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Understanding Hemolytic Uremic Syndrome in Children

In the summertime, not many people are thinking about getting sick. Still, there is one disease that is more common in the summer months – especially in children – called hemolytic uremic syndrome, or HUS.

HUS is a rare but serious illness that causes damage to the blood cells and kidneys, but what exactly is it, how do children get it, and how is it treated? 

For answers, we turned to expert Emmanuel Apostol, MD, a pediatric nephrologist with Banner – University Medicine.

How do children get HUS?

HUS is more common in the summer and can develop due to certain infections. It usually occurs after an infection involving the gastrointestinal system but can also occur (rarely) after an infection involving the respiratory system.

“Children can get HUS from eating food or drinking liquids that have been contaminated with a bacteria known as Escherichia coli O157:H7 (E. coli),” Dr. Apostol said. 

E. coli infections can occur after eating contaminated foods like undercooked meat and some produce or drinking unpasteurized juices or dairy products. They can also occur after being in contact with infected people or farm animals.

How does HUS affect the blood cells and kidneys?

Imagine the kidneys as filters that clean your child’s blood by removing waste and extra fluids. In HUS, these tiny filters become damaged and stop working the right way. 

Damaged blood cells and clotting issues can clog up the small blood vessels in the kidneys, making it challenging for them to do their job properly. This can result in kidney injury and even kidney failure if left untreated.

How do I know my child has HUS?

Before HUS develops, your child may experience symptoms like nausea, vomiting, stomach pains and bloody diarrhea. They might also look pale, be less active, eat less than usual and feel fussy or irritable. 

Later, more symptoms may appear, such as:

Call your child’s health care provider if your child has blood in their stool or urine, unexplained bruises and/or fatigue. 

How is HUS diagnosed and treated?

Your child’s health care provider will perform a physical exam and order lab work, including blood and urine tests. 

“These tests look at kidney function, red blood cell count, platelet count and blood or protein in the urine,” Dr. Apostol said.

The provider may also run a stool culture to determine whether E. coli or another toxin-producing bacterium is present.

Treatment of HUS involves mostly supportive care. “This care aims to manage the symptoms and complications of HUS while allowing the body to recover from the effects of the illness,” Dr. Apostol said.

Treatment can vary depending on the severity of the illness and the symptoms and complications your child is experiencing. This may or may not include:

  • Fluid replacement: Intravenous (IV) fluids may be given to maintain proper hydration and replace lost fluids due to diarrhea.
  • Management of anemia: HUS can lead to anemia because of the breakdown of red blood cells. Blood transfusions help replenish low red blood cell count.
  • Blood pressure management: High blood pressure can be a complication of HUS, and medications may be prescribed to control it.
  • Nutritional support: A feeding tube may be used if eating is difficult.
  • Dialysis: In severe cases where your child has renal failure, dialysis becomes a lifesaving measure. Dialysis involves using a machine to filter and clean the blood, compensating for the impaired kidney function.

“Most children with HUS fully recover, but a few children will have residual kidney damage and require long-term follow-up,“ Dr. Apostol said.

Ways you can prevent HUS

While HUS is a serious condition, there are steps you can take to protect your child. These include:

  1. Safe handling of ground beef: Avoid consuming rare or undercooked ground beef. Ensure that ground beef is thoroughly cooked before consumption.
  2. Separation of raw meat: Always keep raw meat separate from foods that are ready to eat to prevent cross-contamination.
  3. Properly wash fruits and vegetables: Wash raw fruits and vegetables thoroughly before eating.
  4. Hand hygiene: Wash your hands before and after food preparation. Wash your hands after using the bathroom.
  5. Avoid unpasteurized products: Do not consume unpasteurized milk, milk products, fruit juices or ciders, as they may carry a higher risk of contamination.
  6. Clean kitchen utensils: After handling raw meat, wash hands, utensils, plates and countertops to prevent the spread of harmful bacteria. 
  7. Farm animal contact: If children have been in contact with farm animals, they should thoroughly wash their hands with soap and water to reduce the risk of infection.


Hemolytic uremic syndrome (HUS) is a rare but serious condition affecting children. It usually occurs after gastrointestinal infections, often linked to E. coli bacteria. You can help prevent HUS with proper food handling and hygiene practices. 

Contact your child’s health care provider or find a Banner Health specialist near you if you notice signs of HUS. Early detection and treatment are vital to reduce the risk of long-term kidney damage.

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