Britain’s worrying rise in deaths from sepsis may be due to some doctors not taking the condition seriously, according to the UK’s top sepsis expert.
The life-threatening condition occurs when the immune system overreacts to an infection and starts to damage the body’s tissues and organs, and over the past decade deaths from it have soared – from 37,000 a year in 2013 to about 48,000 a year now.
Despite repeated awareness campaigns aimed at speeding up diagnosis and treatment, sepsis now causes more deaths than breast, prostate and bowel cancer combined.
While the rise has been partly blamed on an ageing population and hospitals recording more sepsis cases than before, according to Dr Ron Daniels, founder and chief executive of charity UK Sepsis Trust, the blame can also fall on a significant number of sceptical clinicians who believe the crisis is ‘all hype and hysteria’.
The problem comes as a case emerged of a 30-year-old primary school teacher who died late last year from sepsis after her infection was mistaken for a virus. Gina Campanini’s family believe more could have been done to save her life.
Gina Campanini, left, pictured with her sister Maria, suffered a stroke and died due to sepsis
On a Monday morning in September, Gina, from Hertfordshire, woke up with what she thought was flu. She was suffering from a tight chest, muscle pain and a high temperature. By Thursday her symptoms had worsened and so she booked a GP appointment for later that day.
‘She was told it was likely just a virus,’ says her sister, Maria, 26, a charity worker from London. ‘Gina wasn’t given any medication – she was told to go home, drink plenty of fluids and monitor her symptoms.’
Her condition deteriorated during the night, and the next morning, when she began struggling to breathe, her parents drove her to hospital.
By that stage Gina had developed sepsis, and she was admitted to intensive care. Sepsis can be triggered by common viruses such as flu, Covid or, as in Gina’s case, bacterial infection group A streptococcus, also known as strep A.
She was treated with antibiotics but suffered a stroke due to the sepsis and, just over a week after entering hospital, Gina died. Her family do not blame the GP for Gina’s death, but question why her health and youth, coupled with severe symptoms, did not cause more concern.
‘Gina was young, fit and healthy, so the fact that she got so unwell so quickly surely should have raised alarm bells,’ says Maria. ‘Perhaps if Gina was advised to go to A&E sooner, or she knew the symptoms of sepsis, she might still be with us.’
Sepsis is caused by the body overreacting to an infection, which sparks a collapse in blood pressure and organ failure.
It can occur at any age, though is most common in the elderly, and urinary tract infections are among the most frequent triggers.
Bacterial infections are one of the most common causes of sepsis. Blood tests can look for an increase in white blood cells, which indicates an infection is present
There is no effective test to spot sepsis. Most NHS clinicians diagnose it based on issues including temperature and heart rate. Blood tests to look for an increase in white blood cells, which indicates an infection is present, are also used, but can take hours to get results and may not be accurate.
In 2013 the UK’s health ombudsman warned that NHS failures to identify sepsis patients were leading to avoidable deaths, including among children. In response, the Government ran an advertising campaign to raise awareness of the early symptoms – which include slurred speech, discoloured skin and severe breathlessness. It also offered NHS hospitals £100,000 annually to keep track of how quickly sepsis patients were receiving antibiotics.
Studies show that speedy delivery of the drugs is crucial for improving survival. Prior to the scheme in 2016, only a third of sepsis patients received antibiotics within an hour. By 2019, this figure had risen to 80 per cent. But the Covid pandemic ended this improvement.
‘When the pandemic began the NHS stopped keeping track of this sepsis data, as there just weren’t enough resources,’ says Dr Daniels. ‘We’re back to where we started.’
Last October, a report from the ombudsman found that the NHS was making the ‘same mistakes’ and required ‘significant improvements’ to reduce the number of avoidable sepsis deaths.
Dr Daniels argues that a major problem is that many doctors still do not take sepsis seriously. He points to a 2019 article in The Lancet medical journal entitled: ‘Sepsis hysteria: excess hype and unrealistic expectations.’
The scientists involved claimed that the majority of sepsis victims were elderly, frail people whose deaths should not be viewed as avoidable. The paper warned that the push to prescribe antibiotics within an hour to suspected sepsis patients would lead to ‘excessive, inappropriate’ antibiotic use that would fuel resistance – where bacteria evolve to become impervious to the drugs.
It also pointed to the fact that only about 150 children die of sepsis in the UK every year as proof that concerns were unfounded.
Gina Campanini’s family believe that more could have been done to save the 30-year-old’s life
The lead author of the paper, Professor Mervyn Singer, an intensive care specialist at University College London, told the MoS that he stands by these conclusions.
‘Sepsis has been built up as this monster, but it’s nowhere near as bad as it seems,’ he says. ‘Most people who die from sepsis are about to die anyway, and the condition is just the final nail in the coffin.’
Dr Daniels disagrees, pointing out that studies suggest that just under half of all sepsis cases occur in working-age adults. ‘There are a lot of health professionals who say sepsis has been prioritised at the expense of other diseases over the past decade,’ he says. ‘But the fact is we are dealing with a serious crisis.
‘Patients with sepsis must be given antibiotics as soon as possible, but too often that isn’t happening, leading to avoidable deaths.
‘It’s frustrating that little has changed. Some 48,000 people die from sepsis every year – that can’t be allowed to continue.’
