UK Edition
Sepsis: everything you need to know about the deadly disease, from early warning signs to treatment
It claims over 50,000 lives every year in the UK and now, according to new research, sepsis can be blamed for one in five deaths worldwide – making it more deadly than cancer.
A report by the University of Washington, published in The Lancet, looked at medical records from 195 countries and concluded that there are 49 million cases of sepsis around the globe every year. 11 million of these lead to deaths – double previous estimates.
In the UK, NHS figures published last year showed that hospital admissions for sepsis had risen by 32 per cent in people under 24 in the space of two years – from 36, 847 admissions to 48,647 in 2017/18. Experts say the increase is partly down to antibiotic resistance, and have warned parents that sepsis is now a bigger risk than meningitis.
The rise may also be down to increased awareness among the public and health professionals, with a drive to diagnose and treat patients more quickly now in place in A&E departments across the country. Under NHS guidlines, introduced last year, staff are required to alert senior doctors if patients suspected of having a serious disease don’t respond to treatment within an hour. Failure to do so could lead to financial penalties for hospitals.
A silent killer – so how do you spot symptoms?
The difficulty with sepsis is that it's a 'silent killer'; difficult to spot and hard to treat unless caught early. The disease, also known as blood poisoning, occurs when the immune system overreacts to infection or injury. In a quarter of cases, survivors suffer permanent life-changing after-effects.
It isn’t fully known how or why the disease works in the way that it does, but essentially it causes the immune system to attack the very organs and body tissue that it is designed to protect.
The disease can be treated with antibiotics but unless it is spotted in time, it can lead to organ failure and death. According to Antibiotic Research UK, the rise in antibiotic resistance is a huge concern and could potentially lead to sepsis becoming untreatable.
Dr Tim Nutbeam, clinical adviser for the UK Sepsis Trust, welcomed the NHS regulations last year, and was optimistic that they could potentially reduce sepsis deaths in the UK: “If delivered correctly, [this initiative] will ensure rapid and effective treatment for the patients who need it most, whilst ensuring that senior clinical decision-makers are supported in making informed, balanced decisions in relation to the prescribing of antibiotics.”
While sepsis can result from any injury or infection anywhere in the body, the UK Sepsis Trust notes examples including chest infections causing pneumonia, urine infections, burst ulcers or holes in the bowel, an infected cut or bite, wounds from trauma or surgery, and states that most cases are caused by common bacteria that don’t normally make us ill.
When it starts, sepsis can look and feel like flu or a chest infection. Symptoms may include fever, chills, shivering, a fast heartbeat and quickened breathing.
However, once a person goes into a more severe state, known as septic shock, they might feel faint, experience confusion or disorientation, start vomiting or have diarrhoea and cold, clammy and pale or mottled skin. Urgent medical attention should be sought if a person is slurring, shivering intensely, breathless, or passes no urine in a day.
One group most affected by sepsis is the very young, so it is important to note any changes in children’s health such as fast breathing, fits, rashes that don’t fade which compressed, lethargy, or being abnormally cold. Under-fives who aren’t eating, vomiting repeatedly, or not passing urine for 12 hours or more should also be taken to a doctor immediately.
If these symptoms are present it is absolutely vital to ask that doctors run tests for sepsis. In 2018, an inquest into the death of 21-year-old Tim Mason found doctors could have saved him had he been screened for sepsis when he first visited A&E during an "extremely busy" day.
Sepsis can occur in anyone, regardless of age or health, but certain groups are more prone to the disease, including the very old, very young, people with diabetes, people on long-term steroids, organ transplant receivers, people who are malnourished, people with serious liver disease, those who are pregnant or have just given birth, and people with a disease which has caused immunodeficiency.
Some research suggests that those who have had sepsis once are more likely to get it again than those who have never had it.
How to guard against sepsis
Unfortunately, there isn’t a huge amount you can do to prevent sepsis, but there are some precautions you can take to make yourself less likely to be infected in the first place.
Vaccines, for example, are important in preventing you from getting ill. You should also practice good hygiene, including hand-washing, in order to prevent bacteria from entering your body.
One of the major ways that bacteria can enter the body is through the bloodstream through any cuts or wounds, so you should dress those immediately by cleaning with running water, and covering to prevent infection. After this, watch out for any redness or discharge and report changes to your doctor.
Of the new guidelines Celia Ingham Clark, medical director for clinical effectiveness at NHS England, said: “We’ve come a long way in the NHS in improving how we identify and tackle sepsis, with more people having the problem spotted and treated than ever before.
“The NHS long-term plan is a blueprint for transforming NHS care and after the success we’ve had ramping up earlier sepsis diagnosis in many parts of the country, all hospitals will now be required to deliver the best possible practices for identifying and treating sepsis.”