What are the symptoms of Group B Strep in infants and adults. How is Group B Strep transmitted. What are the risk factors for Group B Strep infection. How can Group B Strep be prevented during pregnancy.

Understanding Group B Streptococcus: A Common but Potentially Dangerous Bacterium

Group B Streptococcus (GBS) is a type of bacteria that commonly resides in the human body, particularly in the intestines and lower genital tract. While it typically causes no harm in healthy adults, GBS can pose significant risks to newborns and individuals with compromised immune systems or chronic health conditions.

GBS is not a sexually transmitted infection, nor is it spread through food or water. The exact mechanisms of transmission between adults remain unclear, but the bacteria can fluctuate between presence and absence in an individual over time.

Prevalence and Carriage

How common is GBS carriage in adults? Studies suggest that approximately 25% of healthy adults carry GBS in their bodies at any given time. This carriage can be transient or persistent, meaning some individuals may always have the bacteria present while others experience intermittent colonization.

Group B Strep in Newborns: Early-Onset vs. Late-Onset Disease

When it comes to newborns, GBS can cause serious infections, categorized into two types based on the timing of symptom onset:

• Early-onset disease: Occurs within the first 6 hours to 7 days of life
• Late-onset disease: Develops between 1 week and 3 months of age

Recognizing GBS Symptoms in Infants

What signs should parents watch for in their newborns? GBS infection in infants can manifest through various symptoms, including:

• Fever or unusually low body temperature
• Difficulty feeding or lethargy
• Breathing problems
• Irritability or unusual jitteriness
• Seizures
• Skin rash
• Jaundice (yellowing of the skin and eyes)

If any of these symptoms are observed, immediate medical attention is crucial for the baby’s well-being.

Group B Strep in Adults: When Harmless Bacteria Turn Problematic

While GBS typically coexists harmlessly in adult bodies, certain conditions can lead to infections. These infections may affect various parts of the body and present with different symptoms.

Common GBS Infections in Adults

1. Urinary Tract Infections (UTIs)
2. Bloodstream Infections (Bacteremia)
3. Pneumonia
4. Skin and Soft Tissue Infections
5. Bone and Joint Infections

Each of these infections has distinct symptoms. For instance, a GBS-induced UTI may cause a persistent urge to urinate, burning sensation during urination, and possibly blood in the urine. Bacteremia, on the other hand, often presents with fever, chills, and confusion.

Risk Factors: Who’s Most Vulnerable to Group B Strep Infections?

Certain groups of people are at higher risk of developing GBS infections. Understanding these risk factors can help in early identification and prevention of complications.

Risk Factors for Infants

• Mother carrying GBS
• Premature birth (before 37 weeks)
• Prolonged rupture of membranes (18 hours or more before delivery)
• Maternal chorioamnionitis (infection of placental tissues and amniotic fluid)
• Maternal urinary tract infection during pregnancy
• Maternal fever during labor
• Previous sibling with GBS disease

Risk Factors for Adults

Which adults are most susceptible to GBS infections? The following groups face an increased risk:

• Adults aged 65 and older
• Individuals with diabetes
• People living with HIV
• Those with liver disease
• Individuals with heart conditions
• Cancer patients or survivors

These underlying conditions can compromise the immune system, making it easier for GBS to cause infections.

Complications of Group B Strep: Beyond the Initial Infection

GBS infections can lead to serious complications, particularly in infants and vulnerable adults. Understanding these potential outcomes emphasizes the importance of prevention and prompt treatment.

Complications in Infants

What are the most severe consequences of GBS infection in newborns? The primary concerns include:

• Pneumonia: Infection of the lungs
• Meningitis: Inflammation of the membranes surrounding the brain and spinal cord
• Bacteremia: Infection in the bloodstream

These conditions can be life-threatening and may lead to long-term health issues if not treated promptly and effectively.

