Within a day of his eczema being infected Marc was dead
ONE WEDNESDAY night last February, Marc Franks, a fit, 38-year-old company director, mentioned a patch of eczema on his right arm.
As his wife Barbara recalls: ‘I’d given birth to our fourth child three months before, so I didn’t really pay much attention. Marc said the eczema was cracked, dry and probably infected. But he said the pain wasn’t too bad — he’d had eczema before and it always cleared up, so we weren’t too worried.’
The next morning, he said he felt fine and went off to work, leaving Barbara, 38, at home in Didsbury, Manchester, with daughters Ashlea, seven, and Rowan, four, and sons Thomas, five, and Owen, now 15 months.
But Marc felt so unwell that he returned home to spend the day in bed. The couple assumed he’d picked up the winter vomiting bug that had affected the rest of the family. He had an upset stomach and Barbara made sure he kept well hydrated.
However, later that night, she became increasingly concerned as Marc’s skin became clammy and his temperature dropped. ‘He said he didn’t feel great, but wasn’t in pain. But by midnight his breathing had become laboured and shallow and he seemed light-headed,’ says Barbara.
‘His hands felt very cold, too. I was desperately worried, but when I asked if I should call an ambulance, he said “No”.’
At around 3am, after noticing a mottled rash on her husband’s legs and realising he was beginning to slur his words, she frantically called 999. ‘Ten minutes later Marc tried to get up, but collapsed on the bathroom floor just as the paramedics were coming through the front door.’
In the next few minutes, he suffered a fit and then a cardiac arrest. Tragically, the paramedics were unable to revive him — and 45 minutes later he was pronounced dead in hospital.
‘I felt as if I was watching it all happen to someone else — it was surreal,’ says Barbara. ‘ Marc and I had known each other since primary school and suddenly he was gone. In an instant my four children had lost their daddy.’
THE family are still struggling to cope with what happened. ‘It’s left a huge hole. My eldest two still sleep in my bed as that’s the only place they feel secure. Marc was a hands-on dad who loved to cook and spend time at home. Every month there’s some sad anniversary where he is missing.
‘On his birthday in December, we sent birthday cards tied to balloons up to heaven from the garden. Baby Owen celebrated his first birthday in November, but Marc wasn’t there to share it.’
It wasn’t until an inquest six months later that Barbara learned Marc’s death had been triggered by that tiny patch of eczema.
Doctors think bacteria from the infected eczema had entered his bloodstream, leading to sepsis — a life-threatening illness where the immune system goes into catastrophic overdrive and begins attacking the body it is meant to protect, leading to organ failure and tissue damage.
Many infections can potentially trigger sepsis, as well as the infected eczema, and it’s thought the vomiting bug might have made Marc more vulnerable. ‘I couldn’t understand how a big, strong, 6ft man like Marc could die so quickly from something so apparently trivial that he hadn’t even seen his doctor about it,’ says Barbara.
There are 102,000 cases of sepsis (previously known as blood poisoning or septicaemia) each year in Britain and it kills 37,000 people — more than breast, bowel and prostate cancer combined.
Sepsis is also the biggest killer of pregnant women, who are particularly susceptible because their immune systems are suppressed in pregnancy. However, it can strike any age.
The Brazilian f ootball star Socrates died from sepsis in December; it also claimed the lives of Superman actor Christopher Reeve and Pope John Paul II.
Hollywood actor Johnny Depp’s daughter Lily-rose contracted sepsis after developing E-coli at the age of seven in 2007 — but survived thanks to prompt treatment at Great Ormond Street Hospital, London.
Yet while most people are aware of the symptoms of killer diseases such as meningitis and heart attacks, few can spot the warning signs of sepsis. Tragically, it’s often confused with other conditions such as flu and so patients do not receive the right treatment until it’s too late.
A new campaign to highlight the symptoms and make the Government recognise sepsis as a medical emergency has been launched by the UK Sepsis Trust, a pressure group set up by health professionals.
‘Sepsis is a silent killer and as an intensive care doctor I have seen too frequently the devastating impact it causes,’ says Dr Ron Daniels, a consultant in intensive care medicine at the Good Hope Hospital, Birmingham, who is also chairman of UK Sepsis.
‘It’s the primary cause of death from infection despite advances in medicine, including vaccines, antibiotics and acute care.’
What few realise is that there doesn’t have to be a cut or wound to get blood poisoning. ‘Any type of infection — i ncluding chest infections, pneumonia, urinary tract infections, burst ulcers, appendicitis, bites and skin infections such as eczema can trigger sepsis,’ says Dr Daniels.
‘And it can kill rapidly — within 24 hours in some cases — so spotting it early is vital.’
There are international guidelines on the treatment of sepsis including, crucially, that patients should have intravenous antibiotics within an hour of the onset of symptoms.
But only 15 per cent of British patients receive care that meets these standards, as it is not diagnosed early enough.
‘During an infection the body tries to shut down the pathogen that has invaded it, and it does this by unleashing the cells and components of the immune system,’ says Professor Mark Fielder, medical microbiologist at Kingston University and member of the Society of Applied Microbiology.
‘But if the infection is severe, the immune system over- reacts, triggering widespread inflammation that damages tissue and organs, eventually causing them to shut down.’ Once one organ stops functioning, the others soon follow, and toxins enter the bloodstream. This is why catching this process early, before organs start to fail, is so crucial.
‘Outside of intensive care and emergency medicine units there is little awareness of the symptoms of sepsis — though awareness is improving among paramedics,’ says Dr Daniels. ‘The problem is that symptoms can be similar to flu and be non-specific — but there are key symptoms that set it apart.’
These are a rapid heart rate, a high or very low temperature (below 36c or above 38.3c), shallow rapid breathing and confusion or slurring. Dr Daniels says patients with two or more of these symptoms should seek medical advice.
‘If a patient also has cold, pale or mottled skin, loses consciousness or has not passed water for more than 18 hours, they need to be taken to hospital as an emergency as soon as possible.’
In research published last year, Dr Daniels found survival rates doubled if within an hour of presenting to a doctor the patient was treated with the ‘sepsis six’ — a treatment package involving antibiotics, fluids, oxygen, urine monitoring, blood-testing for bacteria and lactate checks (for signs of tissue damage).
‘We know what works: we just need to diagnose sepsis sooner,’ he says.
DR DANIELS is working on a pilot project training ambulance crews in the East Midlands and East of England Ambulance Trusts to alert staff to the warning signs.
‘In the future we hope paramedic ambulance crews will be able to administer intravenous antibiotics, which they are not currently allowed to do for sepsis — though they can in cases of suspected meningitis.’
The UK Sepsis Trust has collected more than 1,900 signatures on an e-petition calling for Health Secretary Andrew Lansley to make a commitment to ensure all patients with sepsis get access to rapid care.
For bereaved families like Barbara Franks and her children, greater awareness of sepsis symptoms will come too late, but she hopes the campaign will prevent others suffering a similar fate.
‘When I was told Marc had died from sepsis and tissue infection, I’d never even heard of it. I had to go and look it up on the internet — and when I did I couldn’t believe how common it is, but equally how little awareness there is.’
For many months Barbara was haunted by memories of the night Marc died and bitter frustration at the thought that his death could have been preventable.
‘I went over and over that night, and wondered if he’d still be alive today if we’d called an ambulance sooner. But now I realise I’m not alone and most people are not aware of the symptoms.
‘That’s why I’m telling my story. I want more people to be aware of the risks of sepsis, to stop this happening to other families.’
TO SIGN the e-petition, go to sepsistrust.org