29 July 2019
Written by Jane Plumb MBE, intro by Nadia Vaenerberg
This month is International Group B Strep Awareness Month #GBSAM19, a global campaign that raises awareness of Group B Streptococcus (also referred to as GBS, group B Strep and Strep B).
GBS is a normal bacterium carried by 20-40% of adults and, while normally harmless, when unknowingly carried by a pregnant woman it can cause stillbirth, infant death or disability. Unfortunately, even with the best medical care, approximately 1 in 16 babies with GBS infection will die and almost 50% of the babies who recover from GBS meningitis will have long-term mental or physical problems. [1]
To mark #GBSAM19, CoMO member Group B Strep Support (GBSS) have written a special blog post for us on current preventative practices and the promising signs of change.
Group B Strep – what do I need to know?
July is Group B Strep Awareness Month, so why is it important to be aware of group B Strep?
Group B Streptococcus is the most common cause of severe infection in newborn babies, and of meningitis in babies under 3 months. Around the world, there are at least 320,000 GBS infections in babies – 90,000 babies die and another 10,000 survive with moderate to severe disability.[2]
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Current Prevention
The good news is that many of these infections in newborn can be prevented – simply, safely and cheaply. Antibiotics – ideally penicillin – given in labour to women who are carrying the bacteria will prevent as much as 90% of these infections developing in newborn babies.[3]
Most high-income countries offer women late in pregnancy a test to find out if they are carrying the bacteria and, if they are, then offer the antibiotics in labour. Many middle-income countries (and a handful of high-income countries including the UK) use risk-factors to select which women to offer the antibiotics in labour to, including:
Women in preterm labour
Women with prolonged rupture of membranes
Women with a fever in labour
Women where GBS has been identified during the current (or sometimes previous) pregnancy
Women who have previously had a baby who developed GBS infection.
Countries with a testing approach have reduced their rates of group B Strep infection in babies substantially but the picture is less encouraging in countries using a risk-based strategy – in the UK, for example, the rate has gone up by 19% since before the prevention programme was introduced.[4]
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Current Research
A trial has recently been announced in the UK that will compare the risk-based approach with two testing approaches (one testing women late in pregnancy, and the other testing women in labour) to see which is most clinically and cost effective. Funded by NIHR, the research arm of the NHS, the trial will inform future screening programmes in the UK, and is due to report in 2022. Read more about the trial here.
In addition, work is being continued to develop a maternal vaccine which will, one day, prevent more group B Strep infections than antibiotics can. A vaccine against group B Strep carriage has huge potential benefits, both in preventing these infections in unborn, newborn and young babies, in their mothers and potentially in other adults at higher risk of these infections, and also in reducing the use of antibiotics.
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Roadmap to Defeat Meningitis
The World Health Organization (WHO) has identified group B Strep as one of the four leading causes of bacterial meningitis around the world. The WHO and other major health organisations are behind a new global plan to defeat meningitis by 2030. While the focus is on preventing meningitis using vaccines, until a GBS vaccine is developed, other prevention efforts will be needed if we truly are to defeat meningitis by 2030.
This Group B Strep Awareness Month, tell everyone about group B Strep and use #GBSAM19 #groupBStrep in your social media posts. To support the work of Group B Strep Support or learn more about GBS: visit their website, like their Facebook page, and follow their Twitter profile.
References
[1] Group B Strep Support (2019). 'How will group B Strep infection affect my baby?' [Date Accessed: 29 July 2019].
[2] Seale, A.C. et al. (2017). 'Estimates of the Burden of Group B Streptococcal Disease Worldwide for Pregnant Women, Stillbirths, and Children', Clinical Infectious Diseases, 65(2, 6), pp. S200–S219.
[3] Fairlie, T.; Zell, E.R. and Schrag, S. (2013). 'Effectiveness of intrapartum antibiotic prophylaxis for prevention of early-onset group B streptococcal disease', Obstet Gynecol, 121(3), pp. 570-7. doi: 10.1097/AOG.0b013e318280d4f6.
[4] O’Sullivan, C.P. et al. (2018). 'Group B streptococcal disease in UK and Irish infants younger than 90 days, 2014-15: a prospective surveillance study', Lancet Infect Dis, pii: S1473-3099(18)30555-3. doi: 10.1016/S1473-3099(18)30555-3.
Written by Jane Plumb
Jane Plumb MBE is the Chief Executive of GBSS, which she founded in 1996. GBSS supports UK families affected by group B Strep and health professionals by providing relevant, evidence-based information and education about Strep B.
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