Haemolytic uraemic syndrome (STEC HUS)

Find out about haemolytic uraemic syndrome (STEC HUS): symptoms, diagnosis, treatment and sources of further information and support.

Haemolytic uraemic syndrome (STEC HUS)

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What is haemolytic uraemic syndrome (STEC HUS)?

Haemolytic uraemic syndrome (STEC HUS) is a rare condition that damages the small blood vessels inside the kidneys. This affects their ability to work properly. The condition is also sometimes known as typical HUS or diarrhoea-associated (D+) haemolytic uremic syndrome.

Haemolytic – breakdown of blood cells

Uraemic – the kidneys don’t work as well as they should to remove waste

Syndrome – different parts of the body are affected

STEC HUS is different to aHUS (atypical haemolytic uraemic syndrome).

STEC HUS can occur after a stomach infection caused by the bacteria (germ) Shiga toxin-producing Escherichia (STEC) which is a type of E.coli.

STEC HUS affects around 1 in 100,000 people in the UK. There are about 100 new cases a year. It usually affects children under the age of ten and adults over 65. Men and women are affected equally.

What are the signs and symptoms of STEC HUS?

The first symptoms of STEC HUS are linked to gastroenteritis (a stomach bug). These include:

  • stomach pain
  • feeling and/or being sick
  • diarrhoea that lasts for several days.
  • urinating less than normal or not at all
  • high temperature, often with excessive sweating and/or shivers

Blood may appear in the poo after a few days of diarrhoea.

Excessive tiredness and anaemia can develop after about a week.

Some children develop pinhead-sized red or purple spots on the skin.

What causes STEC HUS?

STEC HUS happens in a few people after they get gastroenteritis. Most people recover from gastroenteritis without any problems but around 1 in 10 people will develop STEC HUS.

This is usually caused by infection of a particular type of the E.coli bacteria that is found in animals. Infection may come from:

  • eating undercooked meat
  • fruit and vegetables that haven't been washed properly
  • drinking contaminated water
  • not washing your hands properly after touching infected animals or areas that they were in, such as farms, petting zoos or campsites
  • being close to other people with the illness
  • swimming or playing in infected water

It is not yet clear why some people develop STEC HUS after infection.

When STEC HUS does develop, the E.coli bacteria produces a poison called Shiga toxin which damages the cells of the blood vessels in the kidneys. This affects how well your kidneys can clean your blood and can cause permanent damage if it is not treated.

How is STEC HUS diagnosed?

STEC HUS is usually diagnosed by blood, urine and stool (poo) tests.

Your blood pressure will also be checked as STEC HUS can cause high blood pressure (hypertension).

Does STEC HUS affect other parts of the body?

In 1 in 4 children with STEC HUS the brain is affected. This can have an impact on how your child sees, thinks or moves. They may need special brain scans if this happens.

Around 3 in 100 people with STEC HUS develop insulin-dependent diabetes as the condition can affect the functioning of the pancreas.

Does STEC HUS run in families?

STEC HUS does not have a genetic cause so it cannot be inherited from a parent.

However, the bacteria that causes STEC HUS is infectious and can be passed from person to person. Your doctor may ask you to stay off work or keep your child home from school or nursery to avoid passing the infection on to other people.

Infection can easily spread to other members of the same household. It is therefore very important to follow good hygiene practices including:

  • high temperature washing of clothes, bedding and towels (60˚C or higher)
  • washing hands with soap and water (not gel or wipes) before eating and after going to the toilet
  • not sharing plates or glasses with someone who is infected
  • avoiding contact with farm animals

How is STEC HUS treated?

There is currently no direct treatment for STEC HUS so care focuses on protecting the kidneys and keeping the body healthy until the illness resolves itself. This usually happens within one or two weeks, as with normal gastroenteritis.

Children with STEC HUS are usually admitted to hospital so that their fluid and salt levels can be monitored. Your child will be looked after in a separate room to stop the infection from spreading to other children.

You may need to make temporary changes to your diet, with the support of a dietitian. Some children may need a temporary feeding tube into their stomach to support their nutrition.

As STEC HUS affects how well your kidneys work, one in two people will need a short-term course of dialysis to temporarily take over the work of your kidneys to give them time to recover.

Some children will need a blood transfusion.

All children with STEC HUS will be followed up by their doctors to look for signs of high blood pressure or protein in their urine as adults.

Around seven in ten people with STEC HUS recover completely and do not need any follow up treatment. Annual reviews may be recommended to check that everything remains stable.

In some adults, the kidney damage is more severe and long-term dialysis or transplant may be needed.

STEC HUS is classed as a notifiable disease so your doctor will tell the UK Health Protection Agency so that they can identify the cause of the outbreak and minimise further infection.

Where can I get more information or support about STEC HUS?

We are not aware of any UK-based support groups for STEC HUS. If you know of any STEC HUS patient groups, please let us know so we can share their details.

Publication date: 08/2025

Review date: 08/2028

This resource was produced according to PIF TICK standards. PIF TICK is the UK’s only assessed quality mark for print and online health and care information. Kidney Care UK is PIF TICK accredited.