GENEVA – Sepsis, one of the most prevalent but misdiagnosed, deadly diseases, was established as a global priority today by the World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO).
On the unanimous recommendation of the Executive Board of the WHO, the WHA adopted the resolution to improve, prevent, diagnose, and manage sepsis through a series of actions directed at developed and developing countries around the world. The resolution was adopted at the seventieth WHA, which is meeting between May 22-31 in Geneva.
Sepsis, commonly referred to as ‘blood poisoning’, is the life-threatening condition that arises when the body’s response to infection results in organ dysfunction or failure. Sepsis is often confused with other conditions in its early stages, with delayed recognition of the signs and symptoms quickly leading to multi-system organ failure and ultimately death.
The resolution urges the 194 United Nation Member States to implement appropriate measures to reduce the human and health economic burden of sepsis. In the USA alone, sepsis causes or contributes to half of all deaths in hospitals and has become the leading cause of annual hospitals costs, at over 24 billion USD per year.
The resolution also requests the Director-General of the WHO, Dr. Margaret Chan, to draw attention to the public health impact of sepsis and to 1) publish a report on sepsis and its global consequences by the end of 2018, 2) support the Member States adequately, 3) collaborate with other UN organizations, and 4) report to the 2020 WHA on the implementation of this resolution.
“Community-acquired and health care-acquired sepsis represent a huge global burden that has been estimated to be 31 million cases every year, six million of which result in death,” said Dr. Chan. “One in ten patients world-wide acquires one health care associated infection which often manifests itself with sepsis conditions. I commend the member states for the content of the resolution on sepsis which point to key actions that need to be taken to reverse these shocking statistics.”
The WHO has allocated $4.6 million USD to help implement their sepsis resolution.
The adoption of sepsis as a global priority was initiated by the Global Sepsis Alliance who gathered the consensus and authority of clinicians and families from over 70 countries.
“Worldwide, sepsis is one of the most common deadly diseases, and it is one of the few conditions to strike with equal ferocity in resource-poor areas and in the developed world,” said Dr. Konrad Reinhart, Chairman of the Global Sepsis Alliance. “In the developed world, sepsis is dramatically increasing by an annual rate of 5-13 per cent over the last decade, and now claims more lives than bowel and breast cancer combined. When sepsis is quickly recognized and treated, lives are saved but health care providers need better training because they are the critical link to preventing, recognizing, and treating sepsis.”
The adopted Resolution on Sepsis states:
1. Each year, sepsis causes approximately six million deaths worldwide, most of which are preventable.
2. Sepsis is a syndromic response to infection and the final common pathway to death from most infectious diseases.
3. Sepsis represents the most vital indication for the responsible use of effective antimicrobials for human health.
4. The UN Member States urgently need to implement and promote measures for prevention; such as clean childbirth practices, infection prevention practices in surgery, improvements in sanitation, nutrition and delivery of clean water.
5. Many vaccine-preventable diseases are a major contributor to sepsis in children and adults; national immunization programs are needed urgently.
6. Sepsis is an emergency that requires time-critical actions, improved training of health care professionals and laypeople.
7. UN Member States are required to promote research aimed at innovative means of diagnosing and treating sepsis across all ages, including research for new antimicrobial and other novel medicines/interventions, rapid diagnostic tests, and vaccines.
8. Public awareness needs to be raised and encouraged, for example by using the term ‘sepsis’ when communicating with patients, relatives, and other parties, or by supporting World Sepsis Day, every year on September 13.
9. Integrated approaches to the prevention and clinical management of sepsis are urgently needed, including access to appropriate health care for survivors.
10. The International Classification of Diseases (ICD) system needs to be applied and improved to establish the prevalence and profile of sepsis and the development of specific epidemiologic surveillance systems.
“With the exception of maternal and neonatal sepsis, ‘sepsis’ as a diagnosis is not cited in the Global Burden of Disease statistics and is therefore not a priority by policy makers or health care authorities,” said Dr. Reinhart added. “In addition, it is mostly unknown and poorly understood by the public. Further preventable deaths occur as many healthcare professionals lack training and expertise in the prevention, early recognition, and evidence-based management of sepsis as a critical medical emergency.”
In most low and middle income countries, an integrated approach to managing sepsis through clinical and laboratory services and timely access to appropriate sepsis care is limited or absent. In high income countries, effective best practice approaches to the early recognition and management of sepsis are often poorly implemented.
