A retrospective analysis of 37 children with Escherichia coli 0157:H7-associated hemolytic-uremic syndrome (HUS) traced to contaminated hamburger meat is reported from the University of Washington, Children’s Hospital, Seattle. The majority (95%) had severe hemorrhagic colitis, 19 (51%) had multisystem disease, and 6 (16%) had neurological complications. Seizures occurred in 3, stroke in 3, and 3 became comatose. Three (8%) died, 1 en route to the hospital after a seizure and cardiorespiratory arrest. A poor outcome was seen in all 3 with coma, 2 of 3 with seizures, and 1 of 3 with focal neurologic abnormalities. 
COMMENT. Neurologic complications of the HUS occur in 14% to 83% of previously published outbreaks. They were the most common cause of death in one report. The outbreak of E coli HUS in Seattle was a tragic reflection of the hazards of “Environmental Poisons in Our Food” (Millichap JG, PNB Publ, 1993). The importance of this topic in neurologic practice is emphasized by the inclusion of neurotoxicology symposia at the recent meeting of the Child Neurology Society and at the May 1995 annual meting of the American Academy of Neurology in Seattle.