September Blog 2017: Sepsis the Silent Killer

Sepsis the Silent Killer

What causes 44,000 deaths a year, costs the NHS around £2.93 billion a year, affects more people than heart attacks and kills more people than bowel, breast and prostate cancer combined? Awareness about the answer to this question is so low that in May this year the World Health Organisation (WHO) made it a global health priority.

It’s sometimes called the “silent killer” and is colloquially known as “blood poisoning”. The correct medical term is sepsis and it’s a life-threatening complication as a result of an infection when the body’s immune system goes into ‘override’. It can affect various internal organs and it should only be called septicaemia when bacteria have invaded the blood stream.

It occurs when the immune response of the body is so extreme that it damages the body. It can occur because of problems spreading from other parts of the body, such as chest infections, urinary infections, ulcers, or cuts and bites on the skin.

There are three increasingly dangerous stages of sepsis:

1. Sepsis – infection is present and there are symptoms such as high or low temperature, fast heart rate, sometimes with rapid breathing
2. Severe Sepsis – when the infection starts to interfere with the normal function of some of the body’s organs
3. Septic Shock – symptoms of severe sepsis, but, with blood pressure falling to dangerous levels, organs fail as they don’t receive enough oxygenated blood

Who’s most at risk? Unsurprisingly, it’s people with a poorly functioning immune system, such as those with cancer, organ transplant, or AIDS, or because of medical treatment (e.g. chemotherapy, or steroids). However, it is important to remember that healthy people can develop sepsis, so it pays to be vigilant. Other groups at risk are young babies (immature immune system), pregnant women and the elderly (especially those with other conditions such as diabetes).

An appropriate broad-spectrum antibiotic will be given, but bacterial resistance can cause the treatment to fail. It should also be noted that other microbes could cause sepsis including fungi, viruses and parasites. Symptoms will be similar and what may have started as a localised problem becomes widespread affecting all of the body’s organs and tissues. Sepsis should be treated as a medical emergency and treatment is usually given in hospital and often in an intensive care unit.

So why don’t more people know about the condition? Sepsis isn’t talked about very often, although this is beginning to change as various awareness campaigns gain media attention. We hear of people dying from infections, but the cause of death is usually stated as being due to a specific primary condition such as pneumonia (infection of the lungs). This means sepsis is seldom listed as the cause of death and so many people think it’s not a problem.

Public Health England launched a campaign in December last year. The target audience in this instance was parents/carers of children from 0-4 and the key message was that sepsis is a rare, but serious complication of an infection. Catching sepsis early can improve chances of treatment, so if a child has any of these symptoms the parents/carers shouldn’t be afraid to go to A&E immediately or call 999:

• Are breathing very fast
• Have a ‘fit’ or convulsion
• Look mottled, bluish, or pale
• Have a rash that does not fade when you press it
• Are very lethargic or difficult to wake
• Feel abnormally cold to touch

Sepsis was made a global health priority in May 2017 when the World Health Assembly and the World Health Organization adopted a resolution to improve, prevent, diagnose, and manage sepsis. This marks a quantum leap in the global fight against sepsis. It’s World Sepsis Day on Wednesday 13^th September and one of the key ambitions for the day is to raise public and professional understanding and awareness of sepsis.

In the words of Dr Ron Daniels, chief executive of the UK Sepsis Trust:

“We could save 12,500 lives a year and improve the quality of life for another 100,000 survivors just by recognising sepsis earlier and delivering good basic care.”

 Prompt medical treatment saves lives and the first hours are most important. Be vigilant: look out for this silent killer!