7th ESA Annual Meeting Report: A Call for Europe's Leadership on Tackling Sepsis

Hans Kluge, Regional Director, WHO Europe

Prof. Evangelos Giamarellos-Bourboulis, ESA Chair

“Europe is uniquely positioned to spearhead efforts against sepsis. Leveraging cutting edge research, fostering international collaboration and advocating for comprehensive health policies, we can catalyse significant progress in sepsis prevention, diagnosis and treatment”. With this strong message, WHO Regional Director for Europe, Hans Kluge opened the 7th Annual Meeting of the European Sepsis Alliance, reiterating the continued support of WHO and calling on European leaders to join the fight against sepsis.

ESA Annual Meetings are unique opportunities to take stock of the progress of sepsis policy, research and advocacy. We are proud and honoured to have assembled such a distinct panel of speakers, each bringing their unique perspective, contributing to describing the current situation of sepsis care in Europe.
Philippe Roux confirmed the indirect contribution of EU policies through the ongoing focus on reducing the burden of antimicrobial resistance (AMR). The recently approved European Council recommendations on AMR, besides encouraging education on sepsis, will entail European guidelines on infection prevention and control and on antimicrobial stewardship for the treatment of major infections, to the development of which ESA has indicated its interest and availability. Furthermore, the Horizon Europe programme has already provided a total of €35 million support to sepsis-focused grants.

Mariam Jashi, CEO, Global Sepsis Alliance

However, despite the encouraging progress, and the staggering data shared by the speakers, concern was raised that sepsis is still not a priority in European health policy. Both the Global Sepsis Alliance (GSA) CEO, Dr Mariam Jashi, and the GSA founder, Prof. Konrad Reinhart, highlighted the disproportion between the policy focus and financing for AMR, compared to sepsis. Less than 10% of UN member states have prioritised sepsis in their health systems, highlighted Dr Jashi, who also stressed that the 4.95 million deaths attributable or associated with AMR are only part of the 13.66 million sepsis deaths. “Sepsis should be positioned in the global health agenda and in the mainstream of the global health architecture”, she exhorted.

Hon. Nathalie Muylle, Chamber of Representatives, Belgium

The meeting was also an opportunity to learn from countries that have prioritised sepsis. Belgium, currently holding the Presidency of the European Council, was deliberately well represented, also considering the significant progress and concrete steps initiated by sepsis survivor Ilse Malfait and the survivor group SEPSIBEL, who succeded to convince Health Minister Frank Vandenbroucke to commission a sepsis national plan. Ilse is supported in Belgium by far-sighted politicians such as Nathalie Muylle, who explained why in her view it is so crucial to prioritise sepsis: “It is more than just ticking another box in the long list of health priorities. It is about tackling a widespread threat that […] does not choose its victims and does not discriminate”. Muylle also enunciated the key elements of the upcoming Belgian plan, such as data collection, education, awareness campaigns, guidelines for early diagnosis and treatment, and specialised support for sepsis survivors.

Simone Mancini, Nora Lüthi, Edoardo De Robertis, Ron Daniels, Ilse Malfait

Similar elements were also shared in the first panel, where Dr Nora Lühti from Switzerland and Dr Ron Daniels from the UK helped participants understand what it takes to set up a national plan prioritising sepsis nationally. The interventions confirmed that survivors and families can be a powerful trigger for action in a country, as was the case in the UK or Belgium. The leadership of dedicated professionals was instead the main vector of change in other countries like Switzerland. Prof. De Robertis highlighted that tools and knowledge about sepsis are available, however probably only few scientific societies (i.e. intensivists, anaesthesiologists), focus on sepsis while this condition has a horizontal nature and can happen especially outside healthcare facilities. Furthermore, the correlation with AMR and pandemic preparedness must be further explored by healthcare professionals. Prof. De Robertis also stressed on the need to provide support to survivors, which is one of the priorities brought up by Ilse Malfait. Ilse shared once more her poignant story and said she was lucky, as she had “only” the limbs amputated, and also because she has access to a good rehabilitation therapy, but this is not the case for all patients in Belgium, who too often suffer from neurological problems too, without an adequate post-sepsis care. Information and support to sepsis survivors must be improved and widely disseminated, as it is the case for other diseases such as cancer. The issues of improving data collection, personalised treatment, equity in access to healthcare were also discussed by panellists and the audience.

Ulrika Knutsson, Ron Daniels, Ann Gills, Aurica Pripa

Aurica Pripa, ESA Patient and Family support Working Group, shared her dream of a society where sepsis is the most prevented (and no more preventable) cause of deaths, where awareness, treatment and support to patients and their families contribute to improve patient outcome. The key message of the panel “Understanding sepsis: from silos to a common fight” was that the whole society must be involved in improving sepsis awareness, sepsis cannot be an issue of only patients and healthcare professionals, but media, industry, charities and lay persons must all be involved. Ron Daniels once more stressed on the need to change the narrative about AMR, that is something concrete happening today, and hitting certain populations more than others. However, AMR does not kill people, but untreatable infections and sepsis do. Ann Gils, from the Belgian cancer organisation Kom Op Tegen Kanker, stressed on the need to break silos between sepsis and other diseases like cancer, that have much more visibility and support. Finally, Shahrzad Kiavash’s witness, similarly to the one of Ilse, confirmed the need to improve sepsis awareness as her life could have been different right now if the doctors attending her in the first hours of her sepsis experience would have acted adequately.

