Doctor raises alert on sepsis in France, which kills 80,000 a year

People in France need to be more aware of sepsis - a serious condition that kills 80,000 people nationwide per year, but which is avoidable - a leading intensive care doctor has said.

The disease, which is caused by a body’s over-response to an infection, can be particularly lethal for babies and those over 75, as well as those with co-morbidities and weakened immune systems.

Prof Djillali Annane became known in France during the Covid crisis for his awareness raising campaigns.

He is also director of the ‘Larene’ team, which studies sepsis (the Laboratoire d'étude de la réponse neuroendocrine au sepsis) at at the Raymond-Poincaré hospital in Garches (Hauts-de-Seine).

He is now calling for similar awareness about sepsis, a potentially-fatal condition that he describes as an “abnormal response by our body,” which can often be lethal.

What is sepsis?

In an interview with Le Figaro, Prof Annane explained that the body’s response to an infection can sometimes become “disregulated”. 

“In other words, it will be excessive, with far too much inflammation that will damage the organs - kidneys, heart, liver, brain - to the point of failure; or, in the opposite direction, the response developed will be insufficient, sometimes resulting in paralysis of the immune system,” he said. 

Left untreated, sepsis can cause the need for amputations, and is usually fatal.

The NHS website says there are many symptoms of sepsis, but that some of the most common for adults are: 

• acting confused, slurred speech or not making sense

• blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet

• a rash that does not fade when you roll a glass over it, the same as meningitis

• difficulty breathing, breathlessness or breathing very fast

The World Health Organization states that it is the fourth leading cause of death in the world, and kills 11 million people worldwide annually.

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Is sepsis preventable? 

If caught quickly enough, sepsis is preventable, and most people who catch it early make a full recovery.

 “It's a question of education about what to do in the event of infection.”

The professor said that “France is lagging behind the Scandinavian countries and the English-speaking world, where hygiene is taught at school”. 

The earlier sepsis is detected and treated, the better the outcome. 

“Just like a stroke or heart attack, sepsis is a life-threatening emergency that must be treated within three hours,” said Prof Annane. “The patient will be prescribed antibiotics if the source of the infection is bacterial.”

The professor also called for more research into sepsis, and said that France was “well-positioned” to do this. 

A global research centre on the disease (IHU Prometheus) is scheduled to open in the Paris region in the next few years.

“The aim of this organisation, which will bring together research, training and care, is to halve the mortality and after-effects caused by sepsis over the next ten years.”

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How is sepsis treated?

If the source is bacterial, the patient will be given strong antibiotics. 

In the event of organ failure, “attempts will be made to compensate for organ function…and a drop in blood flow”, said Prof Annane. 

“If treatment is delayed and there is a major inflammatory response, corticosteroids may be used,” he added. “Finally, in severe cases, catecholamines (adrenaline, noradrenaline) can be given.”

Even after treatment, however, two-thirds of patients have some form of after-effects, said the professor. These can include cognitive issues, skeletal and limb problems, and even the requirement for amputations.

“That is why it is so vital to inform people about this dreaded disease,” said Prof Annane.