Many people have never heard of it, but sepsis is associated with one in five deaths globally. Also known as septic shock, sepsis has the highest rate of any medical condition – even compared to a heart attack or stroke.

In a study published in The Lancet in January 2020, researchers from the University of Pittsburgh and University of Washington schools of medicine established that there were 48.9 million global cases of sepsis in 2017, which resulted into 11 million deaths – this figure represents one in five deaths worldwide.

The study also found that majority of sepsis cases, 85 per cent occurred in low or middle-income countries – like Kenya, which is classified as a lower-middle-income country.

The highest prevalence of sepsis was reported in Sub-Saharan, the South Pacific islands near Australia, and South, East and Southeast Asia.

What is sepsis?

According to Mayo Clinic, sepsis is a life-threatening condition caused by the body’s response to an infection. Normally, the immune system releases some chemicals into the bloodstream to fight infections. But sometimes, this immune response goes into overdrive, causing organ damage and inflammation through the entire body. This is what is known as sepsis. 

Any kind of infection can trigger sepsis. However, pneumonia, abdominal infection, kidney infection, and bloodstream infections pose the greatest risk of causing sepsis.

There are three stages of sepsis: sepsis, severe sepsis and septic shock. Septic shock causes the blood pressure to drop dramatically, which can result in sudden death.

The symptoms of sepsis include Fever and chills, fast heart rate, rapid breathing rate, an unusual level of sweating. When an individual with a probable or confirmed infection experiences these symptoms, it is advisable to get immediate medical attention.

Severe sepsis occurs when the organs have started to fail. You must have one or more of these symptoms to be diagnosed with severe sepsis: patches of discoloured skin, decreased urination, abnormal heart functions, changes in mental ability, low platelet count, breathing problems, chills due to fall in body temperature, extreme weakness or unconsciousness.

In mild cases that are diagnosed and treated early, the rate of recovery from sepsis is high. However, the septic shock has close to 50 per cent mortality rate. 

Who is at risk?

Because sepsis is caused by an immune response to infections, it can happen to anyone. That said, the following groups are particularly vulnerable: young children (infants and toddlers), old people over the age 65, pregnant women, people with weakened immune systems (such as with HIV or when undergoing chemotherapy, people with chronic conditions (including diabetes, kidney or lung disease, and cancer), those in an intensive care units, and those who use invasive devices (such as intravenous catheters or breathing tubes).

For unknown reasons, the study mentioned above found that sepsis incidences were higher among females than males.

When it comes to age, the incidence of sepsis is the greatest in early childhood. More than 40 per cent of all cases of sepsis occur in children under the age of five. Newborns are particularly at high risk of developing sepsis, which is known as neonatal sepsis.

Neonatal sepsis

This is when a baby develops sepsis within the first month of life. A newborn can develop sepsis from infection contracted during the birth process (early onset), or after birth (late onset).

Premature babies and newborns with low birthweight are more susceptible to early onset sepsis due to their immature immune systems.

Neonatal sepsis is a leading cause of infant mortality. In the developing world, it accounts for 1.6 million neonatal deaths per year. In Kenya, sepsis is responsible for 10-30 per cent of neonatal deaths.

Some symptoms of sepsis caregivers should look out for in newborns include Listlessness, refusal to breastfeed, low body temperature, fever, paleness, apnea (temporary stopping of breathing), abdominal swelling, poor circulation with cool extremities, vomiting, diarrhoea, seizures, and jaundice.

With early diagnosis and treatment, it is possible for newborns to recover from sepsis without lasting damage. When a newborn is suspected to have sepsis, they’re usually started on antibiotics right away, even before tests results are available. This significantly improves the chances of favourable outcomes for the baby.

Neonatal sepsis can be prevented by preventing and treating infections in pregnant women, providing a clean place for birthing, and delivering the baby within 12 to 24 hours of when the membranes break.

Is Toxic Shock Syndrome a form of sepsis?

Toxic shock syndrome is a rare life-threatening condition caused by bacteria getting into the body and releasing harmful toxins. Its symptoms are very similar to those of sepsis.

At face value, both conditions look similar. But they are different. According to www.sepsis.org, toxic shock syndrome occurs when certain bacteria release toxins into the body. This can lead to sepsis or septic shock.

But whereas septic shock follows an overwhelming immune response to an infection, toxic shock syndrome is the result of exotoxins of the bacteria themselves.

Treatment and prevention

Sepsis is diagnosed by observing symptoms and conducting blood tests. Blood tests check for infection, clotting problems, abnormal liver or kidney functions, decreased amount of oxygen, and electrolyte imbalances.

Depending on the results of blood tests, the doctor might order for urine tests, a wound secretion test, or a mucus secretion test. If the source of the infection is still unclear, the doctor might order for CT scans, lung X-rays, ultrasounds, or MRI scans.

Treatment for sepsis involves antibiotics, usually administered intravenously to fight the infection. The doctor might also use vasoactive medications to increase blood pressure, painkillers, insulin to stabilise blood sugar, and corticosteroids to reduce inflammation.

In severe cases, respirators to assist the patient’s breathing and dialysis to help kidney function might be necessary.

It is possible to make full recovery from sepsis. However, some survivors will experience lasting effects of sepsis which include damaged organs, muscle and joint pain, insomnia, poor concentration, nightmares, fatigue, and lowered cognitive functioning.

Preventative steps include staying up to date with vaccinations, practising good hygiene (handwashing, wound care, and bathing regularly), and getting immediate care when you develop signs of an infection. Bear in mind that when it comes to sepsis, every minute counts – the sooner you get treatment, the better the outcome.