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12-07-2011 | General practice | Article

Urgent E. coli referral advice

Abstract

Health Protection Agency - Infection Control Publication

GPs are advised to urgently refer children with a single episode of acute bloody diarrhoea for specialist advice, in case it is linked to an Escherichia coli infection.

The new guidance from the Health Protection Agency (HPA) also stresses that all clinical staff should be aware of the need to take public health action for suspected E. coli cases.

These infections can lead to serious complications such as Haemolytic Uraemic Syndrome (HUS), as highlighted by the recent outbreak of E. coli O104 in Germany. Although a relatively rare complication, HUS is the major cause of acute kidney failure in children.

In the UK, the most common form of E. coli associated with infections is the O157 strain, with the majority of cases linked to farm visits where children come into contact with livestock such as sheep, goats and cattle and their environments.

Younger children are most at risk from E. coli O157 infection, and those under five are most likely to it up because their personal hygiene is not yet well developed.

Dr Nick Gent, a health protection consultant at the HPA who led the new guidelines development team, explained that although cases of acute bloody diarrhoea related to E. coli O157 infection are comparatively rare, around 300 to 500 cases are reported a year in children under 10 years of age, with cases most frequent in late spring, summer and autumn.

"As some cases can lead to kidney failure and fatalities, urgent reporting and referral is necessary to ensure children receive specialist paediatric assessment and have the best chance of recovery," he said.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price