An outbreak of diarrhea-associated childhood hemolytic uremic syndrome: the Walkerton epidemic.

In Canada, the majority of cases of childhood hemolytic uremic syndrome (HUS) are associated with a diarrheal illness (D+) due to verotoxin-producing Escherichia coli (VTEC). Although the ingestion of undercooked beef is an important cause, we report on the largest outbreak of E. coli illness due to a contaminated supply of municipal water. We describe the clinical features and short-term outcomes of 22 children who simultaneously developed D+HUS.