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Korrin Barrett, whose sepsis took several days to diagnose, leading to the loss of several limbs, on a school visit. Photo/Korrin.NZ/Supplied

Raising awareness of the life-threatening sepsis condition

It’s crucial to recognise when the body has gone into overdrive in response to infection.

Hawke’s Bay woman Korrin Barrett knew something was seriously wrong when, one Friday evening in 2012, after several days of abdominal pain, she started shaking uncontrollably and sweating profusely despite feeling freezing cold.

“I was shivering and my teeth were chattering. I felt an impending sense of doom – I had really hit rock bottom.”

Barrett, who was living in Australia at the time, had also stopped urinating – another classic symptom of what was eventually diagnosed as sepsis, a potentially life-threatening condition caused by the body’s response to an infection.

In Barrett’s case, the infection was caused by an undetected bowel perforation. But by the time that had been diagnosed, her body was already shutting down. She spent nine days on life support and the sepsis caused so much tissue damage she had to have both legs amputated below the knee, as well as her right hand and all the fingers on her left hand. At the time, Barrett, whose determination to overcome the challenges of being a quadruple amputee has seen her take up a career as a motivational speaker, had never heard of sepsis. Unluckily for her, while the medical staff who treated her had heard of the condition, it took them several days to recognise that she had it, by which time the damage had already been done.

Waikato Hospital infectious diseases specialist Dr Paul Huggan is one of a group of doctors who are determined to make sure others don’t have the same experience. In 2018, they set up Sepsis Trust NZ to help raise awareness about sepsis among the public and the medical profession.

Dr Paul Huggan. Photo/Waikato District Health Board

A survey of 300 people by the trust at Fieldays last year found that only 40% had heard of sepsis. And although health professionals are aware of the condition, they’re not always good at detecting it during the early stages, when treatment with antibiotics can prevent serious consequences.

“The challenge is to make sure that everyone in the healthcare system understands how to recognise the key symptoms and responds.”

Sepsis – which was previously known as blood poisoning or septicaemia – is caused when the immune system overreacts to an infection, releasing chemicals that trigger widespread inflammation. This causes blood clots and leaky blood vessels and, if left untreated, can cause organ damage. In severe cases, blood pressure drops and the patient goes into a state of septic shock, which can be fatal.

Between 10-20% of people with sepsis die from the condition. The death rate in developing countries is even higher, with a recent study in the Lancet suggesting sepsis causes up to 20% of deaths globally.

In New Zealand, the annual risk of developing sepsis is about one in 1000, and although even healthy people can develop it, it is more common among babies, older adults and people with chronic health conditions such as diabetes, cancer or liver disease. Māori are more than three times as likely to develop sepsis than non-Māori, and about two-thirds of cases are in people aged 65 or older.

For Huggan, the shaking Barrett experienced – known as rigor – is an unmistakable warning sign. “If someone says, ‘I shook uncontrollably, I covered myself with a blanket and I felt cold to the bone, then, when the shaking stopped, I threw the blanket off and sweated profusely’, that is very abnormal and medical staff need to be alert to it.”

He says anyone who experiences rigor should immediately seek medical help. Other symptoms include stopping urinating, breathlessness, slurred speech or confusion, and mottled skin.

Huggan says that in all but about 20% of cases, the source of the underlying infection is clear. “But in 100% of cases, the people affected know that something is terribly wrong. They feel really bad.”

Sepsis is usually caused by bacterial infections and it’s treated using antibiotics, starting with a broad-spectrum drug, followed by a more targeted one once it’s known exactly which bacerium is causing the problem. The sooner treatment begins, the better the outcome.

“There are clear indications from the literature that giving people antibiotics within an hour of them developing septic shock can save lives.”

sepsis.org.nz

This article was first published in the February 8, 2020 issue of the New Zealand Listener.

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