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American Journal of Epidemiology Vol. 129, No. 3: 582-586
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE INCREASING INCIDENCE OF THE HEMOLYTIC-UREMIC SYNDROME IN KING COUNTY, WASHINGTON: LACK OF EVIDENCE FOR ASCERTAINMENT BIAS

PHILLIP I. TARR1,, MARGUERITE A. NEILL2, JILL ALLEN3, CAROLE J. SICCARDI4, SANDRA L. WATKINS5 and ROBERT O. HICKMAN5

Dept. of Pediatrics, U. of Washington School of Medicine Seattle, WA 98195
1Divisions of Gastroenterology and Infectious Diseases, Department of Pediatrics, University of Washington School of Medicine and the Children's Hospital and Medical Center Seattle, WA
2Divisions of Infectious Diseases and Geographic Medicine, Department of Medicine, Brown University Program in Medicine Providence, RI
3Department of Pediatrics, Group Health Cooperactive of Puget Sound Seattle, WA
4Department of Medical Records, Children's Hospital and Medical Center Seattle, WA
5Division of Nephrology, Departments of Pediatrics and Medicine, University of Washington School of Medicine and the Children's Hospital and Medical Center Seattle, WA

Reprint requests to Dr. Philip I. Tarr, Department of Pediatrics, University of Washington School of Medicine, Mail stop RD-20, Seattle, WA 98195

The annual incidence of the hemolytic-uremic syndrome was determined for the well-defined population of King County, Washington, between 1971 and 1986, inclusive, to ascertain temporal trends in the epidemiology of this disease. The average annual incidence rose from 0.69 cases per 100,000 children under age 15 years between 1971 and 1975 to 1.77 cases between 1976 and 1980 and 1.74 cases between 1981 and 1986. The mean hematocrits, platelet counts, and blood urea nitrogen and creatinine concentrations on admission were similar in all periods, as were the mean length of hospital stay and the proportions of patients requiring erythrocyte and/or platelet transfusions and dialysis. These results indicate that the increased incidence of hemolytic-uremlc syndrome in childhood has been sustained in King County, Washington, and that this increase is not due to ascertainment bias caused by the diagnosis of less severely III cases. Further investigations are needed to determine whether this increased incidence is being experienced in other populations arid to assess strategies for the prevention of microangiopathic sequelae to hemorrhagic colitis.

colitis; cytotoxins; Escherichia coli; hemolytic-uremic syndrome; kidney failure, acute; toxins


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