Marco Cavaleri, European Medicines Agency

Konrad Reinhart, Antonio Artigas, Evangelos Giamarellos-Bourboulis, Adam Linder

The last session discussed the challenges of setting up and running research networks on sepsis, ARDS and related areas, and their critical value contributing to the preparedness of Europe for the next pandemic. Prof. Giamarellos raised the importance for research networks of involving physicians beside qualified research centres to make sure that results are broadly embraced and adopted in sepsis treatment, as for the case of biomarkers. Prof. Artigas went even further by suggesting including non-physician investigators in research networks for pre-clinical studies, benefiting from their knowledge and scientific approach. The importance of networks was also stressed by Prof. Artigas, if Europe wants to compete with the US. The point was echoed by Marco Cavaleri, who stressed on the importance of European clinical trial networks which should be well funded through European money (via HERA for example) or national funds, to operate effectively and continuously. Those networks should also involve patients, ARDS and sepsis experts, identify products, biomarkers and phenotypes that could help us be prepared for the next pandemic. Regarding the issue of comparability of data, Prof. Linder also suggested using the ongoing national plans to collect harmonised clinical data.

Despite realising that sepsis still needs to gain visibility, that awareness must be continuously improved and that the scientific knowledge still investigated, the event concluded with a shared feeling of empowerment, as participants realised the progress since the inception of ESA in 2018. We are today in the right direction of a strong European sepsis agenda, jointly led by advocates, patients, physicians, industry and policymakers.

The recording of the entire event is available below and on YouTube.

Simone Mancini
Join the Free Livestream Now – 7th Annual Meeting of the European Sepsis Alliance in Brussels

Update March 18, 2024: The event has concluded, thank you for joining. You can rewatch it above.


Our 7th Annual Meeting will go down today, Monday, March 18, 2024 – and it’s not too late to join the free livestream on YouTube or embedded above.

We start at 11:00h Brussels Time (click here to see your time zone) and we have an amazing line-up of speakers for you, including sepsis survivors, policymakers, advocates, sepsis experts, and more. In addition to hearing thought-provoking presentations, we are super excited to host 3 distinct panel discussions featuring inspiring panelists and intriguing discussions.

So, what are you waiting for? Join the livesteam now and interact with us and other viewers, directly in the chat on YouTube.

In case you can’t make it live, the event will be available for recap as soon as it has concluded, at the same link and embedded above.

Marvin Zick
Register Now – WSC Spotlight: Unmet Need in Sepsis Diagnosis and Therapy – April 23, 2024

Niranjan ‘Tex’ Kissoon, President of the Global Sepsis Alliance, and Louise Thwaites and Michael Wong, Program Chairs, are honored and excited to officially open the registrations for the 2024 WSC Spotlight on April 23, 2024.


We are thrilled to extend a warm welcome to thousands of colleagues joining us from across the globe for yet another exceptional opportunity to delve into and exchange insights on the newest trends, advancements, and innovations in the field of sepsis practice and research.
— Niranjan ‘Tex’ Kissoon, President GSA

Dr. Niranjan ‘Tex’ Kissoon

As always, the 2024 WSC Spotlight will be free of charge and completely virtual, enabling broad participation from all parts of the world. For years, the WSCs have engaged between 8,000 and 20,000 scholars and practitioners from more than 180 countries.

Over one day and 9 highly relevant sessions, over 40 internationally renowned speakers, panelists, and moderators will address the role of AI, predictive modeling in sepsis, the need for early diagnosis and treatment of sepsis in surgical patients, the role of biomarkers, personalized approaches to sepsis management, how hypervolemia increases the mortality risk in sepsis, community programs to prevent and diagnose sepsis, and much more.

Whatever topic and speaker is most relevant to you, the Program Chairs Louise Thwaites, Board Member of the GSA and APSA, and Michael Wong, Founder and Executive Director of PPAHS, are excited to welcome you on April 23.

Dr. Louise Thwaites

Michael Wong

Just as with our previous World Sepsis Congresses in 2016, 2018, 2021, and 2023, and WSC Spotlights in 2017, 2020, and 2022, this free online congress brings together highly ranked representatives of international and national healthcare authorities, non-governmental organizations, policymakers, patients, patient advocacy groups, clinical scientists, researchers, and pioneers in healthcare improvement.

Marvin Zick
Register for the 7th Annual Meeting of the European Sepsis Alliance, 18 March 2024

Evangelos Giamarellos-Bourboulis, chair of the European Sepsis Alliance, is honored and excited to invite you to join the 7th Annual Meeting of the ESA in Brussels on March 18, 2024.

The whole ESA Steering Committee is delighted to welcome in person and online our friends and stakeholders, to exchange learnings and identify challenges and solutions for the fight against sepsis in Europe. We look forward to hearing the perspectives of prominent leaders on the advances in research, policy, and advocacy.
— Evangelos Giamarellos-Bourboulis, Chair of the ESA

The event “Is Europe ready to lead the Global Agenda on Sepsis?” will take place on Monday, March 18, 2024, in Brussels, with registrations now open for both in-person attendance and the free live stream.

2024 is a year of change in many aspects: sepsis is finally being understood by global leaders as a health emergency that must be prioritized and deserves urgent action, if we want to effectively tackle other global priorities such as AMR, pandemic preparedness, patient safety, and health equity.

