A University of Calgary research team found that only 7% of children infected at child care centres with STEC, developed HUS (of which more than half of whom required dialysis). 

During this outbreak, there were 395 cases, linking food consumption at 11 childcare centres to a shared kitchen in Alberta Canada, perhaps partly due to daily lab monitoring for kidney injury. Links below to this research.

“The study identified significant use of health care resources, the researchers said. Only 7% of children infected with STEC developed HUS, which is lower than reported in most prior outbreaks and sporadic case series, they wrote. These findings highlight the importance of a coordinated public health response integrated with clinical care and suggest that proactive screening for Thrombotic microangiopathy (TMA) has the potential to mitigate adverse outcomes.”

It also stated “HUS occurs in 15% to 20% of children infected by STEC carrying a gene encoding Shiga toxin 2 (stx2), which is termed high-risk STEC”. The stx 2 gene encoding has been mentioned previously by many scientists throughout the world in terms of its risk.

In the UK our National Health Service in coordination with the UK Health Security Agency (UKHSA) should at least give a trial of daily lab monitoring for kidney injury to all patients of STEC including screening for Thrombotic microangiopathy (TMA). This could be undertaken during an outbreak anywhere in the UK or across the UK to ascertain if this is effective in reducing the cases that progress to HUS.

Presently there is no cure for Haemolytic uremic syndrome (HUS) caused by Shiga toxin producing Escherichia coli (STEC) and we already know that approximately 30% of those who suffer from HUS in the UK will have some long term health problems which may be major or minor.  

Whilst such a trial, I believe, could be beneficial, I cannot see it being undertaken in the UK due to the additional patient clinical care required at a time when our NHS service is struggling to cope with the demands being placed on it.  

https://www.cidrap.umn.edu/e-coli/early-detection-kidney-injury-e-coli-outbreak-daycare-centers-may-have-improved-outcomes

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2846153