Representatives of WHO are set to strike a Task Force with the GSA to develop the strategy to implement the resolution and to secure international political and financial support.
For its part, the GSA identifies its key priorities as: 1) achieving adequate documentation of sepsis in the global and national disease statistics and reports, 2) encouraging the development of national action plans for all countries, 3) fostering quality improvement initiatives on all levels of care and for all health care settings, and 4) collaborating with governmental and non-governmental bodies focused on strengthening health systems and improving patient safety.
Today in Madison, Wisconsin, National Family Council Members Ann Ceschin and Tony Galbo held a very successful meeting with Wisconsin Health Services Secretary, Linda Seemeyer to address the issue of mandatory sepsis protocols throughout the state.
The State of Wisconsin Hospital Association already follow a set of guidelines Think Katie First named after Ann’s daughter Katie who died in January 2015 from undiagnosed sepsis. Tony and Liz Galbo’s daughter Gabby died in Illinois in May 2012 and they succeeded in having a set of mandatory sepsis protocols passed in her name “Gabby’s Law” which are now operated throughout the state of Illinois.
The National Family Council on Sepsis seeks to ensure that each state in the United States of America has mandatory sepsis protocols in place in all hospitals. The families of the council believe that it should not be like winning the lottery whether your loved one lives or dies, life saving protocols must be in all hospitals, sepsis deaths are preventable.
August 18, 2016
URBANA, ILLINOIS: Tony and Elizabeth Galbo and the Rory Staunton Foundation today announced the signing of Gabby’s Law by Illinois Governor Bruce Rauner. Sepsis is a medical condition which is the number one killer in hospitals and the eleventh leading cause of death in the United States. Over 258,000 victims die from sepsis every year – many of them unnecessarily. Since Gabby Galbo’s and Rory Staunton’s unnecessary and certainly untimely deaths, over 1 million Americans have lost their lives to sepsis. And the costs in treating unbridled sepsis reaches over $23 billion per year.
Experts agree that the key to fighting sepsis is ensuring quick diagnosis and treatment within the “golden hour” when it can be most effective. Pilot initiatives in some hospital systems have shown great strides in decreasing sepsis mortality through effective implementation of what is basically a “checklist”: a standardized protocol to facilitate quick and accurate diagnosis and fast and effective treatment as soon as any sign of sepsis arises. But no state, with the exception of New York, has required these simple protocols be implemented at all hospitals. Illinois represents a groundbreaking second.
Tony and Elizabeth Galbo, parents of five year old Gabriella Galbo who needlessly lost her life due to sepsis/septic shock in May of 2012, proudly met with Governor Rauner today in order to officially sign Gabby’s Law into effect. Bill 2403 known as Gabby’s Law will require Illinois hospitals to adopt, implement, and periodically update protocols for the early recognition and treatment of both adult and pediatric patients with sepsis or septic shock.
Gabby’s Law, based on Rory’s Regulations signed into law by Governor Andrew Cuomo in 2013, was drafted to address situations that occur every single day in leading medical institutions across the U.S., which led to the May 2012 unrecognized, untreated, and repeatedly ignored symptoms of sepsis which ultimately led to the death of Gabby Galbo from care which started at a local, well known level 1 trauma hospital.
“This new sepsis bill is vital to protect the citizens of Illinois, both adult and child from unrecognized and untreated sepsis,” the Galbo’s continued. “We hope Illinois, after following in the footsteps of Rory’s Regulations in New York, will trigger other states to immediately follow. If these protocols had been in place at the first hospital in which Gabby received care, we have no doubt that she would have lived. After Gabby’s death we knew something had to be done. Sepsis is very easily screened for, and is very treatable. Just weeks before Gabby’s death 12 year old Rory Staunton of NY died due to unrecognized and untreated sepsis in a major NYC medical institution.”
“I knew if the Staunton family successfully petition New York State to implement these sepsis protocols, then Illinois could and should implement them as well, as should every state,” said Tony Galbo. “I took a printout of Rory’s Regulations as they are named in New York, with me to Representative Bill Mitchell’s office and then to Senator Chapin Rose in order to express the urgent need for a sepsis protocol like this in Illinois so that no family should ever suffer the same consequences. This bill has, will, and is going to continue to save lives in the state of Illinois.”
