• By Sharon Theimer

Influenza and Sepsis: Mayo Expert Describes Signs of Severe Sepsis, Septic Shock

January 13, 2015

Sepsis can be a dangerous complication of almost any type of infection, including influenza, pneumonia and food poisoningurinary tract infections; bloodstream infections from wounds; and abdominal infections. Steve Peters, M.D., a pulmonary and critical care physician at Mayo Clinic and senior author of a recent sepsis overview in the medical journal Mayo Clinic Proceedings, explains sepsis symptoms and risk factors, the difference between severe sepsis and septic shock, and how sepsis is typically treated:Sick man with cold or flu lying on sofa checking his temperature for a fever

What is sepsis?Sepsis occurs when chemicals released into the bloodstream to fight an infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.

“Many infections can cause it,” Dr. Peters says. “It is most common with bacterial infections, but you can get sepsis from other types of bugs also.”

What are symptoms to watch for? A high fever; inability to keep fluids down; rapid heartbeat; rapid, shallow breathing; lethargy and confusion are among the signs. If sepsis is suspected, seek emergency care, Dr. Peters advises. Rapid intervention is critical.

Journalists: Soundbites with Dr. Peters are available in the downloads.

For interviews with Dr. Peters, please contact Sharon Theimer
Mayo Clinic Public Affairs at 507-284-5005 or newsbureau@mayo.edu.

“Let’s say one feels some nasal congestion, and achy, like a cold or upper respiratory illness they’d had many times before, or a low-grade temperature of 99 or 100 F, and otherwise they’re up and around and able to drink fluids: That would not call for going to the emergency department,” he says. “But, if one was not able to take fluids, became more sleepy and lethargic and was lying down all day, and starting to look quite ill or appearing confused, for example — that person should definitely be seen by a doctor.”

How is sepsis treated? The first step is diagnosis: Cultures are taken from the blood and any other relevant parts of the body. Intravenous fluids are given, and antibiotics are usually started right away.

“Probably the single most important thing is to try to maintain fluids,” Dr. Peters says. “The damage of sepsis probably begins with loss of fluids.”

If sepsis is severe, with rapid heart rate, rapid breathing and shortness of breath, and the initial fluid given doesn’t prompt rapid improvement, patients are usually hospitalized.

What are the differences among sepsis, severe sepsis and septic shock? Sepsis refers to signs of inflammation in the presence of a presumed infection, Dr. Peters says.

“Severe sepsis means you’ve got that and signs of organ damage: lung injury, impaired kidney function, impaired liver function,” Dr. Peters explains. “Septic shock means you have all of those findings of severe sepsis, but now you’ve been given fluids, and there’s still poor blood pressure, poor urine output, breathing troubles, and there are still ongoing signs of sepsis.”

Septic shock can be fatal. Among hospitalized patients, septic shock is associated with a 20 to 30 percent risk of death, Dr. Peters says.

Sepsis is such a concern in hospital critical care units that Mayo Clinic has developed a sepsis “sniffer” to help detect it in patients and spot who is at higher risk. Recent improvements to the sniffer are outlined in another new article in Mayo Clinic Proceedings.

Who’s at risk? Anyone can develop sepsis. People on chemotherapy or other immune-suppressing drugs are at higher risk, as are the elderly and people with open wounds that could lead to infection. Often, immune-suppressed patients are given antibiotics preventively.  

Is there anything you can do to prevent sepsis if you catch the flu or another illness?

“Taking your temperature is important, because it gives a good assessment of how severe this might be,” Dr. Peters says. “Probably the single most important thing is to try to continue taking in fluids. Watch for signs and symptoms, and seek urgent medical care if you suspect sepsis.”

Will the flu mist be available during these times and at these locations?

Nothing in Kasson?

@cwolfe1972

Nothing in Kasson?

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Got it! Kind of sneaky.

Do we know yet, what brand of Influenza Vaccine that is going to be used for Mayo Clinic employees and whether or not it is single-dose or multi-vial?

@tkmlondon2b

Will the flu mist be available during these times and at these locations?

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I would also like to know if the mist is available at the walk-in clinics for employees. Thank you.

Just being more inquisitive, but why would you as a healthcare provider giving injections, not wear gloves? If I were the nurse giving the injections, I would demand to wear gloves. One microscopic drop of dried, contaminated blood can transmit Hep B for a solid week. Hep C for 4 solid days, dried blood, microscopic amount. Nurse that says she does not get exposed to blood when giving injections without gloves is not truthful. Someone out of 200 people is going to be on an aspirin regimen or very nervous and bleed profusely no matter how you give your injection. Just wondering, why would you take that risk?

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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The flu clinics are not done until October because Mayo wants to be sure it has enough vaccines to cover the needs.

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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How can I find out the manufacturer of influenza vaccine that is being offered in Arizona?

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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Hi Kristen, I am not the expert….. but According to the CDC, the peak flu activity for the US by month using 32-year period of information (1982-2014), the peak time for the Flu Virus is February. It seems that the flu vaccine takes about 2 weeks for our full immunity to activate. According to Dr. Parada (Loyola Univ, Chicago), the end of this immunity cycle waivers (about 6-8) and is called "waning immunity". Therefore, it is possible to get the flu shot too soon, as well as too late. So it may be a good idea to wait until at least October anyway to insure the full immunity during the 'peak month' of February. All of this said with assuming there is no shortage.

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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Thank you, got it.

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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Interesting! Thanks for the info.!

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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Is that 6-8 weeks or months? Thanks!

I would like to know about getting on a list to be informed when there is more of the egg free flu shot available in Red Wing. My family member is severely allergic to eggs and ends up with the flu every year. I have tried calling several numbers and sending emails to the contacts listed and have not heard back from anyone on this. Thank you.

@kristenmeier

Why are the flu shots not offered earlier, like in September? It seems that every year by the time the shot is available, the flu is already rampant.

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Sorry, I noticed that I skipped that too, but I had already clicked the button. It is 6-8 months of immunity.

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