Almost 60 cases of a serious condition that develops after an E. coli infection were reported in 2024 in Italy. One child died.

Hemolytic uremic syndrome (HUS) is a severe complication associated with E. coli infections that causes kidney failure and sometimes brain damage.

Italian data shows there were 57 HUS cases in 2024. Between July 1, 2023, and June 30, 2024, 68 cases were recorded.

The Italian Hemolytic Uremic Syndrome Registry is operated by the Italian Society of Pediatric Nephrology and the National Institute of Health (ISS). It collects information on cases that occur in Italy, information on patients, clinical characteristics and on the causes.

Italian situation
Patients came from 16 regions, four live overseas and illness started for another four people after returning from a trip abroad. Overall, 54 of the 57 cases were younger than age 15. Two were aged 15 to 24 and one was older than 65.

In the first five months of 2024, the number of cases reported was lower than expected. In February and March, only one case was recorded. In June to September, observed cases were lower than the seasonal expectation. From October to December, the number of cases was in line with past years.

The median age of patients at the time of disease onset in 2024 was just over 3 years old.

In 2024, it was possible to examine samples from 52 cases. In 45 cases, an infection by Shiga toxin-producing E. coli (STEC) was found and in 39 cases information was obtained on the STEC serogroup.

Infections associated with the so-called top-5 STEC serogroups O26, O157, O111, O145, and O103 were the majority, representing 38 cases. In two cases, there was evidence of multiple infection with different STEC strains O111/O103 and O111/O145.

The most frequently detected serogroup among HUS cases was STEC O26 as it was identified in 17 patients. This is in line with the European situation wher E. coli O26 dominates among HUS cases associated with STEC infection.

E. coli O111 was second while E. coli O103, E. coli O157, and E. coli O145 were tied in third place.

Potential warning on labels
Data from Santé publique France shows 143 French HUS cases in 2023 compared to 252 in 2022. There were several serious outbreaks in 2022.

Italy is considering introducing revised labeling rules on raw milk products, with the aim of reducing the risk of E. coli infections and HUS in children.

A working group including Ministero della Salute (the Ministry of Health), the Istituto Superiore di Sanità, and trade associations was created in January and will last for three months.

A bill was put forward by politicians Matteo Rosso and Lorenzo Basso to require mandatory information on the label or packaging of the health risk for children younger than the age of 10 from the consumption of raw milk products. This was prompted after a young boy named Elia Damonte, from Arenzano, died in May 2024 after eating raw milk cheese and developing HUS.