The Lurking Killer You Barely Know

The top challenge to your health may not be one of the big three — cancer, stroke, or heart attack — but the deadly infection known as sepsis.

The blood-borne bacterial infection invades the entire body, often causing damage to one or more organs. Sepsis is characterized by high fevers, chills, rapid heart rate, and increased breathing. It can be rated as mild, moderate or severe, depending on which organs are affected and if the organ fails.

Most infections are preventable contamination stemming from ineffective hand sanitizing and poor gloving techniques.

It is important you are able to recognize it: Cases of sepsis have quietly been on the rise.

Septicemia was ranked 20th in medical costs in 1999. It moved up to sixth in 2009 — but it is now by far the most costly condition for hospitals to treat. Sepsis patients represented $23.7 billion in hospital costs in 2013, according to the Agency for Healthcare Research and Quality, a government entity.

Even more costly are the lives it is claiming — 13 percent of the people who contract it will die from the infection.

Most health care-acquired infections (HAIs) stem from common causes of needle or catheter contamination and post-surgical infections. Ineffective hand sanitizing and poor gloving techniques are also common causes, according to Bob Mosby, an executive vice president with LifeRose Products, in South River, New Jersey. LifeRose has developed a patented Infectious Disease Barrier for use by health care staff, which prevents common gloving contamination.

Increased resistance to antibiotics (largely due to over-prescribing) and the growth of superbugs play a role too.

Better recognition of sepsis may also be responsible for the rise in numbers, according to Dr. Christopher Carrubba of Aurora, Colorado. He’s a physician adviser for HealthGrades, an online resource of information about physicians and hospitals. Carrubba works specifically on sepsis recognition and early directed therapy.

Patients may be waiting too long to go to the hospital if they have a high deductible insurance plan and/or lack education about recognizing the signs of sepsis.

“Sepsis is most commonly caused by bacteria, but it can be caused by fungal infections as well,” he told LifeZette. “Respiratory infections account for 50 percent of the cases of sepsis. As such, antimicrobial therapy is a core component of treating a respiratory infection before it leads to sepsis.”

But infections in health care facilities don’t account for the steep and alarming increase in sepsis cases alone.

The Centers for Disease Control and Prevention has been remarkably quiet on the topic — although the Centers for Medicare and Medicaid Services (CMS) recently released an update to its management and reporting guidelines for sepsis.

Al Lewis, president of the Disease Management Purchasing Consortium International, Inc., a consultant to health plans and self-insured employers, said over-reporting sepsis cases in the complicated tracking of illness for insurance companies, hospitals, and government may be the culprit.

Misreporting may be exploiting a coding loophole for hospitals to get higher reimbursement, or the result of health care workers seeking to categorize patients with a code they don’t have to reassess later — a generic dumping ground for a variety of conditions.

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Dr. Monya De, an internal medicine specialist in Los Angeles, California, isn’t so sure.

“In the past, sepsis would get lost because ‘pyelonephritis’ or ‘pneumonia’ was already up as a code and sufficed for the hospital bill,” she said. “But the population is just getting older, more sleep-deprived, fatter, and less active — all of which promote the proliferation and flourishing of bacteria, viruses, and fungi.”

Lewis also says patients may be waiting too long to go to the hospital. They may have a high deductible insurance plan and/or lack education about recognizing the signs of sepsis.

Waiting too long to go to a hospital wasn’t a factor for Paige Wolf, of Philadelphia, Pennsylvania. Her first sign of sepsis was uncontrollable chills on a balmy, 67-degree day. Hours later, she began vomiting and became feverish. When her symptoms did not alleviate after a few days, she headed to the emergency room — only to be sent home with a diagnosis of stomach flu.

Related: Germs Blocked at the Hospital Door

By the next day, her fever hit 103 degrees and her sister-in-law, a nurse, took her to a different hospital. Her blood pressure was severely low, and she was diagnosed with septic shock, an advanced condition of sepsis.

Because doctors were unable to find a cause, she was isolated and unable to see her children for 10 days while doctors attempted to stabilize her condition with various medications. Her fears were exacerbated by the fact that health care workers wore hazmat suits when they entered her room. To this day, no one knows what caused her infection.

Although she recovered, progress was slow and arduous. In her mid-30s, she was unable to walk very far and was exhausted by minor tasks for months.

Avoiding sepsis is crucial for the health care consumer.

Dr. Stuart Hochron, chief medical officer of Uniphy Health, which serves the greater New York City area, believes that “the best protection is to remain healthy.” People at highest risk are those with weakened immune systems, and those who are in acute care settings or nursing homes, where bed confinement and invasive monitoring and treatment occur.

“Eventually, a goal would be for individuals to be able to compare hospitals based on a greater variety of quality statistics, including the incidence of sepsis and sepsis survival rates,” Hochron said. “That would allow the public to make choices as informed consumers.”

Related: ‘Supergerms’ Cause 1 in 7 Hospital Infections

Lewis and Carrubba agree, noting it’s quite common for consumers to “shop” hospitals for the best cardiac care, or success rate with other diseases.

“Why not shop for a hospital based on its safety ratings?” Lewis asked.

Paige Wolf suggests speaking up, even when your observations are refuted.

“I begged for admission, because I wanted to be monitored overnight. I knew something was terribly wrong. Trust your gut. Don’t take chances when you feel like something is very wrong. Hospitals and doctors need to take ill patients more seriously, and no reasonably ill person should be denied hospital admission.”

Lewis, who once witnessed a nurse putting a hypodermic needle between his teeth while he used two hands to start an IV, agrees. “Keep an eye on everything done to you or a loved one in the hospital, and don’t be afraid to challenge people.”

Pat Barone, MCC is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating, which helps clients heal food addictions.