“Since Gabby’s death four years ago in 2012, over one million Americans (258,000 people a year) have died of sepsis in the United States. Every state could and should adopt a sepsis protocol.
One of the biggest reasons every state does not have a sepsis protocol is because no one has asked! Ask! Take action, contact your governor, contact your state health secretary. Fill out a form which can be found on the www.RoryStauntonFoundation.org website under the Take Action tab, in which you can also find contact numbers for every state. Every day that goes by that legislation is not in place in your state, more needless deaths are occurring from sepsis. You don’t need to start from scratch to implement a sepsis protocol for your state. NY provided a model for IL, and IL and or NY can be the model for the next state,” said Elizabeth Galbo.
Orlaith and Ciaran Staunton, the parents of Rory Staunton and founders of The Rory Staunton Foundation, added, “The Third National Forum on Sepsis will take place in New York City on September 12, 2016. We called the nation to action in implementing sepsis protocols in every state and are very proud that the national initiative that started with New York State is now gaining significant momentum. The Galbo family and Governor Bruce Rauner are fulfilling our mission. Let’s not stop in Illinois! Rory Staunton and Gabby Galbo died unnecessarily. Rory and Gabby deserved to come home from the hospital as does every sepsis patient seeking treatment in any medical institution.”
Rory Staunton Foundation
917 523 8467
Liz and Tony Galbo
217 778 0502
See the original Press Release here
Read our original piece about Illinois Senate Passing Manatory Statewide Sepsis Regulations below:
Exciting news out of Illinois last week! The State Senate has passed Bill 2403 mandating that all Illinois hospitals must adopt and implement sepsis protocols. The House will now vote to confirm the protocols.
The bill is based on Rory’s Regulations in New York and is the result of the tireless work of the Galbo family. Five year-old Gabrielle Galbo died from Sepsis on May 11, 2012. The protocols in Illinois will be known as Gabby’s Law, in her honor.
We congratulate the Galbos on their incredible work and welcome them to the National Family Council on Sepsis.
In an emotional conversation with them last night the Galbos committed to working with the Foundation in our efforts to have sepsis protocols in every state in America. Little Gabby should not have died and her parents have been unrelenting in their fight for justice in her name.
The Rory Staunton Foundation for Sepsis awareness announces the release of a critical video
Sepsis: A Hidden Crisis Exposed
NEW YORK, N.Y.-February 25, 2015 – The Rory Staunton Foundation (www.rorystauntonfoundationforsepsis.org) today announced the launch of a critical sepsis awareness video entitled Sepsis: A Hidden Crisis Exposed. The video is available to watch and download at their website here.
Sepsis: A Hidden Crisis Exposed
A vitally important video about one of the most deadly infections in the world which is almost unknown in the United States. Sepsis kills over 258,000 Americans every year. Two families tell their tragic stories about their fight to have government agencies take responsibility and inform the American people about a disease that is largely curable, if detected on time.
The Staunton family, parents of Rory Staunton who died aged 12 years in April, 2012 and Carl Flatley, father of Erin Flatley, who died aged 23 in 2002 speak to the preventable deaths of their children and together with senior health officials make a passionate call to action for government agencies to address this deadly situation, immediately.
“Like countless other parents, we had never heard of Sepsis before Rory died. We established the Rory Staunton Foundation for Sepsis awareness to educate others about Sepsis, so that what happened to us would not happen to them,” said Rory’s Mom, Orlaith Staunton.
About The Rory Staunton Foundation
The Rory Staunton Foundation seeks to ensure that no other young person or adult dies of sepsis because of lack of recognition of the deadly symptoms by the medical community and responsible authorities and to serve as a major information source for the medical condition’s symptoms and outreach efforts. For more information, please visit www.rorystaunton.com.
The Rory Staunton Foundation
Deirdre Hickey, 212.244.6294
Autonomy vs. Accountability
By Nirav R. Shah, MD, MPH
Below is the transcript of the speech given by Dr. Nirav Shah at the First National Forum on Sepsis: Defeating the Killer, held in Washington DC, September 17, 2014.
“It’s my privilege to be with you today to honor the memories of Rory, Tommy, George, Erin, and thousands of others who have died of sepsis.
A few years ago in NY, whether you lived or died of sepsis was like winning the lottery… with mortality rates ranging from 15%-‐37% from one hospital to the next. Doctors approached the care of sepsis as a “complex systems problem,” too complicated to solve with fingers pointing variably to the “source” of the problem as the emergency room, lab, ICU, wards, or community but no accountability. How did we get here?
