Group B streptococcus: Know the signs of infection

Group B streptococcus (often known as group B strep, and sometimes GBS) is a bacteria which can cause infections in newborns. It affects one in every 2,000 babies born and it's usually treated effectively, but in some rare cases its effects can be devastating, so it's good to be aware of the signs.


What is it?

Many pregnant mums carry the group B strep bacteria – in their gut or in their vagina – without knowing it. Sometimes, it will be picked up during a vaginal swab but the bacteria comes and goes and it usually causes no problems or symptoms in adults.

About half of mothers who have group B strep during pregnancy will pass it on to their baby during birth (either vaginal or caesarean), but the majority of babies who are exposed to the bacteria from their mothers do not develop infection. Occasionally, however, this can happen, and sometimes that can lead to problems.


Early-onset infection (which presents itself within six days of birth, but most often within 24-48 hours) affects approximately 340 babies in the UK each year. Late-onset infections are more rare and present after six days.

Most babies who develop an infection are successfully treated, but for some it can cause serious illness, including meningitis, pneumonia and septicaemia (blood poisoning). One in 10 babies who become infected will die. Another one in five babies affected will develop long-lasting complications, which can include deafness, blindness, cerebral palsy and learning difficulties.


What can I do?

Babies who present signs very early might well still in hospital or under medical supervision. But mums and babies often get sent home fairly quickly, so, wherever your baby is born, it is important to know the signs of an early-onset group B strep infection.

They include:

Lethargy and floppiness

Not feeding well

Abnormal heart rate (either fast or slow)

Abnormal breathing rate (either fast or slow)

Abnormal temperature (either high or low)

Grunting

Irritability (for example when being held).

Not all of these will necessarily be present.


Around 10% of babies develop a group B strep infection after one week of age, and an infection which develops between the ages of six days and three months is known as late-onset group B strep infection. Infection is uncommon in babies more than one month old and is very rare in babies of three months. In late-onset cases, the infection is unlikely to have occurred during birth, but as a result of being exposed to he bacteria elsewhere.


Symptoms might include:

Fever

Drowsiness

Poor feeding

Vomiting


Late-onset group B strep infection can lead to meningitis with septicaemia.


Symptoms might include:

Pale, blotchy skin

Skin turning slightly blue

Bulging fontanelle

Stiff, jerking body movements

A dislike of bright lights

Poor feeding

Vomiting

A high-pitched cry

Irritability (especially when being held)

Floppiness

Glazed expression

Not all of these will necessarily be present, but early detection and treatment of late-onset group B strep infection is vital, so if you notice any of the above symptoms, seek medical advice immediately.


Is group B strep infection preventable?

In some countries, antenatal screening is routinely offered to pregnant women. If they are found to be carrying group B strep, they have the choice of having antibiotics during labour which will minimise the chances of their baby picking up an infection during birth.

Currently in the UK, routine screening is not offered, although a public consultation is taking place to decide whether it should be introduced. The charity Group B Strep Support (GBSS) has created a web page with information about the consultation and how you can have your say. The consultation will conclude on October 23 2012.

Some experts have argued that routinely giving antibiotics during labour, to women who carry the bacteria, could lead to group B strep becoming more resistant to the medication. But in other countries, where screening is offered, many infections in newborns have been prevented – cases have fallen by 80% or more in some places, and group B strep hasn't become resistant.

A smattering of NHS hospitals do offer screening specifically for group B strep, and GBSS recommends pregnant women find out whether their local hospital is one of them – you can check here. If not, you can purchase sensitive testing kits privately (a test will cost around £35 and will be posted to you). Click here for a list of laboratories offering tests which meet the Health Protection Agency's standard.

Tests should include a form on which you can fill in the details of your health practioners, and they will be informed if you test positive for group B strep. If that happens, in the UK you should be offered intravenous antibiotics during labour to help prevent passing the bacteria on to your baby. In other words, the NHS will offer you antibiotics for a positive result, it is just unlikely they will help you discover whether you are carrying the bacteria in the first place.

More resources:

For more information about group B strep, and the public consultation, visit the GBSS website.