In Early February, the Sudan Sepsis Alliance hosted the International Sepsis Conference in Khartoum, Sudan.

At this event, the Khartoum Resolution was produced - and Sudan has agreed to host a conference of African Ministers of Health to discuss a joint strategy for Africa. African countries are urged to develop a similar program to tackle sepsis. 

At this opportunity, the Sudan Sepsis Alliance finally received their GSA Award, which it was awarded in 2017 for their major accomplishments in sepsis care and awareness in Sudan. Applications and nominations for the 2018 GSA Awards are now open.

Over 700 doctors, nurses, pharmacists, allied health professionals, and students met at the international sepsis conference organised by the Sudanese Sepsis Alliance on February 1st, 2018, in Khartoum. Participants discussed the challenges and opportunities for improving sepsis care in Sudan and Africa. They also discussed achievements and what needs to be done to improve prevention, recognition, treatment, and rehabilitation. A preconference meeting was also held on the January 31st, 2018, and chaired by Professor Mamoun, Khartoum State Minister of Health.

Most of the participants were from Sudan, however, other African countries such as Nigeria, Djibouti, and Kenya were represented. Representatives from the Global Sepsis Alliance and the African Sepsis Alliance were also present.

The following items are especially important:

1. The Sudanese Sepsis Alliance was given a prestigious GSA Award. This award recognises all the work they have done to improve sepsis prevention, recognition, and treatment in Sudan.
2. The Khartoum Resolution was agreed to arrange a conference of African Ministers of Health to develop a joint strategy and plan for sepsis improvement in Africa. Professor Mamoun agreed to sponsor and host the conference within 12 months and in collaboration with the African Union.

Professor Konrad Reinhart, Chair of the Global Sepsis Alliance, said “This is a great achievement for Sudan and the African Continent. Sudan is leading the world in sepsis improvement and other African countries should learn from it”

We urge you to sign the Kampala declaration and support sepsis improvement in Africa. Everybody in Africa has a right to survive sepsis.

The GSA will hold its next WSD Supporter Meeting on March 21st, 2018 at the International Symposium of Intensive Care and Emergency Medicine. Main topics will be the collaboration with the WHO to roll out the demands of the Resolution on Sepsis, an update on the establishment of regional and national sepsis alliances, the 2nd World Sepsis Congress (September 5th and 6th, 2018), and much more.

Additionally, we are looking forward to your ideas, proposals and suggestions to further improve our GSA activities.

• Wednesday, 21st March 2018
• 12:15 to 14:30h
• Meeting Room: 201 A&B
• Snacks will be provided
• Participation is free of charge and open to everyone

A law known as "Gabby’s Law" will require Illinois hospitals to be better prepared to recognize and treat patients with sepsis or septic shock. The legislation is named in honor of Gabby Galbo of Monticello, who passed away in 2012 due to untreated sepsis. Following her death, Gabby’s parents, Liz and Tony, began work to pass this legislation, which received unanimous support in both the Senate and the House, to honor her memory.

Gabby Galbo developed an infection from an undetected tick bite that led to sepsis. This law requires hospitals to:

• Implement an evidence-based process for quickly recognizing and treating adults and children with sepsis.
• Train staff to identify and treat patients with possible sepsis.
• Collect sepsis data to improve the quality of care and provide to the state (e.g. sepsis data to the Centers for Medicare & Medicaid Services (CMS) Hospital Inpatient Quality Reporting program).

On Tuesday, March 20th, 2018, the Global Sepsis Alliance, jointly with EU Commissioner for Health and Food Safety, Vytenis Andriukaitis, will host the event 'Sepsis - The Most Preventable Cause of Death and Disability in Europe - A Call to EU Action' in Brussels, Belgium.

The event will take place from 14:30 to 20:00 in the Palace of the Académies (Rue Ducale 1, 1000 Brussels), which is in walking distance of both the European Commission as well as the Square Meeting Center, where the 38th ISICEM is held. 

You are hereby cordially invited to join us, the Commissioner, and many more prestigious speakers for this groundbreaking symposium.

This event will highlight the human and economic burden of sepsis in Europe, point out that most sepsis deaths and impairments are preventable, foster the implementation of the requests of the WHO Resolution on Sepsis across the European Union, and call for the development of a Pan-European sepsis strategy. Additionally, this symposium will serve as the kick-off meeting for the European Sepsis Alliance.

Due to limited seating capacity, please RSVP to the event using the button below. We look forward to meeting you in Brussels in March!