The European elections on the horizon provide a unique opportunity to include and prioritize sepsis in a renewed European health policy agenda.

Join policymakers, experts, and patients for an engaging discussion that will explore progress, challenges, and successful ways forward in the fight against sepsis in Europe.

Simone Mancini
ESA Steering Committe member and GSA VP Ron Daniels on Updated UK NICE Guidelines for Sepsis

On January 31, the UK National Institute for Health and Care Excellence (NICE) released updates to the Sepsis Guidelines (NG51).

The guidance is attended for people with suspected sepsis, their families and carers, as well as healthcare professionals working in primary, secondary, and tertiary care.  The latest edition of the document includes updates to the risk stratification of adults, appropriate timing for antibiotic administration for different risk categories, and the reassertion of the importance of clinical judgment. 

Ron Daniels, the Vice President of the Global Sepsis Alliance and the Founder and CEO of the UK Sepsis Trust (UKST):

“We particularly support that the update continues to recommend the identification of high-risk factors, whilst reinforcing the importance of clinical judgment to prevent the injudicious use of antibiotics. The recommendation for GPs and ambulance services to consider how they give antibiotics to people who are at high risk of sepsis is increasingly relevant as transit times increase and could be potentially transformational in terms of patient outcomes.”

— RON DANIELS, GSA VICE PRESIDENT

Based on the new NG51 Sepsis Guidelines, the UK Sepsis Trust has ensured relevant updates to its clinical tools for healthcare practitioners.

Ron Daniels further notes that the revised guidelines present an opportunity to deliver a coordinated and cohesive approach to the recognition and management of sepsis across the National Health Service (NHS).

Simone Mancini
ESA Mourns the Loss of John Ryan, Early Supporter of the Fight Against Sepsis in Europe

The ESA is saddened to learn about the passing of John F. Ryan, former Deputy Director General of DG SANTE, European Commission.

We are privileged to have hosted Mr Ryan at two of the ESA Annual Meetings. He listened with genuine attention and interest to ESA and contributed with clear messages and vision to connect sepsis with other priorities in the European Commission’s agenda. His presence alone was an encouraging sign for ESA and certainly contributed to raise awareness about sepsis amongst European policymakers and stakeholders.

John Ryan was known and appreciated by the entire European health community. ESA joins the chorus of condolences of many other professional organisations. Most importantly, our thoughts are with his family, relatives and close ones.

Simone Mancini
Post-Sepsis Syndrome: a Compelling Review Analyses the Long-Term Effects of Sepsis

Post-sepsis syndrome (PSS) is defined as a constellation of long-term physical, medical, cognitive, and psychological issues following sepsis recovery that puts survivors at risk for hospital readmission, and is associated with a reduction in health and life span. In a review recently published in Infection and Drug Resistance, researchers have delved into the current knowledge of post-sepsis syndrome, shedding light on the lingering consequences of sepsis that extend far beyond the initial illness. The article explores the aftermath of sepsis and the challenges faced by individuals on their road to recovery.

“This review underscores the significance of ongoing efforts in the field of sepsis management. As we strive to enhance survival rates, it is equally imperative to address the long-term impact on those who overcome sepsis”, says Prof. Adam Linder, ESA Steering Committee member, Coordinator of the Research Working Group, and co-author of the article.

PSS isn't merely a transient phase, it encompasses a range of physical, cognitive, and psychological symptoms. Survivors may deal with fatigue, muscle weakness, and joint pain, affecting their ability to resume normal activities. Cognitive impairments, such as memory loss and difficulty concentrating, pose additional hurdles, impacting both professional and personal aspects of life.

Crucially, the article emphasizes the importance of healthcare providers and patients recognizing these persistent effects. Increased awareness is vital for tailored rehabilitation strategies and comprehensive support systems that address the multifaceted nature of PSS.

For physicians, understanding PSS means acknowledging the complexity of post-sepsis recovery and actively involving survivors in their care plans. Equipping healthcare professionals with the knowledge to identify and manage PSS ensures a more holistic approach to post-sepsis care.

The European Sepsis Alliance remains committed to disseminating information that empowers both medical professionals and individuals affected by sepsis, fostering a collective approach towards comprehensive and compassionate care. The World Health Assembly 70.7 Resolution urges UN member states to integrate sepsis in their national health systems. ESA believes that patient follow-up and survivor support should be an integral part of national sepsis plans, because of the huge impact of PSS on healthcare systems and on the society at large. After publication of an earlier study on the high burden of post-sepsis morbidity, the ESA Patient and Family Support Working Group issued a position paper calling for increased focus on post-sepsis syndrome and asking that patient follow-up must be carried out routinely, at or after hospital discharge, must be multidisciplinary, as patients can be affected by multiple diagnoses after sepsis, and financially sustained by healthcare systems and insurers. 

Simone Mancini
Ilse Malfait, Championing the Fight Against Sepsis in Belgium 

Ilse Malfait’s story is one of incredible human strengths, resilience, and perseverance. In May 2020, Ilse's life took an unexpected turn when she discovered a lump in her right breast. The initial plan involved chemotherapy, breast-conserving surgery, and radiation to combat the aggressive tumor. However, fate had a different agenda. "Four days after my first chemo treatment, severe stomach pain gripped me at night, leading to a rush to the hospital," Ilse recounts.

