Often referred to as blood poisoning, sepsis is caused by the body over-reacting to an infection. Most cases are caused by bacterial infections in wounds and can result from injuries as minor as a cut finger or a jab from a rose thorn while gardening to serious injuries and surgical incisions. However, sepsis can also result from viruses such as COVID-19 or influenza, or fungal infections.
Left untreated, it can progress rapidly to septic shock, and with the potential to result in amputation, organ failure and death.
Worldwide, sepsis affects an estimated 50 million people a year. According to the World Health Organization, it remains one of the world’s deadliest conditions and is responsible for 20 per cent of all deaths. In Australia, about 10,460 people die from sepsis every year, and 87,470 are admitted to hospital.
Anyone can contract sepsis, but cases are markedly higher in children under the age of one and adults aged older than 65. Men are more likely than women to be hospitalised, and people are more likely to be affected if they live in very remote areas, are Indigenous, and or have a medical condition that can weaken the immune system, such as diabetes, cancer, renal disease, liver disease or HIV.
There is no way of knowing when sepsis will strike, or any effective prevention apart from preventing infection through measures like keeping even the smallest wounds clean, and being vaccinated against infectious diseases like the flu.
Sepsis is a medical emergency, and any delay in diagnosing it is associated with a higher risk of complications and death. It can be successfully treated with antibiotics, but only if they are administered early enough.
Unfortunately, it is hard to diagnose sepsis. There is also no blood test that can identify it, and the clinical signs and symptoms can easily be mistaken for a range of other illnesses – even, in some cases, the common cold. Symptoms include fever or low body temperature, chills, shaking, rapid breathing, rapid heart rate, tiredness and feeling generally unwell. It is particularly difficult to identify in very young children, who often have very few symptoms.
Because of this difficulty, it is important that everyone is aware of the disease and its symptoms. Clinicians are the ones who will make the diagnosis, but it is vital that the public also understands that seemingly small things can potentially be very serious if left untreated. Family members have a key role to play, as they are often alert to early changes or deterioration in their loved ones’ conditions. Even if it seems unlikely, it is always important to ask the question, “Could it be sepsis?” especially if the patient is in one of the risk groups, has recently had a wound of some sort or has an existing infection and is deteriorating.
The Australian Institute of Health Innovation at Macquarie University has been working with government and clinicians to further knowledge on sepsis for eight years, including conducting the first epidemiological study in 2020, as well as research on early detection, improving patient outcomes, supporting clinicians to diagnose sepsis, and the burden of morbidity and mortality among sepsis survivors. Work is currently under way to assess mobile apps for sepsis prevention for use by both clinicians and the public.
World Sepsis Day is held on 13 September every year, aiming to save lives by raising awareness of the disease and what can be done to prevent it.
Professor Vincent Lam is a Professor of Surgery and Head of MQ Health Clinical School.
Associate Professor Ling Li is an Associate Professor of Biostatistics and leads Health Analytics and Patient Safety research at the Centre for Health Systems and Safety Research, which is part of the Australian Institute of Health Innovation.
