Comedian Sarah Silverman says she is “lucky to be alive” after a life-threatening case of epiglottitis last week. After visiting the doctor for a sore throat, Silverman said she ended up in the ICU for at least five days, drugged and restrained.
Her terrifying ordeal illustrates how a seemingly run-of-the-mill sore throat can be potentially lethal. What is this unusual “freak” condition, as Silverman called it, and why have many of us never heard of it?
What is epiglottitis?
Your epiglottis is a small piece of cartilage that covers your windpipe. If you’ve ever swallowed food or water “down the wrong pipe,” it’s because your epiglottis didn’t close all the way. The potentially life-threatening condition epiglottitis occurs when that tiny flap of cartilage swells, blocking airflow to your lungs, according to Mayo Clinic. Your epiglottis might swell due to burning with hot liquid, traumatic injury to your throat, or various infections.
Epiglottitis can cause serious complications such as respiratory failure and sepsis. If you haven’t heard of epiglottitis before, that may be because the condition is quite rare and under-recognized.
What causes epiglottitis?
The most common cause of epiglottitis is infection with Haemophilus influenzae type b, known as Hib. This bacteria can also cause pneumonia and meningitis. Hib can be contracted by inhaling germs when infected individuals cough, sneeze or blow their nose. Thankfully, most infants receive Hib vaccinations, which has made epiglottitis quite rare.
Various bacterial infections like Streptococcus A, B or C - the same bacteria that cause strep throat - and the viruses that cause shingles and chicken pox can also lead to epiglottitis.
What are the symptoms?
If you or your child are experiencing a severe sore throat, look out for fever, difficulty swallowing, drooling and an abnormal sound when inhaling, according to Mayo Clinic. This noise is called “stridor,” and it is a high-pitched, almost musical breathing sound that occurs when the airway is blocked.
Children can develop these complications within a matter of hours, while adults tend to develop symptoms over a few days. If you or someone you know suddenly experiences difficulty breathing or swallowing, seek emergency medical help immediately. Stridor may point to other conditions, such as allergic reaction or croup, but may be a sign of an emergency.
How likely am I to develop epiglottitis?
Not very. A 2010 study showed that incidence of epiglottitis in the U.S. dropped from approximately 4,587 cases in 1998 to 3,772 cases in 2006. In a country of over 320 million people, these numbers indicate the ailment is extremely rare. The study did show that the mean age of admitted patients with epiglottitis is 44.94 years - almost exactly Sarah Silverman’s age - with less frequent admission of children and teens.
How can I prevent epiglottitis?
How do we put this lightly? Get the Hib vaccine. While epiglottitis is just one complication from infection with Hib, the bacterium can also cause other potentially fatal diseases including bacterial meningitis and pneumonia. The vaccine is not usually given to adults and children over 5, so make sure your infants are vaccinated. Adults should ask their doctor about the vaccine if their immune system is weakened by a chronic disease, transplant, or chemotherapy.
Before the Hib vaccine, Hib infection was the leading cause of bacterial meningitis in children under 5 in the United States. Approximately 20,000 children contracted Hib diseases each year, and about 3-6 percent of them died, according to the Centers for Disease Control and Prevention. Since the Hib vaccine became available, the number of cases of Hib disease has decreased more than 99 percent.
Standard germ precautions also apply to epiglottitis prevention: Always wash your hands, and try not to share personal items.
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