemic syndromes
This thesis reports the analysis of clinical, laboratory and microbiological data from a national collaborative study of the haemolytic uraemic syndromes (HUS), in which data was obtained from the acute phase and at follow-up to one year from the illness.
Two hundred and ninety eight children were notified, stool samples were obtained from 198, and follow-up data was available from 272. Ninety five percent of cases presented after a prodromal illness of diarrhoea, and of these 75% had bloody diarrhoea. The incidence was greatest in the one to two year age range, most commonly affected under five's, and 80% of cases presented between April and October. Verocytotoxin producing Escherichia coli (VTEC) were isolated from 33%, although the success rate was related to the timing of samples - VTEC were isolated from 66% of cases in whom stools were collected at up to 3 days from onset of diarrhoea. By comparison, VTEC were isolated from only 8% of children who had bloody diarrhoea but had not developed HUS. The mortality rate for children with diarrhoea-associated HUS was 7.7%, with 12.3% having long term sequelae. A high presenting neutrophil count was noted in those who died in the acute phase and in those with long term sequelae.
Sixteen children did not have a prodromal illness, and presented sporadically throughout the year. VTEC were not isolated from any case. Although the mortality and morbidity was 78%, the presenting neutrophil count was uniformly low in this group.
This study confirmed that for epidemiological, clinical and microbiological reasons cases of HUS with or without a diarrhoeal prodrome must be considered separately, and that the former group is closely associated with VTEC in the United Kingdom.
University of Southampton
Milford, David Vernon
27f51797-a036-4fb4-8c7d-f7b6a55d7d37
1994
Milford, David Vernon
27f51797-a036-4fb4-8c7d-f7b6a55d7d37
Milford, David Vernon
(1994)
A national study of the epidemiology, clinical features and microbiology of the haemolytic uraemic syndromes.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
This thesis reports the analysis of clinical, laboratory and microbiological data from a national collaborative study of the haemolytic uraemic syndromes (HUS), in which data was obtained from the acute phase and at follow-up to one year from the illness.
Two hundred and ninety eight children were notified, stool samples were obtained from 198, and follow-up data was available from 272. Ninety five percent of cases presented after a prodromal illness of diarrhoea, and of these 75% had bloody diarrhoea. The incidence was greatest in the one to two year age range, most commonly affected under five's, and 80% of cases presented between April and October. Verocytotoxin producing Escherichia coli (VTEC) were isolated from 33%, although the success rate was related to the timing of samples - VTEC were isolated from 66% of cases in whom stools were collected at up to 3 days from onset of diarrhoea. By comparison, VTEC were isolated from only 8% of children who had bloody diarrhoea but had not developed HUS. The mortality rate for children with diarrhoea-associated HUS was 7.7%, with 12.3% having long term sequelae. A high presenting neutrophil count was noted in those who died in the acute phase and in those with long term sequelae.
Sixteen children did not have a prodromal illness, and presented sporadically throughout the year. VTEC were not isolated from any case. Although the mortality and morbidity was 78%, the presenting neutrophil count was uniformly low in this group.
This study confirmed that for epidemiological, clinical and microbiological reasons cases of HUS with or without a diarrhoeal prodrome must be considered separately, and that the former group is closely associated with VTEC in the United Kingdom.
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Published date: 1994
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Local EPrints ID: 458360
URI: http://eprints.soton.ac.uk/id/eprint/458360
PURE UUID: 2061bd1b-8eae-487f-9e0d-d130b5a1ae9d
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Date deposited: 04 Jul 2022 16:47
Last modified: 23 Jul 2022 00:15
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Author:
David Vernon Milford
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