Her medical journey had unforeseen complications. "A few months earlier, I faced intestinal problems, and now it turned out I had an intestinal perforation. The emergency operation went well, but what followed was beyond anyone's expectations," she shares.  The evening after the intestinal operation, Ilse had so much stomach pain that she thought she was going to die. Increasing the pain medication did not help. Breathing problems, nausea, very low blood pressure, an increased heart rate, fever, and fainting: her condition deteriorated so much that she ended up in intensive care.

Ilse encountered septic shock, a diagnosis that surfaced only thirty hours after the first symptoms, bringing significant consequences. Originally slated for a week, her hospital stay stretched into a staggering 487 days, encompassing intensive care, medical oncology, and a year in the rehabilitation center. "I don't remember anything for the five or six weeks after the operation; I was in a coma," Ilse reflects. Transported to a university hospital in Ghent, her survival chances appeared slim. However, the dedication of the intensive care team saved her life. Unfortunately, the aftermath of sepsis and the medication led to insufficient blood flow, resulting in the amputation of her fingers and lower legs.

The initial four months post-sepsis are defined by Ilse as sheer survival. She faced excruciating pain, compounded by the inability to receive necessary breast cancer treatment due to her weakened heart. The sepsis forced a change in plans – chemotherapy was halted, and a breast-conserving procedure became impossible, ultimately leading to a complete mastectomy. A breathing tube deprived her of speech, food, and drink. The removal of the tube marked a turning point, allowing Ilse to reconnect with her family, express gratitude to the medical team, and savor the simple joys of conversation and meals.

The path to recovery was daunting, with intensive rehabilitation paving the way for Ilse to walk again with prostheses. The transition from a wheelchair to walking was a monumental feat, marked by challenges such as pain and difficulty reaching household items.

As Ilse's range expanded gradually, she faced the delicate balance of not overexerting herself, as stepping caused wounds on the stumps of her legs. Phantom pain in her legs, waking her up at 4 am every night, adds to the ongoing challenges. The struggle continues, but Ilse remains determined to push through. Ilse's cancer check-ups since then have been positive, and she has been declared cancer-free. However, lingering uncertainties persist due to the premature cessation of her chemotherapy.

Ilse Malfait at the Central World Sepsis Day Event in Berlin, 12 September 2023.

On 12 September 2023, Ilse spoke at the Central World Sepsis Day Event in Berlin, where she told her story to an international audience and called the Belgian government to action.

In November 2023, Ilse was featured in the documentary “Kwaad bloed” (Bad Blood) broadcasted by Belgian TV channel VRT. This documentary brought sepsis to the attention of the wider public and triggered a political debate, leading Belgian Minister for Health Frank Vandenbroucke to commission a report from Prof. Erika Vlieghe for a National Plan on Sepsis.

“Kwad bloed”, Pano, VRT.

This was a major success as only a few countries worldwide have implemented the World Health Assembly Resolution 70.7 on Sepsis, urging UN member states to integrate sepsis in their national health systems.

Ilse encapsulated her journey also in the book ‘Elk uur telt'‘ (Every Hour Counts), emphasizing the crucial need for swift intervention in septic shock.

Now, Ilse actively contributes to the cause by co-founding the non-profit organization SEPSIBEL, uniting sepsis survivors like Michael Clarke, whose story was already featured on our website. Their mission involves establishing a National Sepsis Plan with guidelines for early diagnosis and treatment. Ilse, along with the medical council, including Professor Erika Vlieghe and Professor Jan De Waele, President-Elect of the European Society of Intensive Care Medicine (ESICM), and collaborating organizations, endeavors to raise awareness among healthcare professionals and the general population about the symptoms and dangers of sepsis.

GSA founder Prof. Konrad Reinhart and GSA CEO Mariam Jashi with Ilse Malfait in Berlin, 12 September 2023.

Physically and mentally tired after three challenging years, Ilse remains resilient, driven by the urgency to implement the sepsis plan in Belgium. Her advocacy seeks to empower not only medical professionals but also the public, ensuring that the devastating impact of sepsis is met with prompt and informed responses.

The Global Sepsis Alliance and the European Sepsis Alliance are proud of the fight and the incredible achievements of Ilse Malfait. She is a true hero who can inspire millions of survivors and families affected by sepsis worldwide!

The GSA and the ESA stand ready to continuously support Ilse’s advocacy efforts and provide any necessary assistance to Belgian colleagues as they embark on developing the National Sepsis Plan.

Simone Mancini
Clarithromycin for early anti-inflammatory responses in community-acquired pneumonia

A recent randomized controlled trial authored by ESA President Prof Evangelos J Giamarellos-Bourboulis MD, PhD et al was published in Lancet Respiratory Medicine. In the study, 267 patients with community-acquired pneumonia were randomized to treatment either with clarithromycin and standard-of-care antibiotics or placebo and standard-of-care antibiotics. Clarithromycin treatment provided enhanced anti-inflammatory benefit the first 72 hours after randomization. Benefit from clarithromycin treatment was further expanded to reduction of risk of progression to organ dysfunction and secondary sepsis. Clinical benefit was associated with reversal of the complex immune dysregulation of community-acquired pneumonia. 

Please access the study for free via the button below until 21 February.

