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HEALTH-ARGENTINA: Juicy Hamburgers Threaten Young Kidneys

Marcela Valente

BUENOS AIRES, Feb 21 2008 (IPS) - Famed as one of the world’s leading beef producers, Argentina holds the unfortunate record for the highest incidence of Hemolytic Uremic Syndrome (HUS), an infectious disease caused by bacteria present in incompletely cooked foods, such as hamburgers.

With the arrival of summer, parents start worrying. Children love hamburgers, but the media regularly produce reports about families whose children are battling for their lives, after eating contaminated food, usually made from ground beef that was not thoroughly cooked.

The disease mainly affects children under five, producing watery, bloody diarrhoea, vomiting, paleness, irritability, difficulty urinating and, sometimes, convulsions. It can be fatal, or have serious long-term consequences like chronic kidney failure or neurological problems.

The bacterium responsible is an enterohaemorrhagic strain of Escherichia coli, found in raw meat, unpasteurised milk and contaminated water. But experts agree that in Argentina, where HUS is endemic, the main source of infection is improperly cooked beef.

“It is not entirely clear why Argentina has a higher rate of incidence than other countries,” Dr. Marta Rivas, head of physiopathology at the National Institute of Infectious Diseases, told IPS. However, she identified “the habit of eating meat that isn’t properly cooked” as a risk factor.

What is certain is that HUS is the principal cause of acute renal failure in Argentina, and the second cause of chronic kidney failure. “Considerable numbers of children and adolescents have to undergo kidney transplants” as a result of the disease, Rivas said.

Rivas advocates carrying out information campaigns with clear messages to reduce the risks of infection, telling people to wash their hands after handling raw meat. She also recommends “monitoring the entire food chain from farm to consumer, especially the meat industry.”

Argentina produces over three million tons of beef a year, of which 480,000 tons are exported under rigorous controls. The country is among the top five world exporters, together with Brazil, Australia, India and Canada.

However, for domestic consumption, sanitary controls are less stringent.

A study by Dr. Graciela Vallejo, head of nephrology at the Ricardo Gutiérrez Children’s Hospital, indicates that about 460 cases of HUS a year occur in Argentina, equivalent to nearly 14 cases per 100,000 children under five. The average mortality rate is 3.4 percent of patients.

That may not sound like a big problem for Argentina’s 38 million people, but it is alarming when compared with the incidence rate in other countries. In Canada, the United States and France, the rate of infection is between 3.5 and 4.2 per 100,000 children under five.

“Argentina has the highest rate of registered HUS cases in the world,” said Vallejo, adding that the disease should be regarded as a public health problem. In some provinces the incidence is much lower than the average, but in others it is far higher.

For instance in Chaco, one of the poorest provinces in Argentina, there are only 0.9 HUS infections per 100,000 children under five, while in La Pampa, where cattle ranching is well developed, the incidence is 34.4 per 100,000.

In an interview with IPS, Gabriel Lores of the Liga de Lucha contra el Síndrome Urémico Hemolítico (League Against HUS, or LUSUH) said that “the state should exercise better control over the chain of butchering and sales of beef,” but he added that “there are many vested interests in the industry that no one wants to challenge.”

“We know that exported beef is bacteria-free, but apparently contaminated beef is acceptable for the domestic market,” complained Lores, whose son survived HUS but needs to attend annual check-ups. The possibility that he may suffer long-term complications cannot yet be ruled out.

“The state carries out media campaigns, but does nothing to prevent contamination, and that isn’t fair because it shifts the responsibility entirely on to the consumer,” he protested.

Lores’ son Matías suffered his first symptoms of HUS in 2004, when he was five years old. “He had not eaten hamburgers, so we don’t know how he got infected,” his father said. Matías was seriously ill and was hospitalised for a month. “It was a nightmare, we thought we were going to lose him,” Lores said.

His son had to go on a dialysis machine, and had hallucinations, but gradually he recovered. His doctors say that once the bacterium is in the system, there is little to be done about it. Now Matías goes to the renal specialist every year to have an ultrasound scan of his kidneys and other tests, although he is out of danger.

But complications can turn up later on. That is what happened to the son of LUSUH president Carlos Seijo. Esteban became infected when he was six months old, in 1974, when HUS was virtually unknown. He recovered from the acute infection, but as a teenager he was diagnosed with chronic kidney failure, purely by chance.

His condition was not resolved until 2004, when Esteban was 30, and received a kidney transplant donated by his father.