Gillian Dawson's son, Elliott, was eight years old and recovering from chickenpox. After the spots had cleared, he returned to school and his parents expected him to get back to good health quickly. They thought nothing more of it.
But within a few days his condition took a huge turn for the worse. Elliott became lethargic, achy and had a high temperature which stubbornly refused to go away, despite medication.
‘I just knew there was something very seriously wrong with him,’ Gillian said. ‘As a Mum you just know when things aren't at all right. Instead of recovering from chickenpox, he just became more and more tired and lethargic. He didn't want to eat or do anything.’
Gillian instincts were proved to be right. After calling 111 she rushed her child to the hospital where a doctor quickly diagnosed what he believed to be sepsis. ‘I totally panicked at hearing this word, especially when it was explained to us how serious this disease is,’ she said.
‘I immediately associated it with the word “septic”, and, of course, it's another word for blood poisoning, which made sense. Thankfully, we were told we had caught it early and we should hope for the best, but it was to be a long time before Elliott regained his health and got back to something resembling normality.’
Sepsis—which is also known as septicaemia or blood poisoning—is a life-threatening reaction to an infection in the body. It occurs when the immune system overreacts to the infection and begins to damage the body's own tissues and organs. People who have suffered the disease may end up losing fingers, toes or parts of their limbs, or lose the feeling in their limbs, as they recover.
Sepsis is now a major killer globally, causing more deaths than cancer. Figures released in January by researchers at the universities of Pittsburgh and Washingon, put the annual death rate from the disease at 5.5 million deaths from a total of 19.3 million cases worldwide (University of Pittsburgh, 2020). They believe that one in every five deaths worldwide is associated with sepsis, and two out of every five victims are children under the age of 5 years.
In the UK, 245 000 people are thought to be affected by sepsis every year, resulting in some 48 000 deaths, according to The UK Sepsis Trust (2020).
Among the symptoms to watch out for in young children is blue, pale or blotchy skin, lips or tongue, and a rash like the one seen in meningitis cases. The child may also be breathless or breathing very fast. In some cases, children may also make a grunting noise, or their stomach can be seen to be sucking under their ribcage.
Young children may also make a high-pitched noise that is not their normal crying, be off their food and refusing to do any activities and sleepier than usual.
An older child may also act confused or have slurred or incoherent speech. Other symptoms indicating they may have sepsis including not having urinated all day and vomiting. Swelling, redness or pain around a wound or cut may also be a sign of the disease. Experts say that sepsis is particularly hard to spot in very young children, and children and young people who have a learning disability or have difficulty communicating.
Young people who are more likely to get sepsis are those with diabetes, children who have a weakened immune system, for example because of chemotherapy or an organ transplant, and anyone who has recently had surgery or a serious illness. However, it has also been known to strike what appears to be otherwise healthy people. Some of the symptoms are not dissimilar to other illnesses such as colds and flu, or a chest infection, which is why a delayed diagnosis can be fatal.
Sepsis requires quick treatment as the patient can deteriorate within hours.
‘Some of the symptoms are not dissimilar to other illnesses such as colds and flu, or a chest infection, which is why a delayed diagnosis can be fatal.’
‘… one in every five deaths worldwide is associated with sepsis, and two out of every five victims are children under the age of 5 years.’
Many people die within a day or two of becoming ill because they were treating their symptoms with painkillers unaware that sepsis was sending their body into septic shock and attacking their vital organs.
Dr Jacqui Bradley, a GP working in the Midlands, said she had seen a handful of cases of sepsis in the past 3 years. Sepsis cannot be caught from another person, and is treated through antibiotics, though in some cases surgery may be required to remove infected areas. Often it necessitates a prolonged stay in hospital, she said.
‘It would be great if we could raise awareness among school nurses about the signs to watch out for among school pupils,’ she said. ‘The faster sepsis is diagnosed, the greater the chance of survival and a full recovery.
‘Most people will make a full recovery from this illness, but there might be physical or emotional symptoms still present several years later. This is known as post-sepsis syndrome and can be very debilitating.
‘Usually, the after-effects are feeling of weakness and tiredness, difficulty sleeping, being more prone to other illnesses and a lack of appetite.
‘The emotional aspects can manifest in depression or anxiety, mood swings and nightmares. In some cases, even post-traumatic stress disorder. So, this is a serious matter.
‘Given the recent figures on cases of sepsis it's worth school nurses asking themselves if they come across a poorly child “could this be sepsis?”. It is always better to err on the side of caution.’
For Elliott, the speedy diagnosis meant he made a good recovery, though he occasionally still suffers symptoms of post-sepsis syndrome. Gillian said: ‘Even two years on, as healthy has he appears, he will still complain of fatigue and seems more prone to picking up germs at school, such as colds and stomach bugs.
‘Sepsis had barely registered with me before Elliott's illness, but having read the experiences of other families, I realise how lucky we were. Another day or two and he might have gone into organ failure and the outlook would have been devastating. It makes me go cold thinking about it.’
FURTHER INFORMATION
NICE
Sepsis: recognition, diagnosis and early management—NICE guideline [NG51] can be found here: https://www.nice.org.uk/guidance/ng51
NHS England
Sepsis: https://www.england.nhs.uk/ourwork/clinical-policy/sepsis/
The UK Sepsis Trust
https://sepsistrust.org/
Schools against sepsis resources can be accessed here: https://sepsistrust.org/about/about-the-charity/our-current-campaigns/schools-against-sepsis/