Sepsis - The Most Preventable Cause of Death and Disability in Europe - A Call to EU Action
March 20th, 2018, 14:30 to 20:00h
Palace of the Académies, Rue Ducale 1, 1000 Brussels
Use buttons above

Title of Event:
Date & Time:   
Location:
RSVP & Program:

Today, we have completely overhauled the GSA Member section, giving it a new design, including new and accurate maps to show where our members are located.
This makes it easier for you to find what you are looking for, get an overview of our members, and see where blind spots for sepsis still exist, quite literally.
The division into six regions is borrowed from the WHO; African Region, Region of the Americas, Eastern Mediterranean Region, European Region, Region of the Americas, South East Asia Region, and Western Pacific Region. 

What do you think about the redesigned member page? Let us know!

Applications and nominations for the 2018 GSA Awards are now open - click here to submit your application now.
The GSA Awards honor major contributions in the fight against sepsis every year and are exclusively sponsored by the Erin Kay Flatley Memorial Foundation.
They are granted in three categories:

1. Governments and Healthcare Authorities
2. Non-Governmental Organizations, Patient Advocate Groups, or Healthcare Provider Groups
3. Individual Nominees

In addition to glory, prestige, and a beautiful trophy, winners of category 2 and 3 are awarded with $ 2,500 each.

More information, including requirements for submissions, can be found here. 

The deadline to apply is March 31st, 2018. Please share this call with your colleagues, friends, and other interested parties.

Jay and Sue before and after her sepsis case

August 6, 2014 was a typical Oklahoma day with temperatures in the mid-90s (90 F = 32° Celsius) and a heat index of 99. After a family day that included the movies, dinner, and frozen yogurt, Sue started feeling ill with fever and chills and overall body pain, primarily in her neck and throat. Since her symptoms hadn’t subsided, we went to the emergency room in the very early morning hours of August 8th.

On this initial visit to the ER, Sue presented with a high heart rate, low blood pressure, low urine output, slight dehydration, and rated her pain a 9 out of 10. She was tested for strep throat and when the rapid strep test came back negative, the ER doctor diagnosed her with a viral infection, said she would feel worse before she felt better, and prescribed cough syrup with codeine. We didn’t know it at the time, but Sue’s vital signs were critical red flags that she was very ill, but the doctor failed to recognize and act on them. 

Throughout Friday, Sue continued to feel slightly worse and vomited for the first time. We weren’t really concerned because the ER doctor said she would feel worse, but by Saturday morning it was evident we need to go back to the ER immediately. Sue was seen almost immediately and had a blood pressure of 68/42. The second ER doctor thought Sue had urosepsis from a urinary tract infection and said she need to be transported to the ICU. When I asked him how long she would be in ICU, he said probably 3 days.

August 12, 2014, after 3 days in ICU, we said our final goodbyes, as Sue’s kidneys, lungs, and liver had failed and doctors didn’t expect her to survive the night…but they don’t know Sue.  She beat septic shock, but sepsis left her a bilateral below-elbow and bilateral below-knee amputee. Less than 3 months after her amputations, Sue walked on her prosthetic legs for the first time and we went skydiving in August 2015 to celebrate her first “Alive Day”!
 

Jay and Sue have spoken at hospitals and healthcare systems across the U.S., including Johns Hopkins Bayview Medical Center, as they seek to raise sepsis and limb-loss awareness in the hope other families won’t have to go through what they have. For more information on their story, please visit www.suestull-sepsis.org. The whole team here at the Global Sepsis Alliance wishes them only the best and is deeply thankful for being allowed to share their very personal and touching story.

To keep similar stories from happening, please donate to the Global Sepsis Alliance / World Sepsis Day Movement or Sepsis Alliance, so we can continue our quest of educating the whole world about sepsis and its implications, saving millions of lives.

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The article above was written by Jay & Sue and is shared here with their explicit consent. The views in the article do not necessarily represent those of the Global Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice. The whole team here at the GSA and World Sepsis Day wishes to thank Jay & Sue for sharing their story and for fighting to raise awareness for sepsis.

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The WHO has released a statement on maternal sepsis. Download the statement as PDF. 
Here is the unedited statement in its entirety:

Sepsis: a leading cause of maternal deaths
Strategic approaches to reduce maternal mortality in the past 15 years have mainly focused on clinical interventions and health system strengthening (1). The greatest attention has been on postpartum haemorrhage and hypertensive disorders, the two leading direct causes of maternal mortality (2). Further reducing maternal deaths is a priority for achieving the Sustainable Development Goals (3), implementing the UN Global Strategy for Women’s, Children’s and Adolescents’ Health and critical for the Strategies toward Ending Preventable Maternal Mortality (EPMM) (1).

