What is HUS?

Haemolytic uraemic syndrome (HUS) is a rare but serious illness that can be life-threatening. It is most often caused by a bacterial infection.

HUS causes inflammation and clots in the blood vessels of the kidneys. This stops 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 5 years of age.

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 the cause of your HUS, later symptoms can include:

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

What causes HUS?

The most common cause of HUS is a type of bacterium known as STEC (Shiga toxin-producing E. coli). 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

Read more on accidentally eating unsafe foods.

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 toilets. The STEC bacterium produces toxins (poisonous substances) that damage your digestive tract (gut) and can cause HUS. However, most people infected with STEC don't develop HUS.

Antibiotics can increase the risk of developing HUS from a STEC infection. Only take antibiotics if your doctor has advised you to.

Other less common causes of HUS include other infections, medicines (such as some cancer treatments), genetic mutations, autoimmune conditions and a rare complication of pregnancy.

When should I see my doctor?

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

STEC infection 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 STEC infection.

The Department needs to monitor and track all cases of STEC infection 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, stool and sometimes urine tests confirm the diagnosis.

How is HUS treated?

If you have HUS, you will need care in hospital.

Treatments you may need include:

• intravenous (IV) fluids — to treat dehydration if you have diarrhoea
• antihypertensive medicines — if you have high blood pressure
• a blood transfusion — if you have severe anaemia
• dialysis — if your kidneys aren't working properly

HUS caused by genetic mutations is treated using a medicine called eculizumab.

What are the complications of HUS?

In severe cases, HUS can affect other organs, most commonly the brain. Like in the kidneys, clots form in small blood vessels, stopping the brain from working properly. This can lead to seizures, stroke, and coma.

Long-term complications of HUS can include kidney failure and high blood pressure.

Can HUS be prevented?

You can reduce the chance that you or 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
• only drinking treated water (such as Australian tap water and other chemically treated, boiled or purified water)

All these things are part of food safety and reduce your chances of getting many other illnesses as well.

Resources and support

• To find out more about haemolytic uraemic syndrome, or to get advice on what to do next, speak with your doctor.
• Learn about the rare (atypical) form of haemolytic uraemic syndrome (aHUS) from Genetic Alliance Australia.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.
• If your child is 5 years old or younger, and has symptoms of HUS, the Pregnancy, Birth and Baby video call service allows you to speak face-to-face with a maternal child health nurse. Video call is a free service and is available from 7am to midnight (AET), 7 days a week (including public holidays).