Twice as many people as previously thought are dying of sepsis worldwide, surpassing diseases like cancer, an analysis published in The Lancet shows.
Most of these people are a disproportionately high number of children in poor areas. Sepsis also remains the most common cause of in-hospital deaths, with one in five deaths around the world.
The study estimates that, in 2017, there were 48.9 million cases of sepsis worldwide and 11 million deaths. That means that about 20 per cent of all deaths globally were sepsis-related. Previous global estimates were significantly lower.
By comparison, the World Health Organisation estimated that there were 9.6 million deaths from cancer in 2018.
“We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable,” said Dr Mohsen Naghavi, senior author in the study and professor of health metrics sciences at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine.
Sepsis is a potentially life-threatening condition caused by the body's response to an infection. The body normally releases chemicals into the bloodstream to fight an infection. When someone has sepsis, their body essentially overreacts to an infection. This out-of-control immune response can cause organs to shut down. Even if sepsis doesn’t kill its victims, it can create lifelong disabilities in survivors.
In 2017, an estimated 20.3 million sepsis cases and 2.9 million deaths worldwide were among children younger than five. Many were newborn babies. In Kenya, sepsis care is still suboptimal, especially in public health facilities with poor outcomes due to late presentation and limited resources.
Dr Naghavi called for more focus on preventing sepsis among newborns through access to vaccines, clean water and other hygiene measures, as well as action to tackle antimicrobial resistance, which he said was “an important driver of the condition”.
Many infections are no longer easily treatable because bacteria and viruses have evolved to overpower some antibiotics. The leading cause of sepsis was diarrhoeal disease and the leading cause of sepsis-related deaths was pneumonia.
“Watching a baby die of a disease that could have been prevented with basic public health measures really sticks with you,” said the lead author, Dr Kristina E Rudd, an assistant professor in Pitt’s Department of Critical Care Medicine.
The signs vary depending on the age of the sufferer, and it is difficult to diagnose. Sepsis can be, but is not always, a complication of septicaemia, which is severe blood poisoning. Those who survive can suffer severe disabilities.
According to an analysis of data in the Global Burden of Disease study run by the Institute of Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, the overwhelming majority of cases (85 per cent) are in low and middle- income countries. Children were most at risk, with four in 10 cases in children under the age of five.
Whereas deaths from sepsis in 2017 peaked in early childhood, it declined in early adulthood but rose again among the elderly. Further, the infections were higher among women compared to men. By age, the incidence of sepsis peaks in early childhood, with more than 40 per cent of all cases occurring in children under five.