When Laura Williams woke up in the middle of the night with vomiting and diarrhea, she assumed it was just a stomach flu.
As a podiatrist whose work took her to nursing homes near her home town of Worthing, West Sussex, she often found herself in environments where infections such as norovirus – the winter fallow disease – could easily spread.
“I even texted my boss at night to say I was pretty sure I had contracted the norovirus and I wouldn’t be there in a few days,” Laura says.
But instead of recovering quickly, Laura, 40, felt much worse.
In addition to the gastrointestinal issues, for the next 48 hours, she developed severe headaches, a painful toothache on both sides of her mouth, and – terrifying – woke up one morning to find she could barely breathe.
“My neck was all swollen overnight and it felt like my throat was closing,” says Laura.
When Laura Williams woke up in the middle of the night with vomiting and diarrhea, she assumed it was just a stomach flu
Within hours she was in hospital for emergency treatment for sepsis – a potentially fatal condition that affects nearly 250,000 people a year in the UK, killing around 48,000.
It was caused by several abscesses deep in her gums.
Sepsis occurs when the immune system overreacts to an infection. This floods the body with cytokines, proteins that dilate blood vessels, leading to a dramatic drop in blood pressure and widespread inflammation, which can lead to tissue damage. It can cause organ failure and death.
Fortunately, Laura’s sepsis was discovered just in time and after four days in the hospital on high doses of intravenous antibiotics and steroids (to calm the inflammation), she went home.
But her ordeal was far from over. Over the following months, she developed a series of debilitating symptoms, from nightmares to exhaustion and repeated mouth and ear infections.
Her concentration was so bad she would forget what she was saying halfway through the sentence, and her temperature fluctuated so wildly that even with the heating on full blast she would shiver so much I looked like I was riding a roller coaster.
She also had severe hair loss. More than 18 months after falling ill in February 2019, she still experiences crippling fatigue, reduced immunity and anxiety.
Laura is one of approximately 80,000 people a year in the UK with post-sepsis syndrome – physical and psychological symptoms that can persist long after infection.
There are clear parallels to long-term Covid – the persistence of similar symptoms thought to affect more than two million coronavirus survivors in the UK.
The difference for Laura was that her long-lasting symptoms were due to a bacteria from tooth abscesses. If they had been caused by Covid, she would be eligible for NHS treatment and rehabilitation thanks to a £10 million initiative launched last October for people with long-term Covid symptoms such as shortness of breath, fatigue, brain fog and anxiety.
Respiratory consultants, physiotherapists, GPs and other specialists are working together to help tall Covid patients return to normal.
In addition to specific checkups such as a cardiopulmonary exercise test to measure lung strength, these patients benefit from an online rehabilitation program that can only be accessed by referral from a physician.
But campaigners are angry that post-sepsis syndrome and similar long-term complications caused by other critical illnesses, such as pneumonia, are not getting the same attention.
‘Covid-19 can be very disabling, but the post-sepsis syndrome is just as bad,’ said intensive care specialist Dr Ron Daniels, executive director of the UK charity Sepsis Trust. About 40 percent of sepsis survivors experience debilitating symptoms for 12 to 18 months after infection, sometimes longer.
“So why are we providing rehabilitation for Covid-19 survivors but not equally debilitating infections?”
A 2017 analysis by the independent think tank the York Health Economics Consortium estimated that the UK is losing £12.8 billion a year from lost productivity from the aftermath of sepsis – six times more than expected.
The range of long-lasting effects is extensive — muscle weakness, chest pain, damaged kidneys, excessive sweating, changes in taste and vision, swollen limbs, mood swings, and post-traumatic stress disorder. In September, ten medical agencies wrote to Health Minister Sajid Javid to demand better funding for rehabilitation for all intensive care patients – not just those who had had Covid.
The letter from signatories – including the UK Sepsis Trust, the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses – warned: ‘Rehabilitation is inconsistent across the country, with many patients facing these issues alone, with no support or information to help them recover. This is not acceptable.’
They have launched a petition calling for every intensive care patient, regardless of their illness, to be routinely screened for ongoing health problems, provided with a rehabilitation plan and consulted regularly with various specialists to ensure they are on track.
The letter states that the 2009 National Institute for Health and Care Excellence guidelines setting standards for NHS rehabilitation after critical illness have not been implemented in the UK. “The system is unfair,” says Dr Daniels. “We’re not looking to reduce the need for Covid rehabilitation, but it shouldn’t be a priority.”
He added: ‘The government claims that all sepsis patients receive follow-up care, but that is simply not the case. It is often left to GPs to pick up the pieces. Not only are they terribly busy, they also receive little training in critical illness care.’
dr. Stephen Webb, president of the Intensive Care Society, says “tens of thousands” of those with sepsis are not getting the follow-up care they need, with “up to half of those with post-sepsis syndrome.” . . unable to work a year later’.
Laura’s nightmare was caused by Ludwig’s angina, where a bacterial infection in the gums spread to tissues under the tongue and in the neck. Not only is it life-threatening because it blocks the airways, but the bacterial infection almost always leads to sepsis.
Convinced that her symptoms were not serious, she chose to rest at home. But her parents, with whom she lived, became so concerned that they made an emergency doctor’s appointment, at which point she was told to get an emergency consultation with a dentist.
The dentist said she urgently needed intravenous antibiotics and that her parents should take her to the Royal Sussex County Hospital in Brighton, 20 kilometers away, rather than waiting for an ambulance.
Laura, who highlights post-sepsis syndrome in her podcast Your Sepsis Stories, says, “My blood pressure plummeted. I remember the anesthesiologist saying that if I had waited for an ambulance it would have been too late.
“I had emergency surgery to remove three infected teeth. When I woke up I had tubes draining the pus from my neck and for weeks I wore bandages that had to be changed every five hours.
“Yet I was back at work only two weeks after my discharge.”
But within months, Laura was struggling with the symptoms of post-sepsis syndrome. ‘I had severe panic attacks, which I had never had before, and I got really down and cried uncontrollably. My doctor has given me antidepressants.
“And sometimes I get so tired that I have to stop in the car for two hours on the way home from work to get two hours of sleep, even though I only live a few miles away.
“It takes much longer to get over infections and I’m terrified it’s going to be sepsis again, so I’m constantly checking my heart rate, blood pressure and temperature.”
Treatments that turn your stomach. This week: Snail slime for skin healing
“The idea arose when it was noticed that workers at a Chilean snail farm saw cuts on their hands heal faster,” explains Dr Sarah Pitt, a microbiologist at Brighton University.
This led to the use of snail slime as a cosmetic treatment, with the slime applied in facials where the snails slithered over the face. Since then, a way has emerged to “milk” the snails and purify the slime. Greek research from 2009 published in the Journal of Dermatological Treatment showed that snail extract heals burns faster. “While we know it can work, we don’t know why,” says Dr. Pitt. One theory is that something in the mucus helps reduce damage to cells caused by harmful molecules.
The mucus also has antimicrobial properties and fights bacteria called pseudomonas aeruginosa, a leading cause of lung infections in cystic fibrosis. The bug is on the World Health Organization’s list of most in need of alternative treatments.