Outbreak of Hemolytic-Uremic Syndrome in Children in Belarus: Epidemiology, Features of Clinical Course and Laboratory Changes, and Outcomes.

ABSTRACT

Introduction. Outbreaks of hemolytic uremic syndrome (HUS) have been described in many countries around the world, but no such information is available for Eastern European countries. Purpose. To determine clinical and laboratory differences, and to evaluate morbidity and outcomes during and outside the outbreak of HUS in children in Belarus. Materials and methods. A total o f 80 children diagnosed with HUS in 2021 in Belarus were included in the study;64 of them were admitted to the pediatric dialysis center in Minsk and divided into 2 groups group 1 (29 children) - outside the HUS outbreak, and group 2 (35 children) - during the outbreak. In addition to standard laboratory tests, 52 children underwent stool analysis for Shiga toxin-producing Escherichia coli by real-time PCR (TaqMan Array Card). Results. The incidence of HUS in 2021 was 5.0/100 000 children <15 years (80 cases) and 10.6/100 000 children <5 years (59 cases). Boys were 52%, children <5 years old were 74%, patients with atypical HUS were 2.5%. Between 27.09.2021 and 29.10.2021 an outbreak of HUS was registered in 45 children, mostly from three country's regions Minsk city - 17, Minsk region - 16 and Vitebsk region - 11. Patients of groups 1 and 2 did not differ in terms of age, 2.5 (1.6;5.1) and 3.6 (2.2;5.1) years, respectively, incidence of hemocolitis 62% and 69%, respectively, baseline hemoglobin levels, 85 (77;99) and 102 (90;105) g/L, respectively, and platelet counts, 45 (25;71)x109/L and 53 (29;78) x109/L, respectively, need for dialysis, 79% and 57%, respectively, duration of anuria, 13 (7;16) and 12 (8;15) days, respectively, mortality, 3.4% (aHUS) and 2.9% (on the background of COVID-19), respectively, incidence of Shigatoxin-producing E. coli in faecal samples, 33% and 37%, respectively. The cause of HUS outbreak remained undetermined. Conclusions. Thus, the incidence of HUS in children in Belarus remains one of the highest in Europe. A national algorithm should be developed to detect the source of infection and to indicate and identify the pathogen in STEC infections.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.