Introduction: Enteric infection by verotoxin (VT) producingEscherichia coli results in Hemolytic Uremic Syndrome (HUS) in some children (≈10%). The erythrocyte glycosphingolipid Gb3 is lower in infected children who develop HUS than in those who do not (J Infect Dis 168:476, 1993), and Gb3 varies with P blood group type. The Inuit population of Arviat, NWT, Canada displayed unusually high susceptibility to HUS during an outbreak of VT E. coli (J Pediatr 124:21, 1994).

Aim: To determine if the increased HUS susceptibility of the Arviat population over that of mixed populations of mostly European extraction relates to differences in genetically determined P blood group antigens.

Methods: Blood was drawn from 50 children from Arviat, 18 of whom had a history of HUS, 18 of whom had a history of E. coli infection uncomplicated by HUS, and 14 of whom had no known history of this disease; and from 145 children of southern Canada, of whom 14 had histories of HUS, 54 of uncomplicated E. coli infection, and 77 were healthy controls. The blood was tested for hemagglutination by P antibody in microtiter plates. Erythrocyte Gb3 was analyzed by HPLC.

Results: Only 14 of 50 (28%) blood samples from Arviat were positive for P antigen, with no differences among the HUS and control groups, whereas 102 of 145 (70%; p < 0.001) of the samples from southern Canadian were positive.

Conclusions: Samples from southern Canada have a P blood group distribution similar to those of other mixed European-derived populations. In such populations, the lack of P antigen may be associated with increased incidence of HUS. In contrast, the entire Inuit population may be low in P blood group antigen, which may reflect a genetic basis for increased susceptibility to HUS in Inuit when infected with VT E. coli.