1. Working party on routine ultrasound examinations in pregnancy. Report of the Royal Colkge of Obstetricians and Gynaecologists,1984
2. (Accepted 4 September 1985)
3. British Paediatric Association-Communicable Disease Surveillance Centre surveillance of haemolytic uraemic syndrome 1983-4
4. The haemolytic uraemic syndrome, first decribed in 1955,1 is defined by the triad of microangiopathic haemolytic anaemia, thrombocytopenia, and acute nephropathy. Its severity varies, and some patients do not develop uraemia or oliguria.' The disease principally affects children, but cases may occur in adults, often in association with pregnancy.2 The haematological and renal disorder is frequently preceded by diarrhoea, often bloody, and various pathogenic bacteria such as shigellas, especially Shigella dysenteriae serotype 1 (Shiga),3 Salmonella typhi,4 and campylobacter5 have been isolated. A recent study in Canada of 15 sporadic cases of haemolytic uraemic syndrome showed an association in 11 of them with diarrhoea caused by verotoxin producingEscherichia coli.6 This cytotoxin is probably closely
5. Suirveillance of haemolytic uraemic syndrome in the British Isles began in 1983 as part of the voluntary clinical reporting scheme of the British Paediatric Association and the Conmunicable Disease Surveillance Centre. The results ofthe first two years ofsurveillance are reported here