Sepsis can affect anyone at any time but it does tend to strike more often people at the extremes of life, the very old and the very young. As a result, children, particularly premature babies and infants, can be more susceptible to developing sepsis.
Sometimes called blood poisoning, sepsis is the body’s often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, and organ dysfunction (organs don’t work properly) and/or amputations.
In the United States, more than 42,000 children develop severe sepsis each year. Approximately 4,400 of them die – this is more than those who die of pediatric cancers. Sepsis in the developing world is even more serious, causing many more deaths.
In developing countries, many more children develop sepsis and many more die. Sepsis can occur from unsanitary conditions at birth, maternal infections that are passed on to the newborns, or preventable infections that may be more prevalent in countries with limited vaccinations and medical care.
As with an adult, a child can develop sepsis as the result of any type of infection.
How does sepsis occur in children?
When a child develops sepsis within a few months of birth (up to 90 days), it is called neonatal sepsis. If the sepsis develops within 24 hours of birth, it is called early onset and the baby was infected during the delivery. Sepsis that develops after delivery is called late-onset neonatal sepsis.
The risk of early-onset neonatal sepsis is increased if:
- The mother has group B streptococcus infection while pregnant;
- The baby is premature; or
- The mother’s membranes rupture (water breaks) more than 24 hours before the baby is delivered.
Babies can develop sepsis after birth if they become infected by bacteria, a virus, or a fungus (rare). Certain situations increase the risk of a baby getting sick. They include:
- Being in the hospital for treatment and
- Being exposed to people who have contagious infections.
The most common infections that can cause sepsis in babies include:
- Respiratory synctytial virus (RSV)
- Cytomegalovirus (CMV)
- E. Coli
- Herpes simplex virus
- Listeria monocytogenes
Very young babies and those who have medical problems may not be able to receive childhood vaccines at the recommended times. This makes the children vulnerable to catching the diseases. Many of these childhood diseases can lead to severe complications, such as sepsis. The most common ones are:
- Rubella (German measles)
- Varicella (chicken pox)
- Haemophilus influenzae type b (Hib)
Sepsis in Older Children
As children get older, their exposure to illness can increase as they attend daycare, go to school, and participate in activities, such as sports.
Any open cut or scrape should be cleaned properly and kept clean. We all have bacteria on our skin, but when it gets into the wound, it could cause an infection. A common wound infection is caused by Staphylococcus bacteria, or more specifically, the one called Staphylococcus aureus (s. aureus).
The bacteria can enter the body through something as simple as a scrape on the knee or elbow, or even from a surgical incision. With the advent of the “superbug” or methicillin-resistant Staphylococcus aureus (MRSA), there some infections can be much more difficult to treat than others.
Infections can occur in other ways as well. Children, like adults, can develop illnesses such as urinary tract infections, ear infections, pneumonia, even meningitis. Left untreated, these can all lead to sepsis.
Signs and symptoms of neonatal sepsis are:
- Body temperature changes
- Breathing problems
- Low blood sugar
- Reduced movements
- Reduced sucking
- Slow heart rate
- Swollen belly
- Yellow skin and whites of the eyes (jaundice)
In general, signs of sepsis in children include:
- High fever (above 100.4 degrees)
- General illness or a previous injury, such as a scrape or cut
- Shortness of breath
- Very rapid heart beat
- Drop in or no urine output
People who have survived sepsis often say that they felt the worst they ever felt in their life. For example, they had the worst sore throat of their life, the worst stomach pain, etc.
Best rule of thumb? When in doubt, check with your doctor or bring your child to the emergency for evaluation.
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Sepsis needs to be suspected and recognized as quickly as possible. It must be treated fast as every hour that sepsis is not treated increases the risk of death.
Treatment is with IV fluids and antibiotics. Other medications, such as those to raise blood pressure may be needed. If your child is admitted to an intensive care unit (ICU), you may see many machines used to monitor various things, such as body function (heart rate, blood pressure), medications and IV fluids that are being administered, and perhaps a ventilator to help your child breathe.
The key to preventing sepsis is to prevent an infection from occurring in the first place. If an infection does set in, it must be treated as quickly and effectively as possible.
Many illnesses can be and are prevented through regular childhood vaccinations. Cases of meningitis dropped drastically in countries where the HiB vaccine is now routine, for example. If your child cannot be vaccinated because of an underlying problem, it is important that the people around the child be vaccinated, providing a “herd immunity.” To learn more about vaccines and preventable illnesses, visit Sepsis and Prevention: Vaccinations.
The risk of getting an infection also drops with proper hand washing. Thorough, proper, and frequent hand washing with either soap and water or soapless products decrease the number of pathogens that could enter your body.
Infections can also be reduced by proper care of all wounds, even the smallest scrape or cut. A thorough cleaning with soap and water will help remove any bacteria at the wound opening.
Any infection should be taken seriously. Do not hope it will go away. Action must be taken.