In America, our culture is predicated on independence. The lone cowboy, on an open frontier, best represents the classic American doctor. We are taught to rely on ourselves, to resort to heroics to save our patient. Yet sadly, the analogy has broken down, and while the cowboys of medicine are a dying breed, no good analogy exists to replace that penultimate American story.Today, more of how we practice medicine is about accountability, not just autonomy. Team-‐based care, where old hierarchies don’t exist, where a nurse – even a patient – can pull the cord that stops the assembly line – has overturned the sacred, top-‐down, patriarchal tenets of medicine.
So is it really a debate about accountability versus autonomy? About capitalism vs. socialism? About a moral dilemma for doctors trying to do the best for their patients? About the unfettered free market of doctors in a retail market created by high deductible health plans, vs. the unfeeling, cold algorithms of cookbook medicine imposed by HMOs, run-‐away regulators, and big government?In reality, the facts belie the truth. The best medicine today is practiced by those doctors who go the extra mile for their patients, who use their instincts to check one more test, or pull out the abstract from the pile of journals on their desk that informs the care of their patient. And the best medicine is also practiced by integrated delivery systems, like North Shore LIJ and Kaiser Permanente, who achieve stratospheric quality scores, have process improvement experts stationed at every corner, and can tell you – to the minute – when a patient’s lactate results will be available.
That is the paradox and the promise of our American healthcare delivery system. What I’ve learned from Rory’s Regulations is that Autonomy and Accountability are not mutually exclusive; it’s an “AND” not an “OR,” and when the fine balance of each is achieved, only then can our patient-‐centered paradigm be realized. We are beginning to realize that a culture of interdependence, not independence, can result in reliable excellence, where every patient with sepsis wins the lottery every time and has early recognition, aggressive fluids, and quick antibiotics.
In New York State, we have already documented 10,000 cases of sepsis and severe sepsis in the first quarter of this year. Imagine the possibilities for research and care improvement as a result! What Rory’s Regulations have shown us is that it is possible to make regulations general enough to work -‐-‐ in changing times with evolving science and evidence -‐-‐ yet specific to our needs. The previously unexplained, and I would argue unethical, unexplainable huge variability in survival rates are being diminished. Our job as caregivers to first do no harm, includes aggressively understanding and applying the evidence. I believe the moral dilemma has been replaced by an ethical imperative when it comes to sepsis, and I challenge everyone to take this on. Rory, Tommy, George and Erin deserve no less.”
Below is the transcript of the opening remarks given by Congressman Joe Crowley at the First National Forum on Sepsis: Defeating the Killer, held in Washington DC, September 17, 2014.
“I’m so glad to be here today, and I’m so glad to see such a great turnout for this first, national forum on sepsis hosted by the Rory Staunton Foundation and the Northshore-LIJ Health System.
There are, of course, many people who have been focusing on how we can fight sepsis, and I think you’ll see by the lineup of speakers this morning that there are a lot of great minds working on this issue.
But, a major reason why we are here today is because of the work of two people in particular – Ciaran and Orlaith Staunton, and the work they have done to turn their family’s pain into a message of hope for others.
We are also here today because of one other person – Rory Staunton.
I’ve known the Staunton family for a long time. Rory was a great kid, bright and determined, with a real passion for making the world a better place.
Rory wasn’t the type to let wrongs go unaddressed. When he saw injustice or people hurting, he focused right on action to correct it.
It’s in his spirit that we’re here today – to find solutions and to ensure that we’re making things better.
I want to thank Ciaran, Orlaith, their daughter Kathleen, and all their extended family and community who have become part of this effort.
I know that this wasn’t a mission you asked for or wanted, but you have taken it on to help the hundreds of thousands of people affected by sepsis each year – and their families.
Let me add that I know that through their work the Stauntons have formed a community of other families who have shared their sad stories, and I thank you all for adding your voices, your experiences, and your dedication to this issue.
The first problem in fighting sepsis may be one of awareness, but you all have made it clear that you’re committed to turning that around.
That’s why today’s event is so important, to shine a bright light on the issue of sepsis and the answers that we know are there.
Sepsis can be treated – it can be stopped before it takes a life.
But that requires a full-scale, coordinated attack on sepsis in all its forms.
