A child in Norway has died in a hospital after suffering complications from an E. coli infection.

The 2-year-old, from the Oslo area of the country, developed the serious kidney disease hemolytic uremic syndrome (HUS) and died late this past week in Oslo University Hospital.

E. coli was detected in a stool sample from the child and there is a suspicion of infection with enterohemorrhagic E. coli (EHEC). Further analysis is ongoing at the Norwegian Institute of Public Health (Folkehelseinstituttet). EHEC is also known as Shiga toxin-producing E. coli (STEC).

“Deaths in children related to HUS caused by EHEC infection are very uncommon, and it is very sad when they occur,” said Hilde Marie Lund from Folkehelseinstituttet (FHI).

No indication of an outbreak
FHI has not seen an increase in reported EHEC cases recently and there is no indication an outbreak is ongoing.

The last HUS death in a child caused by EHEC in Norway was in 2009. The reporting system for infectious diseases has registered three HUS deaths in children caused by EHEC in 2004, 2006 and 2009.

The municipal health service, Norwegian Food Safety Authority (Mattilsynet), Veterinary Institute and FHI are investigating the source of infection.

In 2019, 511 cases of EHEC were reported to the Norwegian Institute of Public Health, of which 10 developed the serious complication HUS. So far in 2020, there has been a reduction in infectious diseases reported. This is probably because of infection control measures connected to the Covid-19 pandemic, according to FHI.

Two HUS cases in July
This year, FHI has registered 169 EHEC infections, of which four cases have had HUS and two of these were reported in July. Initial investigations do not appear to show any link between patients.

EHEC can cause diarrhea which is sometimes bloody, severe stomach cramps and vomiting. Most people get better within five to seven days. Time between ingesting the EHEC bacteria and feeling sick is usually three to four days after exposure, but may be as short as one day or as long as 10 days.

Clues that a person is developing HUS include decreased frequency of urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems.

The bacterium can be transmitted to humans via food contaminated with feces from animals, from contaminated water or by direct contact with animals. The elderly and children are particularly at risk of serious illness. Primary sources of infection are raw or undercooked ground meat products, raw milk, and fecal contamination of vegetables.

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