Your toddler isn’t their usual bubbly self; no giggles, no dash to the toy box, just silence. At first, it seems like nothing more than a cold. But as the day goes on, that uneasy feeling in your chest grows stronger. Sometimes, that quiet shift is more than a phase; it’s the signal every parent needs to pay attention to.
Dr Olive Lee Pei Ee, Consultant Paediatrician and Paediatric Intensivist at Sunway Medical Centre, Sunway City (SMC)
Sepsis, a condition often misunderstood and dangerously underestimated, has a way of creeping in silently. It can start with something as simple as a fever, tummy ache, or cough, and then spiral into full-body inflammation and organ failure within hours. The World Health Organisation (WHO) reports that sepsis affects 49 million globally each year, causing 11 million deaths, nearly half of which are children, about 2.9 millioni. What makes this especially tragic is that many of these cases are preventable with early detection and rapid treatment.
Dr Olive Lee Pei Ee, Consultant Paediatrician and Paediatric Intensivist at Sunway Medical Centre, Sunway City (SMC), who co-authored a study and has seen the toll first-hand, said, “In 2021, I published a paper with Thailand and Singapore colleagues on our PICU database. Sepsis in our region remains around 20%, but likely higher, possibly up to 50%. The same study also showed a 19.2% death rate in children with severe sepsis or septic shockii. Malaysia’s data highlights the concern. Between 2015 and 2020, the Malaysian National Neonatal Registry recorded nearly 1,000 cases of early-onset sepsis in newborns, most commonly caused by Group B Streptococcusiii.”
The World Health Organisation (WHO) reports that sepsis affects 49 million globally each year, causing 11 million deaths, nearly half of which are children, about 2.9 million
It Can Start From Something Small
The danger lies not just in how fast sepsis develops, but in how deceptively it begins. Dr Lee explained, “Sepsis is not merely an infection. An infection is a trigger that causes an abnormal immune response, which can escalate like a fire igniting a vast forest fire in the body. In Malaysia, we still encounter many chest infections, especially during flu season. What starts as a harmless cough can develop into something life-threatening.”
The greatest challenge for parents and doctors alike is recognising sepsis in its early stages. Children may not show clear signs that something is wrong. “Children can’t talk. They cannot tell you, ‘I’m sick, I’m not well, I need help.’ So, in other words, it’s silent. It can just be as simple as not being themselves,” said Dr Lee. A child may seem more tired than usual, more withdrawn, or generally “off”, all subtle signs that can be easily dismissed.
“Sepsis is not merely an infection. An infection is a trigger that causes an abnormal immune response, which can escalate like a fire igniting a vast forest fire in the body. In Malaysia, we still encounter many chest infections, especially during flu season. What starts as a harmless cough can develop into something life-threatening.” – Dr Olive Lee Pei Ee
What to Watch for
Dr Lee emphasises that while the symptoms may appear minor, they should never be ignored. “If a child becomes unusually sleepy, has trouble waking up, vomits everything they take in, or suddenly looks less alert or energetic, it could be a warning sign,” she explained.
“Breathlessness, extreme temperature changes, or being floppy or limp are signs that something is seriously wrong. If the child is completely limp and very cold or very hot, I would advise going straight to the hospital. The rule of thumb is, if the child doesn’t improve with medication within three days or if the symptoms persist for three days, then it’s time to seek help,” she said.
General practitioners are trained to look out for sepsis and can escalate care appropriately, but delays in seeking medical attention can be devastating. “Time is of the essence in sepsis management. Once it progresses, it progresses very quickly,” Dr Lee warned.
What You Can Do
The most powerful weapon against sepsis is prevention. This begins at home with hygiene, where regular handwashing, safe food practices, and clean environments should be maintained.
But vaccination can also help play an equally important role. Dr Lee shared, “Vaccination creates herd immunity. Vaccinated household members can help create a barrier for that child and offer protection. This means that even if the child is too young or too vulnerable for certain vaccines, they’re still protected by those around them”.
Dr Lee also urged parents to be cautious about antibiotic overuse. “If we start using antibiotics for everybody, then you will have antibiotic resistance. In a hospital setting, the hospital-acquired sepsis will be very hard to treat.” Responsible antibiotic use, combined with vaccination and hygiene, helps reduce the risk of infections developing into sepsis.
Recovery Takes Time
Even after a child survives sepsis, the journey may not be over. Recovery can take weeks or months, and complications may arise. “They can have what we call post-sepsis syndrome, which can affect their physical ability, their cognitive, psychosocial, as well,” Dr Lee said.
Children may experience muscle weakness, emotional or psychological trauma, or developmental delays. Some may need ongoing check-ups to monitor kidney or other organ function. Vulnerable groups, including newborns, children with chronic illnesses, or those living with obesity, face greater risks. “The younger they are, the more at risk they are,” she added.
Most importantly, Dr Lee believes in trusting a parent’s instinct. “Parents know best. If your child seems different, don’t brush it off. Seek help. Don’t wait for others to say it’s serious.” She acknowledges that in Malaysian culture, “waiting and seeing” is often the default reaction, but with sepsis, hesitation can be deadly. Her message is clear and urgent: “Listen to your gut; it could save your child’s life.”
“Parents know best. If your child seems different, don’t brush it off. Seek help. Don’t wait for others to say it’s serious.” – Dr Olive Lee Pei Ee
Dr Lee also shared her insights at SMC’s 2nd International Paediatric Symposium 2025, themed “Paediatrics Without Borders: Bridging Subspecialties, Saving Lives”, bringing together leading paediatric specialists from Malaysia, China, Singapore and the USA, in a hybrid-format symposium.
The event served as a powerful platform for knowledge exchange, evidence-based practice updates, and regional standard-setting in paediatric care that goes beyond borders.
Dr Olive Lee Pei Fei with the key speakers of SMC’s 2nd International Paediatric Symposium 2025