I’m so proud that my home state of New York has been a leader in the fight against sepsis, and a lot of that credit goes to the tireless efforts of the Staunton family.
It’s also due to the partners they had in New York State.
Healthcare providers like Northshore-LIJ stepped up to fight sepsis.
And also leaders like former Health Commissioner Shah, who helped guide Rory’s Regulations to fruition and positioned New York to set an example for the rest of the nation – and it’s an example that must be followed.
We need every state, every hospital, every doctor, every family to be prepared and ready to fight sepsis.
And to do that, we need a strong federal initiative that says sepsis is a priority, and fighting it is our solemn charge.
I’m glad that Dr. Frieden of the CDC is here, because they are and will continue to be integral to these efforts.
And I’ve been glad to see there is some progress being made on this issue at CDC, CMS, and other agencies.
But we can do more – we must do more.
I’m pleased to announce today that I will be introducing legislation to prevent what happened to Rory from continuing to happen to others.
The Rory Staunton Coordination, Awareness, Research, and Education for Sepsis Act, or the “CARE for Sepsis Act,” will improve and strengthen the federal response to sepsis and the tools we have to fight it.
Coordination. Awareness. Research. And Education. That’s what we need to turn the tide against sepsis.
A problem of this magnitude demands a national solution.
My bill will require all our nation’s health agencies to work together and create a National Action Plan on sepsis.
It will ensure that the Department of Health and Human Services has a single, high-ranking point person on sepsis, to show that this is a priority for the federal government, and that we are attacking it with our best resources.
What we need is a broad and comprehensive solution.
My bill will direct resources toward greater public awareness efforts, research to better fight this disease, and improved education for our medical professionals on the need for early intervention.
I look forward to finalizing this legislation, and working with my colleagues to build bipartisan support and move it through Congress.
Aside from our federal agencies, we need to get Congress more involved.
So I will be forming a Congressional Sepsis Caucus, to bring together members of Congress who have a shared interest in fighting sepsis.
Members, parents, families, advocates, health care providers, scientific experts, and sepsis survivors will all have a platform to come together and exchange ideas.
We’ll elevate this issue and do more to educate policymakers on a deadly condition that is killing over 250,000 Americans each year.
And I hope that we’ll see some hearings in the House on the issue of sepsis and what we can do to fight it.
We can’t stay silent. We will make clear that even one death from sepsis is one too many.
I thank the Rory Staunton Foundation and Northshore-LIJ for putting together this first national forum on sepsis.
It seems like a great start to what I hope will be a productive and persistent campaign to stop sepsis.
But as much as I’m looking forward to working with all of you on this important cause, I’m even more looking forward to the last national forum on sepsis, when we’ve put a stop to this killer once and for all.
Below is the transcript of the keynote address given by Senator Charles Schumber at the First National Forum on Sepsis: Defeating the Killer, held in Washington DC, September 17, 2014.
“Hello everyone, thank you for being here today to discuss this extremely important topic on this historic day. Today is the first national forum on Sepsis and we are all here to forward this cause and press for action.
I am pleased to be here with Patrick Conway of CMS, Dr. Nirav Shah of Kaiser Permanente and former New York Health Commissioner, Dr. Frieden of the CDC, and all of the doctors, professionals and family members who have worked tirelessly to raise awareness about an issue that affects more children and adults than any of us could have imagined.
I want to especially thank Ciaran and Orla. I will talk more about this amazing family later, but, knowing them as I do, suffice it to say that I am not surprised to find such an impressive gathering of medical and public health leaders and professionals here to address our sepsis challenge.
Their tenacity, and passion, and intelligence is matched only by the depth of their selflessness and humanity. Thank you both for all you have done for this cause.
Now, I want you all to listen to a few numbers:
Each year, about one million people in the United States develop sepsis. In the past decade, sepsis has killed over four million Americans.
Not only is this a deadly disease, it is a costly one. According to the U.S. Agency for Healthcare Research and Quality, the U.S. spends about $24 Billion – that’s billion with a “B” – each year on treating patients with sepsis, making it the most expensive cause of hospitalization in the country.
Too many families – far too many – are impacted by a loved one developing this devastating condition.
For too long – far too long – the only people beating the drum on sepsis awareness are the people in this room. That must change. That will change.
