Some people are more prone to blood poisoning than others. Gry Hege was affected, and lost her hands and feet.

Gry Hege Henriksen had worked day and night before she finally got to take her Christmas holiday in 2016. She started coughing on a Saturday while wrapping Christmas presents and preparing for Christmas. On Sunday she, her husband and son had guests. During dinner she felt worse and worse. She was listless and cold.

“I remember thinking: I don't have time to get the flu now!,” she said.

When her guests had left, her husband saw that her lips were blue. He called the emergency room at Oslo University Hospital, Ullevål. Just a few hours after Gry Hege started to feel really ill, she went into a coma.

She woke up again after four weeks. Her doctor told her that she was lucky to have survived at all. She had had sepsis, which probably started with pneumonia.

“He told me that they had to amputate both my hands and my feet,” she said.

At first she thought it was a bad joke. It turned out it was not.

Symptoms are poorly known

Many people are familiar with the most common symptoms of stroke. A simple test — talk, smile, lift your arm — has likely saved many lives.

But most people are not familiar with the symptoms of sepsis, says Erik Solligård. He heads the Gemini Centre for Sepsis Research at the Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital in Trondheim.

“There is not enough awareness of how serious this condition is,” he says.

More than 30 per cent die

In 2018, more than 6,000 people were admitted to Norwegian hospitals with sepsis.

As many as 34 per cent of them had died after a year. In comparison, 10 per cent of people who have had a heart attack die one year after their illness.

The figures are probably even higher, says Solligård. There are no exact figures, but the researchers at his centre estimate that more than 10,000 people get sepsis in Norway every year. Between three and five thousand die from it.

Sepsis can result from most infections, including pneumonia, urinary tract infections — or from a single cut on your finger.

What is most tragic is that many could survive the infection. It’s easy to treat sepsis — if it is diagnosed properly and the treatment starts on time.

Was sent home from the hospital

Unfortunately, emergency room staff may not always understand what is wrong with you when you have sepsis, because the symptoms are so ambiguous: fever, rapid breathing, pain, and feeling listless and confused.

You may even be sent back home, which is what happened to Storting representative Nicholas Wilkinson in May 2018, who has still been unable to return to his elected position in the government.

The challenge is that the diagnosis can be made in different ways and that the disease is treated by all medical specialists.

Stig Slørdahl, CEO of the Central Norway Regional Health Authority, says data show that Norwegian hospitals have very different sepsis rates.

“I don't think there are big differences in the population, so we have some work to do in educating people in the health services sector,” he said.

Information campaigns needed

Solligård thinks Norway should undertake a national information campaign similar to that of stroke. The problem is that the symptoms aren’t as simple.

The symptoms of sepsis are very unclear, unlike the symptoms of stroke or heart disease. With sepsis, you may have a fever, but you might not. You may be in pain, but you might not.

“That's why we believe the incidence is underestimated, both in Norway and internationally. We are now a part of a European working group that will try to determine the real occurrence of the illness,” says Solligård.

Genetic differences and cancer

While anyone can get sepsis, the risk increases with age and with chronic diseases and cancer, says Solligård. And it probably doesn’t happen completely at random.

Research shows that those who survive sepsis are at higher risk of getting a new infection that will lead to sepsis again.

“Genetics plays an important role in terms of who gets sick,” says Solligård. He says researchers are now studying families with children where both have had sepsis. Their findings have not yet been published, but preliminary results suggest there may be a genetic component.

Research at the Gemini Centre for Sepsis Research also shows that an increased BMI, cardiovascular disease, smoking, alcohol, anxiety and depression can increase the risk of sepsis. Iron levels that are either too low or very high can also put people at greater risk.

Beate Hundhammer from the Norwegian Cancer Society says that cancer patients also have a 10 times higher risk of getting sepsis.

“Cancer is a tough enough disease without getting sepsis,” she said.

And because of concerns about overuse of antibiotics and the development of antibiotic resistance, those who get sepsis may not get the most effective treatment, she said.

It wasn't a bad joke

Gry Hege Henriksen lost her hands and feet. It wasn’t a bad joke.

But she didn’t lose her motivation, and after a year the oil engineer was back at work.

She feels lucky, after all. None of the other sepsis patients she has met have managed to get back to work. A lot of them are in wheelchairs.

Henriksen has prostheses for her hands and feet that need to be attached in the morning and taken off at night.

Like Solligård, Henriksen thinks more information is vital.

“I just read online that those who have had sepsis before are at higher risk for another infection. Nobody has ever told me this.”

Nobody has ever told her that some people are more genetically prone to get sepsis either.

“This is information I would have liked to have”, she said.

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Read the Norwegian version of this article on forskning.no