July is Group B Strep Awareness Month - a campaign spearheaded by the charity Group B Strep Support (GBSS), which is aimed at raising awareness of problems that Group B streptococcus can cause.
What is Group B streptococcus (GBS)?
Group B streptococcus (GBS) is a normal bacterium which colonises between 20-30% of men and women in the UK, usually without symptoms or side effects. GBS can, however, occasionally cause serious infections, usually in newborn babies.
GBS is not a sexually transmitted disease and treatment of a woman and of her partner carrying GBS does not prevent recurrence. Importantly, most women who have GBS do not pass it on to their babies. Most babies are born well, with no medical consequences. However, a few do go on to get the infection.
How can GBS infection affect newborn babies?
In newborn babies, most cases of GBS infection occur in the first six days of life (known as early onset). It is characterised by the rapid development of breathing problems, associated with septicaemia (blood infection). In late-onset GBS, which occurs in babies older than six days and rarely occurs after the age of one month, symptoms usually present as GBS meningitis
GBS is a recognised cause of pre-term delivery, maternal infections, stillbirths and late miscarriages. Pre-term babies are known to be at particular risk because their immune systems are not as well developed. Overall, without preventative medicine, GBS infections would affect one in every 1,000 babies born. This would result in the deaths of 75 babies a year from the infection.
Key GBS meningitis facts
- It is the most common cause of severe infection and meningitis in newborn babies
- Most cases are early onset (zero to six days)
- 10% mortality (10% of babies infected pass away as a result of the infection)
- It can cause pneumonia, septicaemia and meningitis
- 50% GBS meningitis survivors suffer long-term consequences such as learning disabilities, lung problems, visual or hearing loss
- 12% have severe disabilities.
What does current medical guidance on GBS say?
Currently, the guidance from the Royal college of Obstetrics and Gynaecologists (which was written in 2012 and is due for renewal) is that only mothers at high risk of having GBS should receive IV antibiotics prior to labour. Mothers at high risk include:
- Women who have had a previous baby with severe GBS infection
- GBS cultured in the urine or on swabs during current pregnancy
- Women who develop a fever during labour, or other signs of infection
- Women who experience prolonged rupture of membranes (over 18 hours) in labour
- Pre-term labour (if membranes rupture).
The treatment of at-risk women will pick up about 60% of cases of GBS. Group B Strep Awareness Month is aiming to increase public knowledge about GBS, and to question whether screening for GBS should be rolled out in all pregnancies, in line with a number of other countries who already do this. The hope is that screening would help pick up the 40% of GBS babies who have no risk factors at all.
What can be done to help prevent GBS infection?
With a disease as serious as GBS infection, it is argued that prevention is much better than treatment. The best preventative treatment (or prophylactic treatment) for GBS developing in new born babies is giving intravenous antibiotics (to the mother) during labour (ideally over four hours before delivery), rather than after delivery. The best way to manage GBS risk in pregnancy is still up for debate.