And it is already starting. At the insistent and inspirational prodding of Ciaran and Orla Staunton, New York has taken the lead in this fight and last year passed Rory’s Regulations, named after the beautiful boy you all saw earlier who tragically died from sepsis.
A word of praise here goes to Dr. Shah and to Governor Cuomo, who were courageous, bold and decisive when presented with the challenge of what to do to confront sepsis.
They didn’t study the problem to death; they took action to save lives and they promulgated Rory’s Regulations.
Rory’s Regulations require health care providers in New York to develop and implement protocols to rapidly diagnose and treat sepsis infections.
There’s no two ways about it…this will go a long way improving the rate at which we catch sepsis in its early stages. And for those of you who are familiar with the condition, early detection is one of the most important factors in treating, and ultimately curing, the illness.
We are trying to do the same at the federal level. My colleagues and I in Congress are working with stakeholders, as well our hosts the Rory Staunton Foundation, to do our part in combating this serious illness.
CMS has been engaged on this issue, as you have heard from Dr. Conway, and they are working on addressing the sepsis challenge. But like New York, we need real action, we need clear across the board protocols, and we need better methods of identifying and treating sepsis before it threatens lives.
I will also be working with CMS to ensure that they incorporate sepsis detection and reduction goals into their pay-for-performance programs. (like Value-Based Purchasing and Accountable Care Organizations)
On top of a clear national protocol modeled on New York’s regulations, I believe that awareness, simple awareness, is such a crucial piece of the puzzle.
Ciaran and Orla have already done extraordinary work on this front. By telling the world their story – as unfathomably painful as that is — they have exponentially increased awareness of the lurking dangers of sepsis, and in so doing they have already altered and saved lives. They will never know those people, but the gift that their activism and passion have bequeathed to others is infinite.
And we must carry forward this message in a more coherent way. We must all do our part where we can.
That’s why I am introducing a resolution to designate September as “National Sepsis Awareness Month.”
It is my sincere hope that my colleagues will work with stakeholders in the Administration to help educate the public, doctors, hospitals and clinics about the early signs of sepsis so that no family has to experience the unfathomable loss of a loved one stolen too soon.
So I am going to push the Senate Appropriations Committee to direct some of the CDC’s funding to go specifically to sepsis awareness, outreach and education activities.
Again, we need real goals and deadlines and action to drive awareness and knowledge into every corner of the American health care system.
To close, I commend the efforts of the Rory Staunton Foundation for their tireless dedication to the issue.
I know this is personal for them. I can’t imagine how hard it is for them. But I wholly believe that their efforts that brought us all here today will save lives.
Rather than curse the darkness, Ciaran and his wife Orla chose to light a candle. And those of you who know Ciaran and Orla know that they are not just a candle, they are a beam of light. And their foundation, the Rory Staunton Foundation, is a beam of light for this cause.
It’s time we take up their cause at the federal level: to help increase awareness of sepsis nationwide; to establish clear national standards for early identification and prompt treatment of sepsis; and to dedicate more resources and energy to the implementation of early detection and treatment protocols. That will help save countless lives.
So we will continue pushing and we will continue working together, in honor of Rory, and the countless others who were unnecessarily lost to this devastating illness, to stop preventable deaths from sepsis.
Thank you again.”
Sepsis is a serious infection usually caused by bacteria — which can originate in many body parts, such as the lungs, intestines, urinary tract, or skin — that make toxins that cause the immune system to attack the body’s own organs and tissues.
Sepsis occurs when a serious infection causes the body’s normal reaction to infection to go into overdrive. With sepsis, bacteria and the toxins they create cause changes in a person’s body temperature, heart rate, and blood pressure, and can result in dysfunction of the body’s organs.
Sepsis can be frightening because it can lead to serious complications that affect the kidneys, lungs, brain, and hearing, and can even cause death. Sepsis can affect people of any age, but is more common in:
– infants under 3 months, whose immune systems haven’t developed enough to fight off overwhelming infections
– the elderly
– people with chronic medical conditions
– those whose immune systems are compromised from conditions such as HIV
If your infant has a rectal temperature of 100.4°F (38°C), seems lethargic, irritable, uninterested in eating, or seems to be having difficulty breathing or appears ill, call your doctor right away.
In older kids, symptoms may include a fever, irritability, difficulty breathing, and lethargy. Your child may also seem irritable, confused, have trouble breathing, have a rash, appear ill, or may complain that his or her heart feels like it’s racing. Call your doctor right away if your child has these symptoms.
