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UK to Seek ‘Urgent Specialist Advice’ for E. coli

The United Kingdom’s government-run health care system will be taking verocytotoxin-producing E. coli infection (VTEC) in children more seriously in the future.

pettinggoat-featured.jpgThe UK’s Health Protection Agency (HPA) Monday said new guidelines will emphasize the need for primary care clinicians to seek “urgent specialist advice” whenever a child is reported to have had a single acute  episode of bloody diarrhea.

Primary care clinicians will be required to provide secondary care clinicians with guidance on assessment and manage referrals to ensure that all clinical staff are aware of the need for urgent public health action when E. coli infection is suspected.

In a statement, HPA said the recent outbreak of E. coli O104 in Germany has demonstrated the need for rapid management and treatment of E. coli cases and the serious health complications that can result, such as hemolytic uremic syndrome (HUS).

HUS can damage blood, kidneys and, in severe cases, the entire central nervous system. It involves about 10 percent of the E. coli cases in the UK.  HUS is the most common cause of acute kidney failure in children.

The new HPA guidelines for managing E. coli cases cover emergency medicine, pediatrics, and all public health and health protection professional including both primary care and specialists.

In the UK, like the United States, the most common form of virulent E. coli is O157.  A common cause of such outbreaks in the UK in recent years has been children visiting so-called open farms. On average, there are about three outbreaks each year linked to petting farm visits.

Although cases of acute bloody diarrhea in children  linked to E. coli E coli O157:H7  are comparatively rare, according to Dr. Nick Gent,  a health protection consultant at the HPA, between 300 to 500 cases are reported a year for children 10 or younger, with cases increasing in the late spring, summer and autumn.

Because some cases can lead to kidney failure and fatalities, urgent reporting and referral is necessary to ensure children have specialist assessment and the best chance of recovery, Gent added.

He encouraged parents and children visiting open farms to remember that hand washing with soap and water is the best way to avoid infections and that sanitizing hand gels are not a good substitute — they don’t remove dirt in the same way as running water and soap can.

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