HUS-epidemin sommaren 2011 var allvarlig. Tyska och svenska erfarenheter av EHEC-utbrottet
Sammanfattning
From May to July 2011 a large EHEC-HUS epidemic occurred in Germany. In Sweden 53 patients were diagnosed with E. coli O104:H4, and 17 of them developed hemolytic uremic syndrome. The patient characteristics were similar to those observed in the German patients with a predominance of middle-aged and older women. One patient died of a respiratory complication. Two thirds of the patients needed supportive therapy with dialysis, and one third needed mechanical ventilation. Twelve patients also developed neurological symptoms. Focal neurological symptoms still remained in one patient six months after she was taken ill, while all of the other patients slowly recovered completely. The regression of neurological symptoms was slow. Also renal function recovered completely. Four of the twelve patients with neurological symptoms were treated with eculizumab. There was no difference in patient characteristics and outcome between eculizumab-treated and not eculizumab-treated patients compared with patients only receiving supportive therapy. Thus, our experience does not support that the eculizumab therapy has any beneficial effects in severe EHEC-HUS.