Signs and Symptoms
Sepsis in newborns can produce a wide variety of symptoms. Frequently, these babies “just don’t look right” to their caretakers.
Symptoms of sepsis in newborns and young infants include:
– disinterest or difficulty in feeding, or vomiting
– fever (above 100.4°F [38°C] or greater rectally) or sometimes low, unstable temperatures
– irritability or increased crankiness
– lethargy (not interacting and listless)
– decreased tone (floppiness)
– changes in heart rate — either faster than normal (early sepsis) or significantly slower than usual (late sepsis, usually associated with shock)
– breathing very quickly or difficulty breathing
– periods where the baby seems to stop breathing for more than 10 seconds (apnea)
– change in skin color — becoming pale or blue
– jaundice (when the skin and eyes look yellow)
– decreased amount of urine
Older children who have sepsis might have a fever, vomiting, a rash, change in skin color, trouble breathing, feel like their hearts are racing, or may be lethargic, irritable, or confused. A child with sepsis may have started with an infection such as cellulitis or pneumonia that seems to be spreading and getting worse, not better.
Causes of Sepsis
Bacteria are almost always the cause of sepsis in newborns and infants. Bacteria such as group B streptococcus (GBS), E. coli, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, and Salmonella are the more common culprits in sepsis in newborns and infants younger than 3 months.
Premature babies receiving neonatal intensive care are particularly susceptible to sepsis because their immune systems are even more underdeveloped than other babies, and they typically undergo invasive procedures involving long-term intravenous (IV) lines, multiple catheters, and breathing through a tube attached to a ventilator. The incisions an infant gets for catheters or other tubes can provide a path for bacteria, some of which normally live on the skin’s surface, to get inside the baby’s body and cause an infection.
In some cases of sepsis in newborns, bacteria enter the baby’s body from the mother during pregnancy, labor, or delivery. Some pregnancy complications that can increase the risk of sepsis for a newborn include:
– maternal fever during labor
– an infection in the uterus or placenta
– premature rupture of the amniotic sac (before 37 weeks of gestation)
– rupture of the amniotic sac very early in labor (18 hours or more before delivery)
Some bacteria (GBS in particular) can be acquired by the newborn during delivery — 15% to 30% of pregnant women carry the bacterium for GBS in the vagina or rectum, where it can be passed from mother to child during delivery.
Diagnosing and Treating Sepsis
Because symptoms of sepsis can be vague in infants, laboratory tests play a crucial role in confirming or ruling out sepsis:
– Blood tests (including white blood cell counts) and blood cultures may be taken to determine whether bacteria are present in the blood. Other blood tests may be done to see how well certain organs, such as the liver and kidneys, are functioning.
– A urine test is usually done by inserting a sterile catheter into the baby’s bladder through the urethra for a few seconds to collect a small sample of urine; this will be examined under a microscope and cultured to check for the presence of bacteria.
– A lumbar puncture (spinal tap) may be performed, depending on the baby’s age and overall appearance. A sample of cerebrospinal fluid will be tested and cultured to determine if the baby could have meningitis.
– X-rays, especially of the chest (to make sure there isn’t pneumonia), are sometimes taken.
If the baby has any kind of medical tubes running into the body (such as IV tubes, catheters, or shunts), the fluids inside those tubes may be tested for signs of infection.
Sepsis, or even suspected cases of sepsis in infants, will be treated in the hospital, where doctors can closely watch the child and administer strong antibiotics intravenously to fight the infection.
Usually, doctors start infants with sepsis on antibiotics right away — even before the diagnosis is confirmed. If needed, they may start them on IV fluids to keep them hydrated, blood pressure medication to keep their hearts working properly, and respirators to help them breathe.
Although there’s no way to prevent all types of sepsis, some cases can be avoided, namely the transmission of GBS bacteria from mother to child during childbirth. Pregnant women can have a simple swab test between the 35th and 37th weeks of pregnancy to determine if they carry the GBS bacteria.
If a woman tests positive for GBS, she can receive intravenous antibiotics during labor. It is best if these antibiotics are given at least 4 hours before delivery, so women who are GBS positive may need to go to the hospital earlier in labor than others.
Women are at higher risk of carrying GBS if they have a fever during labor; if the amniotic sac ruptures prematurely; or if they had other children with sepsis or other diseases triggered by GBS, such as pneumonia or meningitis. A woman who has not been tested for GBS, but has one of these risk factors, can receive IV antibiotics during labor to lower the risk of transmission to her child.
