Sepsis is a severe bodily reaction to infection. Its symptoms include breathlessness, disorientation, fever, tissue damage, and organ failure. Bacterial infections are the main cause of sepsis, but other infections, such as influenza or pneumonia, may result in sepsis if they are not properly treated.
Image Credit: B Medical Systems S.à r.l
Typically, the body’s immune system fights against any infection to support the health of the body. However, in the case of sepsis, the immune system stops fighting and attacks itself, often due to unexplainable causes. The immune system produces an uncontrolled and extreme amount of infection-fighting proteins, such as cytokines, which can cause a harmful cytokine storm.
Sepsis develops into severe sepsis and subsequently septic shock, while the indicators of sepsis organ dysfunction (e.g., change in mental status, abnormal liver tests, disruption to the renal flow) occur.
This results from the uncontrolled immune response and small clots forming throughout the body, preventing nutrients from reaching vital organs.
The three stages of sepsis are sepsis, severe sepsis, and septic shock.
Sepsis, the first stage, is an infection that reaches the bloodstream and causes inflammation. Severe sepsis occurs when the infection is severe enough to impact organ function.
Finally, septic shock occurs when a significant reduction in blood pressure can cause heart or respiratory failure, stroke, dysfunction of other organs, and potentially death.
How common is sepsis?
Despite sepsis being one of the most preventable causes of death globally, according to a report from WHO, it is the cause of death for almost 11 million people each year, many of whom are children.
Approximately 27% of hospital patients with sepsis do not survive, while those who do survive may experience life-changing effects, including chronic pain, post-traumatic stress disorder, organ dysfunction, and fatigue.
Sepsis itself is not transmissible, but the underlying infectious disease that causes sepsis may be transferred to others.
While anyone can develop sepsis, certain demographic groups are more vulnerable. This includes adults over 65 years old, infants under one year old, people with chronic illnesses or reduced immune systems, and people who have already survived sepsis.
Testing for sepsis
Since a specific pathogen does not trigger sepsis, no single test can be employed for its diagnosis. Instead, its diagnosis involves an evaluation of symptoms and the patient’s history, as well as other tests based on the patient’s condition.
Specific molecular markers are present in blood, which will be elevated in the case of infection or inflammation. These markers are typically examined to determine if a patient has sepsis. Testing for certain infections can also be employed to confirm the presence of the disease.
Sepsis treatment
Although sepsis is preventable, late diagnoses and the underlying infection frequently make the treatment challenging.
Sepsis treatment must begin immediately; studies have demonstrated that the risk of death from sepsis increases by 7.6% with each passing hour before treatment begins.
The most common therapy regimen involves the administration of antibiotics and intravenous fluids to help the body fight against the infection.
However, the symptoms of sepsis may vary, ranging from shortness of breath, low blood pressure, shortness of breath, and mental disorientation to organ failure. The treatment must include additional medications to address these problems in these cases.
Preventing sepsis
Preventing sepsis is only possible by preventing infection, and an effective method for this is adequate sanitation and vaccinations.
The link between sanitation and sepsis prevention
Effective sanitation serves a multifaceted role in the prevention of sepsis:
- Controlling pathogen transmission:
Appropriate sanitation practices, including handwashing, sterilizing medical equipment, and maintaining clean environments, reduce the transmission of infectious agents.
Contaminated surfaces and hands can act as reservoirs for harmful viruses and bacteria, which can cause infections that may develop into sepsis.
- Reducing healthcare-associated infections (HAIs):
In healthcare settings, where vulnerable individuals are already fighting illnesses, preventing HAIs is fundamental to minimizing sepsis risk. Improved sanitation protocols in clinics and hospitals can substantially reduce infections acquired during medical care.
- Ensuring safe drinking water and sanitation facilities:
Access to clean drinking water and appropriate sanitation facilities is vital to preventing waterborne diseases. If left untreated, waterborne infections can lead to the development of sepsis.
- Enhancing hygiene practices in communities:
Insufficient sanitation and poor hygiene practices in communities can result in the spread of infectious diseases.
Employing sanitation programs, educating the community about proper hygiene, and offering access to basic sanitation facilities can help reduce the incidence of infections and sepsis cases.
- Supporting wound care:
The correct care of wounds is crucial to preventing infections that may lead to sepsis. Access to soap, clean water, and sterile dressings can significantly reduce the risk of infected wounds.
Effective sanitation is a pillar of sepsis prevention and plays a key role in global public health efforts.
By controlling pathogen transmission, reducing HAIs, offering access to safe drinking water and sanitation facilities, promoting hygiene practices, and advocating proper wound care, the burden of sepsis can be reduced worldwide.
Governments, healthcare institutions, and communities must collaborate to prioritize sanitation initiatives and invest in the infrastructure to protect people from avoidable infections and the devastating consequences of sepsis.
The crucial role of reliable vaccinations in the prevention of sepsis
Vaccinations are a medical intervention that triggers the immune system to produce a protective response against specific infectious agents, such as viruses or bacteria.
The administration of vaccines enables individuals to develop immunity to diseases without suffering the severe symptoms linked to natural infection.
This developed immunity is vital to the prevention of infections and the risk reduction of severe complications that can result in sepsis.
Prevention of infections that can lead to sepsis
Vaccinations are available for infectious diseases that can lead to sepsis, such as bacterial infections like Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitidis, in addition to viral infections such as measles and influenza.
Vaccinating individuals against these pathogens significantly reduces the incidence of infections and, subsequently, the cases of sepsis caused by these diseases.
Herd immunity
Vaccination contributes to herd immunity, as well as protecting vaccinated individuals. Herd immunity occurs when a significant percentage of the population has immunity to a disease through previous infection or vaccination.
