Jacquinet S, De Rauw K, Pierard D, Godefroid N, Collard L, Van Hoeck K, Sabbe M
Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Sciensano, Brussels, Belgium.
2Vrije Universiteit Brussel (VUB), Department of Microbiology and Infection Control, National Reference Centre for STEC, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.
Arch Public Health. 2018 Aug 6;76:41. doi: 10.1186/s13690-018-0289-x. eCollection 2018.
The Haemolytic Uremic Syndrome (HUS) is the most severe manifestation of infection with Shiga toxin-producing (STEC). In Belgium, the surveillance of paediatric HUS cases is conducted by a sentinel surveillance network of paediatricians called Pedisurv. In this article, we present the main findings of this surveillance from 2009 to 2015 and we describe an annual incidence of HUS.
For each case of HUS < 15 years notified by the paediatricians, clinical, microbiological and epidemiological data were collected by a questionnaire. National hospital discharge data with ICD-9 code 283.11 were used to calculate the incidence of HUS in children < 15 years.
From 2009 to 2015, 110 cases were notified to the Pedisurv network with a mean annual notification rate of 0.8/100,000 in children < 15 years. Death occurred in 2.5% of all patients and the median number of days of hospitalization was 10 days. One third (35.4%) of the HUS cases were confirmed positive STEC, with a majority of STEC O157. The mean annual incidence based on the hospital discharge data was 3.2/100,000 in children < 15 years and 4.5/100,000 in children < 5 years.
The incidence of paediatric HUS in Belgium is high compared to other European countries. Its surveillance in Belgium is quite comprehensive and, although less effective than monitoring all STEC infections to detect the emergence of outbreaks, is important to better monitor circulation of the most pathogenic STEC strains. In this context, efforts are still needed to send samples and STEC strains from HUS cases to the National Reference Centre.
溶血尿毒综合征（HUS）是产志贺毒素大肠杆菌（STEC）感染最严重的表现形式。在比利时，儿科HUS病例的监测由一个名为Pedisurv的儿科医生哨点监测网络进行。在本文中，我们展示了2009年至2015年该监测的主要结果，并描述了HUS的年发病率。
对于儿科医生通报的每例15岁以下的HUS病例，通过问卷收集临床、微生物学和流行病学数据。使用国际疾病分类第九版（ICD - 9）编码283.11的国家医院出院数据来计算15岁以下儿童的HUS发病率。
2009年至2015年期间，有110例病例通报给了Pedisurv网络，15岁以下儿童的年平均通报率为0.8/10万。所有患者中有2.5%死亡，住院天数中位数为10天。三分之一（35.4%）的HUS病例STEC检测呈阳性，其中大多数为STEC O157。根据医院出院数据，15岁以下儿童的年平均发病率为3.2/10万，5岁以下儿童为4.5/10万。
与其他欧洲国家相比，比利时儿科HUS的发病率较高。比利时对其监测相当全面，尽管在检测疫情暴发方面不如监测所有STEC感染有效，但对于更好地监测最具致病性的STEC菌株的传播很重要。在这种情况下，仍需要努力将HUS病例的样本和STEC菌株送往国家参考中心。