Another way to help prevent some types of sepsis is through vaccination. Immunizations routinely given to infants today include vaccinations against certain strains of pneumococcus and Haemophilus influenzae type b that can cause sepsis or occult bacteremia, an infection of the blood.
Hand washing can go a long way toward preventing infection. Also make sure that people who come near your baby are not sick and have been fully vaccinated. For children with indwelling medical devices, such as catheters or long-term IV lines, make sure to follow the doctor’s directions for cleaning and accessing the site.
When to Call the Doctor
Symptoms of sepsis can be very difficult to identify in newborns and young infants, so call your doctor immediately or seek emergency medical care if your baby shows any of these symptoms:
– disinterest in feeding
– fever (100.4°F [38°C] and above rectal temperature) in newborns and young infants
– labored or unusual breathing
– change in skin color (paler than usual or mildly bluish) or a rash
– listlessness or lethargy
– change in the sound of the baby’s cry or excessive crying
– change in baby’s muscle tone — either seeming too stiff or especially floppy
– a slower or faster heart rate than usual
– bulging or fullness of the “soft spot” on the baby’s head
– decreased amount of urine
– any type of behavior or appearance that concerns you
If your older child has fever, vomiting, a rash, trouble breathing, change in skin color, feels like his or her heart is racing, or is lethargic, irritable, or confused, call the doctor or get emergency medical care immediately.
These signs don’t necessarily mean a child has sepsis, but it’s important to let the doctor know about symptoms to make sure an infection is caught before it becomes more severe.
It’s a disease that kills more Americans each year than breast, lung, and prostate cancers combined. It accounts for more than 1 million hospitalizations annually in the United States.
When it comes to the top deadly illnesses, few people talk about sepsis. In fact, a recent survey found that 69 percent of us have no idea what sepsis is even though the condition is extremely serious, killing 20 percent of its victims.
Sepsis is a toxic response to an infection, explains Jim O’Brien, M.D., director of Sepsis Alliance and Associate Professor at the Center for Critical Care at the Ohio State University Medical Center.
“You can get it following a hospital stay or from getting your nail infected after a manicure,” he tells Newsmax Health. ”The most important message is that if you feel an infection is getting worse, you need to treat it like a heart attack. It’s a medical emergency, and the sooner you get treatment, the better your chances of survival.”
Treatment often includes intravenous antibiotics — and the faster the drug can be administered, the better. In fact, every hour of delay before antibiotics are given causes an 8 percent drop in survival rate.
Early symptoms may include mottling of the skin, confusion, chills, decreased urination, lightheadedness, rapid heart rate, and shaking. As the infection advances, blood pressure can drop, resulting in shock. Sepsis can interfere with blood flow and lead to tissue dying, or necrosis, resulting in the amputation of limbs.
Medical experts say sepsis can arise from an infection anywhere in the body. No one is immune to sepsis, although some groups are at higher risk.
“People on both ends of the age spectrum are particularly vulnerable,” says Dr. O’Brien, adding that sepsis is the leading killer of kids under the age of 5 worldwide. Those suffering from cancer, liver disease, and alcoholics are among high-risk groups.
New research shows that people who do survive the disease may develop difficulties with thinking, called cognitive dysfunction. In fact, a recent study suggests there are 22,000 cases of cognitive dysfunction among sepsis survivors every year.
Dr. Derek Angus, a lead researcher at the University of Pittsburgh Medical Center who is currently studying sepsis, says that even after treatment, the disease can remain a long-term problem. “Even though people may survive, a significant number of them still have some inflammation under the surface and face trouble for months,” he says.
Dr. O’Brien says the key to surviving sepsis with fewer long-term effects is that when patients see that a wound is infected, they get treatment immediately. “Early detection and treatment is what will help you get better,” he says. “Public awareness is key to defeating this disease We, as patients, need to do our bit to protect ourselves against this devastating disease.”
“Keep immunizations up to date, follow a full course of antibiotics when you have an infection, and wash your hands carefully,” says Dr. O’Brien. “And if you go to the hospital or emergency room, mention that you are concerned about sepsis. This will put the staff on notice and they won’t delay your treatment.”
For more information visit the Sepsis Alliance website at: sepsisalliance.org