However, the third most common direct cause of maternal mortality, maternal sepsis (2), received less attention, research and programming. Undetected or poorly managed maternal infections can lead to sepsis, death or disability for the mother and increased likelihood of early neonatal infection and other adverse outcomes.
Recognizing the need to foster new thinking and to catalyse greater action to address this important cause of maternal and newborn mortality and morbidity, the World Health Organization (WHO) and Jhpiego have launched the Global Maternal and Neonatal Sepsis Initiative, dedicated to focusing additional effort, energizing stakeholders and accelerating progress in the area of maternal and neonatal infection and sepsis (Box 1). The Initiative has received extensive support from the International Federation of Gynecology and Obstetrics (FIGO), International Confederation of Midwives (ICM), International Pediatric Association (IPA), Global Sepsis Alliance and the Surviving Sepsis Campaign in collaboration with the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM).

Defining maternal sepsis
In July 2015, Jhpiego hosted the “Enhancing the Focus on Maternal Sepsis” meeting, which developed Key Themes and a Framework for Action as a first step in recognizing and addressing the importance of maternal infection. An important outcome of this meeting was the recognition of the need for a clear, evidence-based and actionable definition for maternal sepsis. Existing definitions related to maternal sepsis may be confusing (e.g. maternal infection, puerperal sepsis, postpartum sepsis) and imprecise, potentially leading to misdiagnosis, inadequate treatment or delays in care.
A literature review on maternal sepsis definitions and identification criteria was then conducted (4). The review included all review articles related to maternal sepsis or articles reporting on the development and testing of identification criteria for maternal sepsis, as well as current guidelines, published between 2010 and 2016, with no language or geographical restrictions. Information was extracted from 27 articles, out of 245 citations identified in the systematic review, and 9 guidelines and 3 additional WHO documents. This review found several terms, definitions and sets
of criteria being used to describe maternal sepsis. A substantial proportion of studies (11/27) and guidelines (7/9) included definitions that consisted of variations and attempts at adaptation of the First and Second International Consensus Definitions for Sepsis and Septic Shock, which were developed for the general adult population but excluded pregnant women.
In April 2016, WHO convened an expert consultation to discuss, develop and propose a new global definition for maternal sepsis. A multidisciplinary
international panel of 48 experts was surveyed through an online and in-person consultation in March–April 2016 for their opinion on the
new definition of sepsis proposed for the adult population and the importance of different criteria for identification of maternal sepsis. Members of the panel had expertise in obstetrics, midwifery, adult and obstetric critical care, infectious disease, epidemiology and public health from across all regions of the world. During the in-person meeting the definition of maternal sepsis, attributes of its identification criteria and considerations for implementation were discussed. Informed by the literature review and a structured expert consultation, the new definition of maternal sepsis reflects the thinking embedded in the 2016 Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) (5). Previously defined as an infection with a Systemic Inflammatory Response Syndrome (SIRS), the SEPSIS-3 consensus shifts the focus of the definition of sepsis from
inflammatory response to life-threatening organ dysfunction.
Based on this work, the new maternal sepsis definition reads as follows: maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion, or postpartum period. Specific identification criteria for maternal sepsis will be developed (Box 2).
During the consultation, experts agreed on thefollowing attributes:

• Identification criteria for maternal sepsis cases should be based on the presence of suspected or confirmed infection plus signs of mild to moderate organ dysfunction (e.g. tachycardia, low blood pressure, tachypnoea, altered mental status, reduced urinary output).
• Two sets of identification criteria will be required to fulfil two different purposes:
  • early identification of women with possible severe maternal infections to enable prompt therapeutic action; and
  • confirmation of maternal sepsis for epidemiological and disease classification purposes (confirmed maternal sepsis).
• These criteria should be simple to obtain, preferably based on bedside clinical signs, actionable and applicable to high- and low-resource settings.
• Confirmed maternal sepsis cases need to be compatible with the current International Classification of Diseases (ICD-10) and contribute to the ongoing revision of the Classification to allow comparability of data.

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Box 1: The Global Maternal and Neonatal Sepsis Initiative

Vision
The Global Maternal and Neonatal Sepsis Initiative will contribute to the Sustainable Development Goals by
developing solutions able to reduce maternal and neonatal deaths related to sepsis.

Goal

• Accelerate the reduction of preventable maternal and neonatal deaths related to sepsis.

Objectives

• Raise awareness about maternal and neonatal sepsis among health care providers, policy-makers and the public
• Assess the burden and management of maternal and neonatal sepsis at the global scale
• Develop and test effective strategies to prevent, detect and successfully manage maternal and neonatal sepsis.