This indirectly protects vulnerable individuals who cannot be vaccinated, such as the elderly, infants, and those with compromised immune systems, by reducing the overall transmission of the infectious agent within the community.
Reducing healthcare-associated infections
The vaccination of healthcare workers against infections such as hepatitis B and influenza is crucial to the prevention of healthcare-associated infections (HAIs).
Preventing secondary infections
Some diseases can weaken the immune system, leading to infected individuals being more vulnerable to secondary infections. Vaccinations can prevent primary infections, which reduces the probability of subsequent infections that may cause sepsis.
Through preventing infections and boosting herd immunity, vaccinations reduce the incidences of sepsis caused by infectious diseases.
When employed together with effective sanitation practices and infection control measures, widespread vaccination programs are vital in improving global health and reducing the sepsis burden worldwide.
However, vaccines are frequently temperature-sensitive and demand an effective medical cold chain for their safe storage and transportation around the world. From the point of manufacture to delivery, the vaccine cold chain comprises a series of interconnected steps:
- Manufacturing and quality control
Vaccine manufacturers follow strict quality control measures to guarantee the potency and safety of the vaccines. Maintaining the correct temperature conditions during production is fundamental to the preservation of the vaccine's integrity.
- Storage and transportation
Vaccines are stored in temperature-controlled medical devices, e.g. refrigerators and freezers after their production to maintain their stability.
During transportation, specialized refrigerated containers and insulated packaging ensure that vaccines are kept within their required temperature range. This offers protection from fluctuations in temperature that could compromise their molecular stability and effectiveness.
- Distribution to healthcare facilities
The vaccines are subsequently distributed to healthcare facilities, where they are required to be stored in specialized refrigerators and freezers at optimal temperatures until they are administered to patients.
The regular monitoring of storage conditions is necessary to promptly identify and rectify any deviations.
The future of the fight against sepsis
Sepsis continues to be a considerable global health challenge, but its prevention can be significantly improved through reliable vaccinations and effective sanitation practices.
Reliable vaccinations serve a crucial function in preventing infections that can cause sepsis, reducing the overall burden of the condition. Vaccinations promote a safer and healthier world by boosting herd immunity and protecting vulnerable populations.
The vaccine cold chain is a vital infrastructure that guarantees the potency and safety of the vaccines from manufacture to the last mile of administration.
Upholding the correct temperature conditions during manufacturing, storage, and transportation is critical to maintain the efficacy of vaccines. Safeguarding the vaccine cold chain allows vaccines to remain effective in the prevention of infections and, consequently, sepsis.
To effectively combat sepsis, a concerted effort by governments, healthcare institutions, and communities to prioritize reliable vaccinations and preserve the vaccine cold chain is required.
Public awareness campaigns, better access to vaccines, and investment in sanitation infrastructure are necessary to reduce sepsis-related morbidity and mortality.
The combination of reliable vaccinations and effective sanitation practices enables us to work toward preventing sepsis, reducing its impact on global health, and enhancing the overall well-being of populations worldwide.
With continued commitment and collaboration, we can pave the way for a healthier future where sepsis is a controllable threat.
References and further reading
- Sepsis Alliance. (2023). Blood poisoning. Retrieved from https://www.sepsis.org/sepsisand/blood-poisoning/
- Centers for Disease Control and Prevention. (2023). What is sepsis? Retrieved from https://www.cdc.gov/sepsis/what-is-sepsis.html#anchor_1547213983
- World Health Organization. (2020). WHO calls for global action on sepsis - cause of 1 in 5 deaths worldwide. Retrieved from https://www.who.int/news/item/08-09-2020-who-calls-for-global-action-on-sepsis---cause-of-1-in-5-deaths-worldwide
- Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006 Jun;34(6):1589-96.
- B. Brook, D. J. Harbeson, et al. BCG vaccination-induced emergency granulopoiesis provides rapid protection from neonatal sepsis. Sci. Transl. Med.12,eaax4517 (2020).
- Fidel PL, Jr., Noverr MC. 2020. Could an unrelated live attenuated vaccine serve as a preventive measure to dampen septic inflammation associated with COVID-19 infection? mBio 11:e00907-20.
- Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.
- Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020;395(10219):200–211.
- Vincent JL, Teixeira L. Sepsis biomarkers. Intensive Care Med. 2014;40(2):260-263.
- Prüss-Ustün A, Wolf J, Bartram J, et al. Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries. Int J Hyg Environ Health. 2019;222(5):765-777.
- Greenwood B. The contribution of vaccination to global health: past, present and future. Philos Trans R Soc Lond B Biol Sci. 2014;369(1645):20130433.
- Fine P, Eames K, Heymann DL. “Herd immunity”: a rough guide. Clin Infect Dis. 2011;52(7):911-916.
- Kartoglu U, Milstien J. Tools and approaches to ensure quality of vaccines throughout the cold chain. Expert Rev Vaccines. 2014;13(7):843-854.
About B Medical Systems S.à r.l
B Medical Systems S.à r.l (formely Dometic/Electrolux) is a global manufacturer and distributor of medical cold chain solutions. Based in Hosingen, Luxembourg, the company was founded in 1979, when WHO approached the Swedish manufacturing giant Electrolux to provide a solution to safely store and transport vaccines around the world. Across the 3 major business portfolios of Medical Refrigeration, Blood Management Solutions, and Vaccine Cold Chain, the company currently offers 100+ models. B Medical Systems’ major products include Laboratory Refrigerators, Laboratory Freezers, Pharmacy Refrigerators, Ultra-Low Freezers, Plasma Freezers, Contact Shock Freezers, Vaccine Refrigerators (Ice-Lined Refrigerators and Solar Direct Drive Refrigerators), and Transport Boxes. All products have integrated 24/7 temperature monitoring capabilities that further ensure that these products offer the highest level of safety and reliability.
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