Sepsis and Children

Sepsis can affect anyone at any time, but it does tend to strike more often people at the extremes of life like the very old and the very young. As a result, children, particularly premature babies and infants, can be more susceptible to developing sepsis.

Sepsis, which was often called blood poisoning, is the body’s often deadly response to infection.

Thousands of children affected worldwide

More than 18 children die from sepsis each day in the U.S. Sepsis in the developing world is even more serious. Globally, sepsis is the leading cause of death of children, taking nearly 3.4 million lives each year. Approximately 85% of pediatric sepsis deaths occur in children under age 5.

Many children who survive sepsis are left with long-term problems. More than 1 in 3 children (34%) who survive experience a change in cognitive skills still at 28 days following their discharge from the hospital. Nearly half return to the hospital at least once after surviving sepsis.

In developing countries, sepsis can occur from infections that occur as a result of unsanitary conditions at birth, infections during pregnancy 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.

Here are some more facts and statistics:

With the recent news about measles outbreaks across the country, parents are concerned about their children, their risk of infection, and complications. For more information, please scroll down to “Measles and Sepsis.”

Suggested Citation:
Sepsis Alliance. Sepsis and Children. 2024. https://www.sepsis.org/sepsisand/children/

Updated March 27, 2024.

 

More About Children

Neonatal Sepsis

Neonatal sepsis occurs when a child develops sepsis within a few months of birth (up to 90 days). If the sepsis develops within 24 hours of birth, it is called early onset. Sepsis that develops after delivery is called late-onset neonatal sepsis.

The risk of early-onset neonatal sepsis is increased if:

  • There is a group B Streptococcus infection during pregnancy;
  • The baby is premature; or
  • The 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
  • Exposure to people who have contagious infections.

The most common infections that can cause sepsis in babies include:

  • Respiratory syncytial virus (RSV)
  • Cytomegalovirus (CMV)
  • E. Coli
  • Candida
  • 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)

Symptoms

Signs and symptoms of neonatal sepsis are:

  • Body temperature changes
  • Breathing problems
  • Diarrhea
  • Low blood sugar
  • Reduced movements
  • Reduced sucking
  • Seizures
  • Slow heart rate
  • Swollen belly
  • Vomiting
  • Yellow skin and whites of the eyes (jaundice)
Sepsis in Older Children

As children get older, their exposure to illness can increase as they attend daycare, go to school, and participate in other activities.

Infected wounds:

Clean any wounds properly and keep them 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).

Bacteria can enter the body through something as simple as a scrape on the knee or elbow, or even from a surgical incision. As superbugs, like methicillin-resistant Staphylococcus aureus (MRSA), continue to develop, there are some infections that will be much more difficult to treat than others.

Illnesses
Infections can occur in other ways as well. Children, like adults, can develop illnesses such as urinary tract infections, ear infections, pneumonia, or even meningitis. If left untreated, these can all lead to sepsis.

Symptoms

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 heartbeat
  • 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.

When in doubt, check with your doctor or bring your child to the emergency room for evaluation.

Treatment

Sepsis needs to be suspected and recognized as quickly as possible. The risk of death increases for every hour of delayed treatment.

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.

Prevention

The key to preventing sepsis is to prevent an infection from occurring in the first place. Treat infections as quickly and effectively as possible. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Regular childhood vaccines prevent many illnesses. 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.

Proper care of all wounds also reduces infections, even the smallest scrape or cut. A thorough cleaning with soap and water will help remove any bacteria at the wound opening.

Nutrition also plays a role in staying healthy. Children who are malnourished are at higher risk of contracting infections.

Take all infections seriously. Do not hope it will go away. Take action.

Sepsis and Measles

Measles is typically a childhood infection, although unvaccinated adults can get measles as well. The virus is spread through the air and is one of the most contagious viruses for humans. If you have the measles virus and you cough or sneeze, the virus can stay in the room’s air or on surfaces, like a door knob, for up to 2 hours after you’ve left. Anyone who is with you or comes into the room after is at risk of infection. People who are not vaccinated against measles have a 90% chance of getting the infection if they are close to someone who has it.

Another reason why measles can spread quickly is you can be contagious for up to 4 days before you get a rash, so you probably won’t know that you have the virus yet. Therefore, you would not be quarantining yourself, protecting others.

The childhood infections, measles, mumps, and German measles (rubella), are preventable with a two-prong vaccine called MMR. In North America, the first MMR dose is usually given around 12 months and the second, around 18 months or later. Some children get the second dose just before they start school, between 4 and 6 years.

As MMR vaccination rates are dropping, unprotected children and adults are contracting measles. According to the Centers for Disease Control and Prevention (CDC):

  • About 1 in 5 people in the U.S. who get measles will be hospitalized
  • 1 out of every 1,000 people with measles will develop brain swelling, which could lead to brain damage
  • 1 to 3 out of 1,000 people with measles will die, even with the best care

Children who get measles can develop pneumonia, which can lead to sepsis. (Learn more about Sepsis and Pneumonia.)  The CDC lists pneumonia as the most common cause of death among young children who have measles. Other complications include encephalitis, seizures, and hearing loss.

Adults who get measles can become very sick too. Those who are pregnant could have premature birth or have a low-birth-weight baby. Both put the babies at risk for infections that can lead to sepsis.

Related Resources

Mi Guía Para la Sepsis y La Unidad De Cuidados Intensivos

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My Guide to Sepsis and the Intensive Care Unit

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Sepsis and Children (Pediatric Sepsis)

My Guide to Sepsis and the Intensive Care Unit – Children

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My Guide to Sepsis and the Intensive Care Unit – Adult Companion

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Information Guide

Children

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Shelley P.

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Steven Keske

In April 2020 my son came to me and said his leg hurt. I coughed it up to growing pains. The next morning he woke up to a rash and a fever. He said he leg hurt. Called his doctor and was referred to urgent care. The urgent care doctor said it was a virus and let it take its course. And do Google Covid testing sites. Within 24hrs I found my son’s lifeless body, I rushed him to the children’s hospital and that’s when we found out what he really had. If I didn’t check on him that night ... Read Full Story

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Other Topics

Children

Sepsis can affect anyone at any time, but it does tend to strike more often people at the extremes of life like the very old and the very young. As a result, children, particularly premature babies and infants, can be more susceptible to developing sepsis. Sepsis, which was often called blood poisoning, is the body’s often deadly response to infection. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.