Priority areas of work

• Strengthening Health Programmes
• Research, Development and Evidence Generation
• Innovations
• Global Advocacy

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Box 2: The New WHO Definition of Maternal Sepsis
Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion, or postpartum period.

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Operationalizing the new maternal sepsis definition
The operationalization of the new maternal sepsis definition guides providers to focus on actionable elements such as the administration of antibiotics
and fluids, and support of vital organ functions. It also recognizes the need to act promptly, prior to laboratory confirmation. Therefore, two sets
of identification criteria for maternal sepsis will be developed and tested: one pertaining to early identification of women with possible severe maternal infections (presumed maternal sepsis), and another focused on confirming the diagnosis of maternal sepsis.
Adoption and implementation of the new definition will strengthen clinical management at the facility level and focus health system improvement
efforts (Fig. 1). Operationalizing the new maternal sepsis definition is a step toward more progress in addressing maternal sepsis. Continued success,
however, will require a coordinated, cohesive and strategic approach with dedicated resources on the part of international organizations and agencies,
ministries of health, programme managers, researchers and donors. The Global Maternal and Neonatal Sepsis Initiative will further the
development of identification criteria, prevention strategies and management bundles and promote a global mobilization with the aim of accelerating
the reduction of preventable sepsis deaths during pregnancy, childbirth and postnatal period by 2030. Key advances, however, are still needed in the area of innovation, research, programme implementation and advocacy, both at the global and national levels, in order to be effective and reach more women and babies.

References

1. Chou D, Daelmans B, Jolivet RR, Kinney M, Say L; Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality (EPMM) working groups. Ending preventable maternal and newborn mortality and stillbirths. BMJ. 2015 Sep 14;351:h4255. doi: 10.1136/bmj.h4255. Review. PubMed PMID: 26371222.
2. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun;2(6):e323-33. doi: 10.1016/S2214-109X(14)70227-X. Epub 2014 May 5. Review. PubMed PMID: 25103301.
3. United Nations. Sustainable Development Goals. United Nations, New York, 2015. (Available at: https://sustainabledevelopment.un.org, accessed 16 December 2016).
4. Bonet M, Pileggi VN, Rijken MJ, Coomarasamy A, Lissauer D, Souza JP, et al. Towards a Consensus Definition of Maternal Sepsis: Results of a Systematic Review and Expert Consultation. (unpublished)
5. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10

Acknowledgements
We gratefully acknowledge the contributions of participants to the technical consultation (in alphabetical order): Edgardo Abalos (Centro Rosarino de Estudios Perinatales, Argentina), Aniekan Abasiattai (University of Uyo Teaching Hospital, Nigeria), Linda Bartlett (Johns Hopkins University, USA), Fernando Bellissimo Rodrigues (University of São Paulo, Brazil), Arri Coomarasamy (University of Birmingham, UK), Maria Fernanda Escobar Vidarte (Fundación Valle del Lili, Colombia), Carlos Füchtner (FIGO, President Elect), Asmae Khattabi (National School of Public Health, Morocco), David Lissauer (University of Birmingham, UK), Zahida Qureshi (University of Nairobi, Kenya), Sadia Shakoor (The Aga Khan University, Pakistan), Claudio G. Sosa (Latin American Center for Perinatology, Women and Reproductive Health (CLAP), Uruguay) and Jos van Roosmalen (VU University, Amsterdam, The Netherlands). Special thanks are due to all respondents to our online survey. The Maternal and Neonatal Sepsis Initiative Secretariat: Rajiv Bahl, Mercedes Bonet, A Metin Gülmezoglu , Cynthia Pileggi Castro, João Paulo Souza (World Health Organization, Switzerland); Elizabeth Kizzier, Jeffrey Smith (Jhpiego, USA).

This statement has been endorsed by:

• Global Sepsis Alliance (GSA)
• International Pediatric Association (IPA)
• Jhpiego
• Surviving Sepsis Campaign (SSC)
• The European Society of Intensive Care Medicine (ESICM)
• The International Confederation of Midwives (ICM)
• The International Federation of Gynecology and Obstetrics (FIGO)
• The Society of Critical Care Medicine (SCCM)

If your organization would like to endorse this statement, please contact: mpa-info@who.int

For more information, please contact:
Department of Reproductive Health and Research
World Health Organization
Avenue Appia 20, CH-1211 Geneva 27, Switzerland
E-mail: reproductivehealth@who.int

© World Health Organization 2017. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence. WHO/RHR/17.02
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This publication contains the collective views of an international group of experts and does not necessarily represent the decisions or the policies of WHO.