Hemolytic Uremic Syndrome
Reportable by Laboratories and ProvidersAbout this Reportable Disease
Infectious agent: Shiga toxin-producing E. coli (most commonly STEC O157).
Description of illness: HUS is a serious sequela of enteric infection with Shiga toxin-producing E. coli (most commonly STEC O157). Children under 5 years of age, the elderly and immunocompromised persons are at greatest risk of developing HUS. About 8% of children (and a small percentage of adults) with STEC O157 diarrhea develop HUS. HUS is diagnosed by microangiopathic hemolytic anemia, thrombocytopenia and renal failure. HUS is usually preceded by a prodromal gastrointestinal illness, or less commonly, an upper respiratory illness. The prodrome is nonspecific and may include malaise and diarrhea, which may be bloody, within 10 days of diagnosis. If patients have no laboratory evidence of hemolysis, thrombocytopenia or nephropathy 3 days after resolution of diarrhea, their risk of developing HUS is low. Up to 5% of pediatric HUS results in death, and 12% of patients will have severe sequelae such as renal impairment, neurological injury or hypertension.
Interactive Disease Data
Laboratory Reporting for this Disease
Hemolytic Uremic Syndrome
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| ORDERING INFORMATION | TDH DLS Requisition: PH-4182 Clinical Submission Requisition |
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Laboratory Reporting
Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.
- Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
- Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
- Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
- Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for Healthcare Providers
Clinical Summary
- Post-diarrheal HUS is a severe condition that follows infection, often from Shiga toxin–producing E. coli.
- It causes hemolytic anemia, low platelets, and acute kidney injury.
- Symptoms start after diarrhea, with fatigue, pallor, decreased urine, or swelling.
- Treatment is mainly supportive, including fluids and possible dialysis.
Healthcare Provider Reporting
Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.
Providers must report cases of all diseases and conditions listed through one of these methods:
• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857
• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.
• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for the Public
What It Is
Hemolytic Uremic Syndrome (HUS) is a serious condition after a diarrheal infection, usually from E. coli. It damages blood vessels, causing broken red blood cells and kidney injury. It mainly affects children but can occur at any age. It leads to anemia, low platelets, and acute kidney failure.
Types
Typical HUS: Caused by Shiga toxin-producing bacteria after diarrhea. Atypical HUS: Not linked to infection, often due to immune or genetic factors. Secondary HUS: Triggered by other conditions like medications or autoimmune diseases. Typical (post-diarrheal) is the most common form
Signs and Symptoms
Starts with diarrhea (often bloody), followed by weakness and fatigue. Pale skin, easy bruising, or small red spots from low platelets. Reduced urine output, swelling in legs or face, high blood pressure. Nausea, irritability, or confusion may appear in severe cases.
Treatment
Supportive care with fluids and electrolyte balance in hospital. Blood transfusions for anemia or platelets if needed. Dialysis if kidneys fail to filter waste properly. Avoid antibiotics and anti-diarrheal drugs in early infection phase..
This Page Last Updated: March 25, 2026 at 8:53 PM