Underestimated risk of blood poisoning: one in five dies of sepsis - these are the symptoms

Underestimated risk of blood poisoning: one in five dies of sepsis - these are the symptoms

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Estimates wrong: Twice as many people die from sepsis

Eleven million deaths were caused by blood poisoning in 2017. This means that every fifth death worldwide is due to sepsis. Around 40 percent of the victims are children under the age of five. Worldwide, twice as many people die of blood poisoning than previously thought. This emerges from a comprehensive global study on the subject.

Researchers from the medical faculties of the University of Pittsburgh and the University of Washington conducted a comprehensive analysis of the global spread of blood poisoning. It was found that the prevalence of sepsis was largely underestimated. Contrary to previous estimates, around twice as many cases of sepsis occur worldwide than previously thought. There are a disproportionate number of children among the victims. The results were recently published in the renowned journal "The Lancet".

Almost 50 million sepsis cases per year

There were 48.9 million sepsis cases in 2017. 11 million cases were fatal. According to the current study, this corresponds to one in five deaths worldwide. Sepsis occurs when organs stop working properly due to an infection. Even if blood poisoning is not fatal, it can cause lifelong harm.

Poor children are hit hardest

According to the report, the vast majority of sepsis cases (around 85 percent) occur in countries with low or medium socio-demographic status. The highest pollution was found in sub-Saharan Africa, the South Pacific Islands near Australia and in South, East and Southeast Asia. The incidence of sepsis was higher in women than in men. The group of children under the age of five is particularly affected - they make up 40 percent of all victims.

Sepsis was largely underestimated

"We are concerned that the sepsis deaths are much higher than previously thought, especially since the disease is both preventable and treatable," reports Dr. Mohsen Naghavi, one of the study authors and professor of health metrics at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine.

"We need to focus again on preventing sepsis in newborns and fighting antimicrobial resistance, a major driver of the disease," said the professor.

Sepsis is not a primary cause of death

For his analysis, the team around Naghavi used the Global Burden of Disease (GBD) study, a comprehensive epidemiological analysis that is coordinated by IHME. The study currently lists over 282 primary causes of death. Sepsis is not one of them because it is an intermediate cause of death. A primary cause of death is the underlying condition, such as cancer. An intermediate cause of death is an incident that is favored by the primary cause of death, but ultimately leads to death.

Why were the estimates so far wrong?

Previous global estimates of sepsis have been limited as they rely on hospital databases from a select group of middle and high income countries. Estimates so far have overlooked the significant burden of sepsis that occurs outside the hospital, particularly in low-income countries. The current study is the first study to show mortality both inside and outside the hospital.

Sepsis in decline despite high occurrence

The researchers analyzed the annual trends in sepsis incidence and mortality from 1990 to 2017 and found that rates are declining. In 1990 there were an estimated 60.2 million sepsis cases and 15.7 million deaths. By 2017, the incidence decreased by 19 percent to 48.9 million cases and the death toll by 30 percent to 11.0 million.

Lower respiratory tract infection often leads to sepsis

According to the report, the most common underlying cause of sepsis-related death is lower respiratory tract infection.

"I worked in rural Uganda and sepsis is what we see every single day," adds lead author Dr. Kristina E. Rudd of Pitts Department of Critical Care Medicine. "To see a baby die from an illness that could have been prevented with basic public health measures is something you really remember," said Rudd.

Sepsis is not in the top 10 lists of deaths

"I want to help solve this tragedy, so I'm participating in the research on sepsis," explains Rudd. However, the progress is difficult to understand, since sepsis is not even in the top ten list of global deaths. Blood poisoning is simply not counted.

How can you counteract this?

"You should start with the basic public health infrastructure," Rudd suggests. These include, for example, vaccines, access to a toilet and clean drinking water, adequate nutrition for children and health care for mothers.

First symptoms of blood poisoning

The first symptoms of sepsis are mostly non-specific. However, the emergency doctor should be called anyway for the following complaints. Not all complaints have to occur at the same time. The faster a diagnosis is made, the higher the chances of recovery.

  • Rapid heart rate (tachycardia)
  • sometimes rash
  • “> Low blood pressure (hypotension)
  • Fever or hypothermia (often with chills)
  • Pain
  • rapid breathing (tachypnea), difficult breathing (dyspnea)
  • Dehydration of the body
  • inner restlessness, confusion
  • slight drowsiness - even to a coma.

Flu can also trigger sepsis

"But sepsis is still a problem in the United States," emphasizes Rudd. Blood poisoning ranks first among the causes of hospital patient deaths. Typical diseases such as influenza or pneumonia can lead to sepsis. People with diabetes are also at greater risk because they are more susceptible to infectious diseases.

Researchers want more support from rich countries

“Finally, for people in high-income countries who want to help reduce sepsis rates in low-income areas, we need to support research into treatments and our elected representatives for the importance of helping prevent and control sepsis in communities with low income, ”summarizes the study author. (vb)

For more information on sepsis read: Blood poisoning (sepsis; septicemia) and sepsis: 140 deaths per day from blood poisoning.

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek


  • Kristina E Rudd, Sarah Charlotte Johnson, Kareha M Agesa, et al .: Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study, The Lancet, 2020,
  • Institute for Health Metrics and Evaluation: Sepsis associated with 1 in 5 deaths globally, double previous estimate (published: 16.01.2020),

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