Simone Mancini
ESA Member Sepsis en Daarna Publishes ‘Sepsis Alarm Boek’ , with Contributions by Dr. Daniels and Dr. Fleischmann-Struzek

Our friends from ‘Sepsis en daarna’ from the Netherlands have published a new resource on sepsis, called the ‘Sepsis Alarm Boek’.

The booklet contains contributions from former patients, relatives, the bereaved, as well as experts in the field. Amongst them Dr. Ron Daniels, Vice-President of the GSA, and Dr. Carolin Fleischmann-Struzek, researcher and author of various articles and studies about the burden of sepsis.

The booklet was distributed amongst the Members of Parliament who are spokespersons in the field of public health, the Minister and Secretary of Public Health, and the Prime Minister. The aim is to plea for a national plan, enhancing sepsis awareness, research, and aftercare, including a public campaign.

The booklet is available free of charge and can be accessed and downloaded here in full.

Marvin Zick
CME Credits Now Available for ESA Webinar Series on Antimicrobial Stewardship

To celebrate World Antimicrobial Resistance (AMR) Awareness Week #WAAW, the ESA is making CME credits available for the webinar series “Antimicrobial stewardship, a role for biomarkers”.

The webinars took place on 16, 26 October and 9 November (more information via the button below), but if you have missed them, recordings will be available for the next six months and you will still be able to request CME credits. In order to request your CME credits, you must have either attended live or watched the recording of all three webinars. To watch the recordings, please register here and then access the recordings via the button below. Afterwards, please follow this procedure:

  1. Download the CME certificate request form.

  2. Download the EACCME® participant’s evaluation form.

  3. Fill both documents and send them together to esa@global-sepsis-alliance.org

  4. The ESA Secretariat will do technical checks to verify that you have attended the webinars and will send you back the CME certification for all three webinars.


Each of the three webinars have been accredited by the European Accreditation Council for Continuing Medical Education (EACCME®) with 1.5 European CME credits (ECMEC®s). Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity.

Through an agreement between the Union Européenne des Médecins Spécialistes and the American Medical Association, physicians may convert EACCME® credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME® credit to AMA credit can be found at https://edhub.ama-assn.org/pages/applications.

Live educational activities, occurring outside of Canada, recognised by the UEMS-EACCME® for ECMEC®s are deemed to be Accredited Group Learning Activities (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.

Information regarding the conversion of EACCME® credits

Credit will be converted based on one (1) hour of participation equalling one credit for all activities. Physicians wishing to convert EACCME® credits to AMA PRA Category 1 CreditTM will be required to access the AMA website at https://edhub.ama- assn.org/pages/applictations to obtain the necessary paperwork and instructions. Physicians and other health care professionals will be required to pay a processing fee to the AMA.

For other countries, please contact the relevant national/regional accreditation authority.

Simone Mancini
Major European scientific societies ask ECDC to include sepsis in its work plan

Five major European societies published a letter on Intensive Care Medicine asking European policymakers to support the integration of sepsis in the work plan of the European Centre for Disease Prevention and Control (ECDC), after the recently agreed extension of the agency’s mandate.

The European Sepsis Alliance (ESA), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the European Society of Anesthesiology and Intensive Care (ESAIC), the European Society for Intensive Care Medicine (ESICM) the European Society for Pediatric and Neonatal Intensive Care (ESPNIC), observe that the importance of sepsis and the correlation with infectious diseases is not yet reflected in the work of the European body in charge of monitoring and surveilling their development, spread and burden.

Estimates extrapolated from a Swedish study of 2015 suggest that in Europe more than 3 million people suffer from sepsis each year resulting in 680,000 deaths, a higher burden compared to other conditions such as stroke or coronary diseases. Sepsis is also a huge burden for European health systems and society.

The ECDC’s mandate was extended in 2022 as part of Europe’s response to the pandemic and to improve preparedness and response to future threats.

“With the revision of the ECDC mandate, the EU now has the opportunity to set new standards for sepsis care”, write the authors. “Any strategy aiming at tackling communicable diseases cannot prescind from including sepsis prevention and treatment.”

The letter recommends the following concrete actions:

  • Sepsis should be considered as one of those “special health issues” mentioned in the ECDC’S extended mandate, such as AMR and healthcare-associated infections (HAIs), because of its close interlink with these public health threats and with communicable diseases.

  • ECDC should also use its influence to include sepsis among the research priorities for EU-funded programs, and to include sepsis management in guidelines for the case management of communicable diseases.

  • Finally, sepsis should be considered as an extremely valuable indicator for the capacity of health systems to diagnose, prevent and treat communicable diseases and their burden.

Simone Mancini
ESA to host series of webinars on antimicrobial stewardship, 16, 26 October, 9 November - Register for free

The European Sepsis Alliance will host a series of three webinars on 16 and 26 October, and 9 November on the challenges and solutions of antimicrobial stewardship, with the aim to raise awareness on antibiotic surveillance and the role of biomarkers to limit the emergence of antimicrobial resistance. 

Continuing medical education (CME) credits will be available. The webinars will be broadcasted live and recorded.

Check the programme below and register via the online form.


Register now

Simone Mancini
"Superwoman died in the ICU, but I survived" – Now Marianne wants to raise sepsis awareness in Spain

I felt like Superwoman, strong and invincible! Running my own catering company with my husband, working over 60 hours a week, but never skipping my daily 6:15 am run, and in my free moments playing with my five-year-old daughter. I had just turned 40, but I have never been in better shape. Unbreakable… until July 16th, 2021.

