Caught early enough Strep B can be treated successfully. Jane Plumb of the Group B Strep Support Group gives a brief outline of how to identify it and what to do.
Group B streptococcus (GBS) is a common type of the streptococcus bacterium. Approximately a third of men and women "carry" GBS in their intestines and a quarter of women of childbearing age carry it in their vagina.
Most of us are unaware it's there, as GBS can be difficult to detect and carrying it doesn't cause problems or symptoms. GBS is just one of a number of bacteria which normally live in our bodies and carrying it is perfectly normal.
Once GBS has 'colonised' the intestines, no antibiotics tested so far can eradicate it.
Although GBS is the most common cause of bacterial infection in newborn babies, this complication is still relatively uncommon (around one in every 1,000 newborn babies in the UK develops a GBS infection, that's about 700 babies a year).
Babies are usually exposed to GBS shortly before or during birth. This happens to thousands of babies with no ill effects - just why some babies exposed to GBS are susceptible to the bacteria and develop infection is not clear. What is known is most GBS infection in newborn babies can be prevented by giving women in high risk situations antibiotics intravenously (through a vein) from the onset of labour or their waters breaking until the baby is born.
Aggressive intravenous antibiotic therapy successfully treats most babies who develop a GBS infection, but even with the best medical care 10-20% of these babies die (usually from septicaemia, pneumonia or meningitis) and a few suffer long-term problems, most usually those who developed GBS meningitis.
The GBS bacteria can be passed from hands to a baby, so it is very important to make sure your hands are clean before handling a newborn baby.
Very occasionally GBS causes infection of the 'waters', womb or urinary tract in mothers of newborn babies.
If a woman believes she carries GBS, she should tell her GP, midwife and obstetrician and her baby's paediatrician. Proven methods for stopping most GBS infections from developing in newborn babies exist. In most cases, the babies of women who carry GBS can be protected and born healthy and free from infection.
Maybe, maybe not - and, if you do carry GBS, that's you and a third of the population, normally with no ill effects! But you may not be able to find out for sure, as no really reliable test is routinely available in the UK. The current tests miss up to 50% of GBS carriers plus GBS can come and go from your body (so if your test results were negative, would you believe them?). What you can do is make sure you know when it's more likely for babies to develop GBS infection and what the signs of this infection in babies are.
In higher-risk situations, giving pregnant women intravenous antibiotics at regular intervals during labour until delivery has been proven to be effective in stopping most GBS infections in newborn babies. There are a few serious risks associated with taking antibiotics, so the decision must be considered carefully.
Our medical advisory panel's 6 key recommendations for preventing GBS infection in newborn babies are:
Please contact GBSS if you would like more information and you know you carry GBS or have had a baby who developed a GBS infection.
Editor's note: We have not been able to find out, definitively, what the options are for women with Strep B who wish to pursue a home birth. Can anyone tell us whether midwives attending home births administer antibiotics to women at home. And if not, why not? Someone out there must know. Please write in and tell us.
At least 60% of GBS infection in babies are apparent at birth and around 90% are apparent within the baby's first 2 days of life, so these infections should be detected and treated in hospital. In the unlikely event this information is needed, the typical signs of GBS infection in a newborn baby include grunting, poor feeding, lethargy, low blood pressure, irritability, and/or abnormally high or low temperature, heart rates or breathing rates.
Around 10% of GBS infection develops after the baby is 2 days old ("late-onset" GBS infection), usually as meningitis with septicaemia. Approximately 5-10% of babies who develop the late-onset GBS die and a third suffer long-term handicaps.
The warning signs of late-onset GBS infection may include:
The warning signs of meningitis in babies may include, as well as any of those listed above, one or more of:
If your baby shows signs consistent with late-onset GBS infection or meningitis, call your GP immediately. If your GP isn't available, go straight to your nearest Accident & Emergency Department. If your baby has late-onset GBS infection or meningitis, early diagnosis and treatment are vital: delay could be fatal.
The risk of a baby developing a GBS infection decreases with age - GBS infection in babies is rare after one month of age and virtually unknown after three months.
There are seven situations in which it is more likely a baby will be exposed to GBS and, if susceptible, will develop a GBS infection:
Clinical risk factors: each increases the risk at least 3 times:
Mothers who carry GBS: multiplies the risk at least four times:
Mothers who have had a baby infected with GBS: multiply the risk about 10 times:
For more information about GBS, you should contact your medical professionals or contact:
UK Group B Strep Support Group: www.gbss.org.uk/ (Information leaflets can be downloaded from website.)
UK Midwifery Archives on GBS www.midwifery.org.uk, from the Association of Radical Midwives
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