HUS Disease Timeline: From E. coli to Hemolytic Uremic Syndrome

Most cases of hemolytic uremic syndrome (HUS) in the United States are caused by E. coli O157:H7, bacteria found in the intestines of cattle, deer, goats and other animals. Below is a general timeline from ingestion of food or water contaminated with E. coli O157 to diagnosis of HUS. Please note that each E. coli-HUS victim will respond differently and the number of days listed can vary. In fact, in some cases a child has HUS before E. coli poisoning is even suspected.

1. Animal feces with E. coli O157 bacteria contaminate food or water;
2. The food or water is consumed;
3. The E. coli bacteria colonize (grow in number) in the colon–less than 100 bacteria can cause serious illness and death;
4. 3 days after the E. coli are in the human colon, diarrhea and significant abdominal pain develop;
5. 3 days later, bloody diarrhea (hemorrhagic colitis) develops;
6. Shiga toxin 1 and/or shiga toxin 2 “enter the blood circulation, setting in action a series of toxemic reactions that culminate in renal failure in 5-15% of patients” (Obrig);
7. About 4 days after the onset of bloody diarrhea, “the toxemic period advances to acute renal failure” (Obrig).

Attorney Fred Pritzker represents children who develop hemolytic uremic syndrome (HUS) from E. coli infections. Most of his cases involve children whose illnesses are part of an outbreak linked to a food product, usually ground beef, lettuce or sprouts, but also many other food products. He has also represented children who drank water contaminated with E. coli and then developed HUS. Fred and his Bad Bug Law Team represent E. coli and HUS victims nationwide.

Reference: Obrig, Tom G., Escherichia coli Shiga Toxin Mechanisms of Action in Renal Disease, Toxins 2010, 2(12), 2769-2794. The above HUS timeline is from this article by Tom G. Obrig, who based his HUS timeline on a large prospective clinical patient referral study of children in the Pacific Northwest. Professor Obrig was not consulted regarding our use of this article; however, we want to thank him for his work in the area of E. coli and HUS. To read his impressive biography, click here.