The day before, everything was as usual: starting my day at 6.15 am with a 10km run. After breakfast, I brought my daughter to summer school, and it was just another typical busy high-season day on sunny Minorca. After work, we enjoyed a Spanish family dinner at 10 pm, as my mother-in-law was going to fly back to the mainland the morning after.

At 4 am, I woke up with a funny feeling in my tummy. Not sure if I am just hungry or feeling sick, I went to the kitchen to eat a banana. Ten minutes later, I start vomiting and have diarrhea. After that, my health was declining rapidly. At 7 am, I can just crawl the two meters between the bathroom and my bed. My mother-in-law has canceled her flight and started calling for an ambulance. I felt like flying and could barely move. Because no medical is coming and neither does the ambulance, my mother-in-law makes me an ORS. Finally, at 11 am, I stopped vomiting and was able to drink some water.

At 11:30 am, I had the honor of a cranky doctor and a clumsy nurse next to my bed. My blood pressure was on the floor and my fever was through the roof. Diagnosis without any test: COVID-19 (what else?). The order is to isolate me, and a COVID-19 ambulance will pick me up as soon as possible. After tens of calls, my mother-in-law throws in her final weapon, telling them that she will call the police if they do not send an ambulance immediately because I am on edge. Just 15 minutes later, I lost consciousness for a moment while they try to get me to the ambulance in a wheelchair.

At the hospital I do not show any progress, my blood pressure keeps on dropping and my heart rate is going up. During the X-ray, I passed out again. My caring emergency doctor brought the head of the ICU to my bed, and he takes me to his unit at 11:30 pm. In less than 24 hours I went from doing perfectly fine to the ICU. Diagnosed with severe sepsis and septic shock with multi-organ failure, of unknown origin (definitely not COVID-19!). I will turn out to be the most annoying ICU patient ever, as I hardly sleep.

The super friendly and caring head of the ICU tells me that I have been amazingly lucky and that having a strong (runners) heart probably saved my life. My good physical shape and 2 guardian angels on each shoulder make me recover almost as quickly as I got ill. After only 3 days in the ICU and one in the traumatology unit (the only free bed because of COVID-19), I asked to go home. Before going, I asked my doctor if there is any risk if I go for a run next week…

I never imagined the battle that was waiting for me. Hospital dismissal was just the beginning of my recovery. To be very clear: I was extremely lucky to get out of a septic shock like I did. But the road to recovery has been a fight, full of tears, fears, and frustration. And mostly, it has been a lonely road without any understanding and information from medical professionals. There is near to nothing available for sepsis patients in Spain.

That made me decide to do something and use my experience for something worthy. Being Dutch and understanding English, I could contact ¨Sepsis en daarna¨ in the Netherlands and the European Sepsis Alliance and read about sepsis. After going to medical specialists and getting no answers or conflicting information about my sequelae, reading the ESA’s “Life after sepsis guide” made me realize that I am not crazy, and I am definitely not the only one. Although Superwomen died in the ICU, I am determined to make Spanish sepsis survivors feel the same: together the battle is more bearable!


The article above was written by Marianne Haverkamp and is shared here with her explicit consent. The views in the article do not necessarily represent those of the European Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice. The whole team at the ESA and World Sepsis Day wishes to thank Marianne for sharing her story and for fighting to raise awareness for sepsis. The text has been lightly edited for clarity.


Simone Mancini
Summary of the 6th Annual Meeting: ESA Urges European Governments and Institutions to Act

E. Giamarellos

At the 6th ESA Annual Meeting that took place in Brussels on 21 March, ESA Chair Evangelos Giamarellos called on national and European institutions and authorities to help improve sepsis care in Europe via a list of actions pertaining to their responsibilities. The call, available here and via the button below, asks for concrete measures to support research, awareness, education, quality improvement, antimicrobial stewardship, support for survivors and political focus on sepsis. The ESA calls on other organisations to join the call.

K. Björkqvist

The day started with the story of Kristina Björkqvist. She had sepsis twice, once in 2007 and another time in 2016 that affected her more severely and from which she still suffers the long-term consequences. Kristina shared her experience and her work on engaging with other sepsis survivors that brought them to set up a Swedish patient association.

K. Reinhart, E. Giamarellos, V. Andriukaitis, H. Beton.

Education, data, impact measurement and collaboration are the words coming out of a beautiful day of discussions, learnings and togetherness. We were honoured to host former European Commissioner for Health and Food Safety, and now WHO Special Envoy for Europe, Vytenis Andriukaitis. He shared his unique passion for improving health for all Europeans. When asked what can be done to improve sepsis awareness and quality of care, he is sure that communication towards policymakers and media must be intensified, also in relation to the current global health threats and policy priorities, such as AMR, infectious diseases, cancer, with which sepsis has strong links. ESA Chair Evangelos Giamarellos insisted on the importance of education, both towards the public, but most importantly for healthcare professionals. Moderator Hatice Beton questioned the panellists on the potential benefits that digitalisations could bring to sepsis care. Speakers agreed that better data collection thanks to technology is key, but it must be accompanied by the will and the resources to use those data to really improve patent care. GSA founder and past president, Konrad Reinhart described the challenges to correctly communicate about sepsis, especially by policymakers. He closed the first panel with an optimistic note. He reminded of the huge progress made so far by sepsis advocacy, and he stressed that more needs to be done, also by breaking silos and unite with other advocacy groups and organisations.

