Haemolytic uraemic syndrome (HUS) is a rare but serious, potentially life-threatening condition, which can cause anaemia, kidney failure and can affect the brain, guts, heart, liver and pancreas. HUS can develop as a complication of a stomach bug caused by a harmful type of E. coli bacteria called Shiga toxin-producing Escherichia coli (STEC). STEC is the most common cause, but HUS can also be caused by some medicines and other infections. Most cases of HUS are in young children (under the age of five years).

STEC infections are risk worldwide and can occur in a wide range of travel and holiday settings, including all-inclusive resorts. It is extremely contagious, as only a small number of bacteria are needed to cause illness.

STEC can spread through:

contact with infected people or animals (either by direct contact or from exposure to animal droppings at farms, petting farms/zoos and campsites)
eating contaminated food, such as meat (for example, under-cooked burgers), salad, raw vegetables or unpasteurised dairy products
drinking contaminated water
swimming or playing in contaminated water (ponds or streams)

The first symptoms of HUS caused by STEC include:

diarrhoea (often with blood)
fever (often high temperature >38°C with sweating and shivers)
stomach cramps and pain
vomiting

When HUS progresses, it can cause symptoms related to anaemia and kidney damage, including:

passing less urine than normal or none at all
build-up of fluid causing swelling of the feet, ankles and legs
extreme tiredness
pale skin
fainting
bruising easily

Get medical advice urgently if you or your child:

have bloody diarrhoea
show signs of dehydration (such passing less urine than usual or drowsiness)
develop any of the symptoms listed above

There is no specific treatment for STEC infection. Drinking plenty of fluids is very important to avoid getting dehydrated. Some people, especially young children can get dehydrated quickly and may need urgent medical care to receive fluids.

Antibiotics are not usually recommended for treating STEC infections because they increase the risk of complications like HUS. Parents and carers are encouraged to discuss this with the healthcare provider and ask about the benefits and risks of antibiotics for their child.

If HUS does develop, it often needs hospital treatment to replace lost fluids and minerals, and support kidney function (such as dialysis in severe cases).

STEC can spread through:

contact with infected people or animals (either by direct contact or from exposure to animal droppings at farms, petting farms/zoos and campsites)
eating contaminated food, such as meat (for example, under-cooked burgers), salad, raw vegetables or unpasteurised dairy products
drinking contaminated water
swimming or playing in contaminated water (ponds or streams)

The first symptoms of HUS caused by STEC include:

diarrhoea (often with blood)
fever (often high temperature >38°C with sweating and shivers)
stomach cramps and pain
vomiting

When HUS progresses, it can cause symptoms related to anaemia and kidney damage, including:

passing less urine than normal or none at all
build-up of fluid causing swelling of the feet, ankles and legs
extreme tiredness
pale skin
fainting
bruising easily

Get medical advice urgently if you or your child:

have bloody diarrhoea
show signs of dehydration (such passing less urine than usual or drowsiness)
develop any of the symptoms listed above

If HUS does develop, it often needs hospital treatment to replace lost fluids and minerals, and support kidney function (such as dialysis in severe cases).

Haemolytic uraemic syndrome

STEC can spread through:

contact with infected people or animals (either by direct contact or from exposure to animal droppings at farms, petting farms/zoos and campsites)
eating contaminated food, such as meat (for example, under-cooked burgers), salad, raw vegetables or unpasteurised dairy products
drinking contaminated water
swimming or playing in contaminated water (ponds or streams)

The first symptoms of HUS caused by STEC include:

diarrhoea (often with blood)
fever (often high temperature >38°C with sweating and shivers)
stomach cramps and pain
vomiting

When HUS progresses, it can cause symptoms related to anaemia and kidney damage, including:

passing less urine than normal or none at all
build-up of fluid causing swelling of the feet, ankles and legs
extreme tiredness
pale skin
fainting
bruising easily

Get medical advice urgently if you or your child:

have bloody diarrhoea
show signs of dehydration (such passing less urine than usual or drowsiness)
develop any of the symptoms listed above

If HUS does develop, it often needs hospital treatment to replace lost fluids and minerals, and support kidney function (such as dialysis in severe cases).

Prevention

There is no vaccine or medicine to prevent STEC infection, but there are ways to reduce the risk of infection:

always follow good personal, food and water hygiene advice
avoid swallowing water when swimming in rivers, lakes or streams
follow UK Health Security Agency advice about avoiding contact with animals when visiting farms, petting zoos and campsites abroad

If you or anyone in your family become unwell after travel abroad, seek urgent medical advice. Always tell your nurse, doctor or other health professional that you have travelled abroad recently and make sure you mention every country you visited.

If you have been diagnosed with STEC infection, wait until your symptoms have stopped and check with your health professional before going back to school or work to avoid spreading the infection to other people.