C. Scheer

The picture of the quality of sepsis care is not the brightest. Procedures for early recognition are not sufficiently widespread. The offer of microbiological laboratory services is too often time limited, which causes significant delay in pathogen identification and therefore in effective treatment. Overall, quality improvement initiatives do not follow a structural path. These are the conclusions of the European Sepsis Care Survey, conducted by Christian Scheer, covering more than 1000 hospitals in Europe. Conclusions mirrored somehow also by the European Sepsis Report, updated in occasion of the event, that shows that in only 11 European countries there are ongoing initiatives on sepsis, of which only four are government-led national sepsis plans.

A. Artigas

L. Schlapbach

The programme looked at specific issues related to two of the most vulnerable groups: elderly and children. The presentation of Antonio Artigas illustrated the challenges that an ageing population brings to sepsis management. Elderly patients are more vulnerable to sepsis due to several factors, including their unique vascular system and the fact that they often receive other treatments and medications. Sepsis symptoms are also different by the elderly. Luregn Schlapbach instead explained how difficult it is to detect sepsis in children, because of their incapacity to communicate deterioration, and the lack of focus on children in currently ongoing national sepsis plans in Europe. In this context, parents participation in discussions and in the clinical management of small sepsis patients is paramount.

K. Björkqvist, E. Ozcelik, R. Daniels

However, data show that sepsis is not a prerogative of one or the other population group, shared Ron Daniels, UK Sepsis Trust CEO and GSA Vice President, who moderated the final panel, which drew parallels between sepsis and COVID-19, in terms of impact on the health systems and on people. Because of the lack of available data, OECD’s work does not focus on sepsis. However, the data shared by Ece Ozcelik on the impact of infectious diseases and AMR on the G7 economies are impressive: AMR is costing every year twice as much the cost of HIV treatment, and these figures are deemed to increase. The impact of the pandemic was big for patients and for family doctors. Thiago Villanueva highlighted the need for GPs to be prepared to deal with emergency situations. Integrating point of care diagnostic tools into clinical systems is key to help GPs identify pathogens and provide the right therapy, be it for sepsis or other conditions. As often argued by ESA, the impact of COVID-19 on the sepsis burden is significant, considering that the vast majority of ICU-treated COVID-19 cases presented a viral sepsis. However, because of recent changes in the ICD coding system, it was impossible to record those cases as sepsis, argued Caroline Fleischmann, from the Jena University Hospital. Her study from 2021 also looked at the heavy long-term consequences of sepsis: within the twelve months following sepsis, 3/4 of patients require care for conditions that they did not have before and 1/3 cannot return to work within the same period. Participants raised the point on the need to focus on rehabilitation of patients, as the extended economic impact on the society can be huge. Kristina wished for clinical hubs where patients can receive appropriate support from trained professionals, similarly to what is being set up for long Covid. Of course, this might come with a cost, but it should rather be seen as an investment, because, as it was rightly pointed out, the cost of non-action can be far bigger.

In this regard, the event moderator Ulrika Knutsson announced plans by ESA to run an economic impact assessment study and asked supporters to get in touch as we are seeking funding for this project.


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The 6th ESA Annual Meeting was kindly sponsored by

 
Simone Mancini
Register for the 6th ESA Annual Meeting "Integrating sepsis management in Europe's response to global health threats", 21 March

Join ESA Patron Vytenis Andriukaitis and other high-level speakers for the 6th Annual Meeting of the ESA. This year, we will discuss with policymakers, experts, and sepsis survivors what it takes to integrate sepsis into the broader picture of European health policies. Panellists and participants will reflect on the importance of including sepsis (research, education, awareness, treatment, and patient support) in strategies and initiatives on infection prevention and control, AMR, pandemic preparedness and patient safety, and discuss how European institutions and agencies can support member states.

The event will take place at the same venue of the International Symposium on Intensive Care & Emergency Medicine (ISICEM), therefore please understand that for organizational and security reasons a free registration for the ESA meeting is mandatory. Participation at the ESA event will not grant access to the ISICEM sessions.

A livestream will be available on the event page.

 

Sponsors

NB: Sponsors do not influence in any way the content of the event.

Simone Mancini
Register Now for the 4th World Sepsis Congress – One Global Health Threat: Sepsis, Pandemics, and Antimicrobial Resistance on April 25-26, 2023

On April 25 and 26, 2023, World Sepsis Congress will return – and registrations are now open.

Over the course of two days and 16 highly-relevant and unique sessions, over 80 internationally-renowned speakers will share the newest research and insights into sepsis, pandemics, antimicrobial resistance, and – most importantly – how they are linked.

As always, the 4th WSC will be free of charge and completely virtual, enabling broad participation from all parts of the world.

Just as with the previous World Sepsis Congresses and WSC Spotlights, this free online congress brings together highly ranked representatives of international and national healthcare authorities, non-governmental organizations, policymakers, patient advocacy groups, clinical scientists, researchers, and pioneers in healthcare improvement.

Marvin Zick
Season Greetings by the New ESA Steering Committee

The ESA Steering Committee and the ESA Secretariat jointly wish all our members and stakeholders peaceful and healthy festivities, and a great start to the new year. We look forward to our continued collaboration in 2023 to improve awareness and mitigate the burden of sepsis in Europe.

At the occasion of the last ESA Annual Meeting on 20 September, the ESA formally elected its new Steering Committee and confirmed Prof. Evangelos J. Giamarellos-Bourboulis as Chair for this new two-year term.

He commented: “While sharing my best wishes, I also congratulate my colleagues for their election, and I am honoured and humbled by their trust for serving as chair for this second term. I take it as a sign of the good work we have done together in the past three years since the first ESA Steering Committee was elected in 2019. From the inception of the ESA until now, we have tirelessly worked to make our stakeholders understand the urgency of improving sepsis management across Europe, via our advocacy initiatives, research projects, and the sharing of best practices. Looking back at 2022, I am happy to count a number of successes, culminating recently with the involvement of European Commissioner Kyriakides at the last ESA Annual Meeting, the publication of the results of the European Sepsis Care Survey and the announcement by G7 leaders, in May under the German Presidency, to commit to foster the implementation of the WHA 70.7 Resolution on sepsis. 

I look forward to keeping on working with this amazing and diverse group of colleagues who bring to the table a varied set of skills and backgrounds. I am sure that together we will achieve great results and contribute to mitigate the burden of sepsis in Europe.”

Simone Mancini
Join the ESA panel at the EHFG 2022 "Sepsis: the unrecognised health emergency" – September 28, 09:00 CEST

On September 28, at 9 am CEST the European Health Forum Gastein will host the session organized by ESA, in partnership with Becton Dickinson. This is the first time that sepsis is on the program of this well-known forum, which celebrates its 25th anniversary this year.

Despite being the most common cause of death from infections – including COVID-19 – sepsis is not yet sufficiently known amongst lay people and health professionals. One in five deaths worldwide is associated with sepsis.

Low awareness rates make it difficult for patients and clinicians to detect sepsis symptoms in time and respond adequately. However, sepsis can be treated relatively easily. Early recognition and cost-effective tools can save lives and minimize the socio-economic burden on health systems. Yet, still today, too many sepsis patients die or suffer long-term consequences of wrong diagnoses and therapies.

In this session, we will learn about sepsis from the patient perspective, share new data on the quality of sepsis care, and discuss its importance in infection management and AMR strategies. We will present sepsis as an indicator of the quality of care, explore best practices in sepsis management, and discuss how harmonized approaches at the EU level could save lives across Europe.

Speakers

Moderation

Simone Mancini
ESA Annual Meeting, Kyriakides: “It is crucial to try and address this global threat by working together”

It is estimated that every year 680.000 people die of sepsis in Europe “This is more than the population of Luxembourg“ noted European Commissioner Kyriakides at the European Sepsis Alliance annual meeting in Brussels on 20 September. Sepsis, a deadly consequence of infections due to a dysregulated immune system reaction to them, must be treated early and with broad-spectrum antibiotics. “The nexus of AMR to sepsis is an area where we can and we must do better“ added Kyriakides, echoed later by Swedish AMR Ambassador Malin Grape. Last June, also G7 leaders stressed this link in their conclusions.

“Via existing and new processes, the European Commission and Council can facilitate the sharing of knowledge and best practices that some countries are putting in place to implement the World Health Assembly Resolution of 2017 on sepsis, that they signed up to.”, commented Prof. Evangelos Giamarellos-Bourboulis, ESA Chair, after the meeting. “Sepsis should also be integrated into the ECDC work plan, as a consequence of communicable diseases and possible outbreaks. This was already demonstrated by the pandemic: close to 80% of COVID-19 patients in ICU have sepsis, which remains the most common cause of death.”

Tereza Šauer, a sepsis survivor from the Czech Republic, almost lost her life to sepsis back in March and shared her moving story at the meeting. After the first symptoms, she was sent back home from the hospital with painkillers. Subsequently, she developed septic shock, the ultimate and lethal stage. Tereza was lucky, but diagnosis is one of the areas of sepsis management that must be improved.

Difficult diagnosis, low awareness rates, incorrect reporting of sepsis cases, and lack of surveillance of the incidence of AMR on sepsis, make it difficult to assess and monitor the real burden of sepsis.

The cause triggering sepsis is still not totally well known. Sepsis research also needs to find innovative solutions, and more funds: “Thousands of mice have been saved, not one human in the last thirty years has been saved thanks to new therapeutical approaches.”, shared Prof. Cavaillon, from the French National Research Agency.

The issue of sepsis-related costs for the health system was also discussed at the meeting. The US CDC estimated $62 billion in the overall cost of sepsis on the US health system. Equivalent European data is missing, but a recent German study calculated €15,000 as the cost of hospitalization per sepsis patient, which amounts to €9 billion in total costs to the health system. However, sepsis survivors very often need rehabilitation and continued support in the years following their hospitalization. The same German study estimates €6.8 billion as the total cost of sepsis patients’ follow-up over three years.

Funds to set up processes and implement sepsis guidelines in European hospitals are urgently needed, as demonstrated by the result of the European Sepsis Care Survey presented by Dr. Christian Scheer at the event. The long-term benefits of sepsis guidelines have not yet been fully quantified, but “what is the cost of non-action?” concluded Malin Grape.

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Simone Mancini