Complications in Pregnant Women

How does GBS affect expectant mothers? Potential complications include:

• Urinary tract infections
• Chorioamnionitis
• Endometritis (infection of the uterine lining)
• Bacteremia

Complications in Other Adults

In adults with risk factors, GBS can cause various serious conditions:

• Skin infections
• Bacteremia
• Pneumonia
• Bone and joint infections
• Endocarditis (infection of heart valves)
• Meningitis

Prevention Strategies: Protecting Against Group B Strep

While GBS is a common bacterium, there are strategies to reduce the risk of infection, especially for newborns and high-risk adults.

Prevention During Pregnancy

How can expectant mothers protect their babies from GBS? The American College of Obstetricians and Gynecologists recommends the following approach:

1. Universal screening: All pregnant women should be tested for GBS between 36 and 37 weeks of pregnancy.
2. Intrapartum antibiotic prophylaxis: If a woman tests positive for GBS, she should receive antibiotics during labor to reduce the risk of transmission to the baby.
3. Risk-based approach: In cases where screening results are unavailable, antibiotics may be given based on risk factors such as preterm labor or prolonged rupture of membranes.

This preventive strategy has significantly reduced the incidence of early-onset GBS disease in newborns.

Prevention for Adults

For adults, especially those in high-risk groups, prevention focuses on managing underlying health conditions and practicing good hygiene. Regular check-ups, proper treatment of chronic diseases, and maintaining a healthy lifestyle can help reduce the risk of GBS infections.

Diagnosis and Treatment: Tackling Group B Strep Infections

Proper diagnosis and timely treatment are crucial in managing GBS infections effectively.

Diagnostic Methods

How is GBS detected? Diagnostic approaches may include:

• Cultures: Swabs from the vagina and rectum for pregnant women, or from the infected site in other cases
• Urine tests: To detect GBS in urinary tract infections
• Blood tests: For suspected bacteremia or systemic infections
• Spinal fluid analysis: In cases of suspected meningitis

Treatment Options

What are the primary treatments for GBS infections? The mainstay of treatment is antibiotics, typically penicillin or ampicillin. For individuals allergic to penicillin, alternative antibiotics are available. The duration and method of administration depend on the severity and location of the infection.

In severe cases, particularly in newborns or adults with systemic infections, hospitalization may be necessary for intravenous antibiotic therapy and supportive care.

Living with Group B Strep: Management and Long-term Considerations

For most healthy adults, carrying GBS doesn’t require any specific management. However, for those who have experienced GBS infections or are in high-risk groups, certain considerations are important.

Pregnancy and Future Pregnancies

Women who test positive for GBS in one pregnancy are not guaranteed to be positive in subsequent pregnancies. Therefore, screening is recommended in each pregnancy. However, women who have previously given birth to a baby with GBS disease may receive antibiotics during labor regardless of their current GBS status.

Chronic Carriers

Some individuals may carry GBS for extended periods. While this doesn’t typically cause problems, awareness is important, especially if they develop symptoms of infection or undergo certain medical procedures.

Ongoing Research

Scientists continue to study GBS to develop better prevention and treatment strategies. Current areas of research include:

• Development of a GBS vaccine for pregnant women
• Improved rapid diagnostic tests
• Alternative preventive measures to reduce antibiotic use

These advancements hold promise for further reducing the impact of GBS infections in the future.

Group B strep disease – Symptoms & causes

Overview

Group B strep (streptococcus) is a common bacterium often carried in the intestines or lower genital tract. The bacterium is usually harmless in healthy adults. In newborns, however, it can cause a serious illness known as group B strep disease.

Group B strep can also cause dangerous infections in adults with certain chronic medical conditions, such as diabetes or liver disease. Older adults are at increased risk of illness due to group B strep, too.

If you’re a healthy adult, there’s nothing you need to do about group B strep. If you’re pregnant, get a group B strep screening test during your third trimester. If you have group B strep, antibiotic treatment during labor can protect your baby.

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Symptoms

Infants

Most babies born to women carrying group B strep are healthy. But the few who are infected by group B strep during labor can become critically ill.

In infants, illness caused by group B strep can be within six hours of birth (early onset) — or weeks or months after birth (late onset).

Signs and symptoms might include:

• Fever
• Low body temperature
• Difficulty feeding
• Sluggishness, limpness or weak muscle tone
• Difficulty breathing
• Irritability
• Jitteriness
• Seizures
• Rash
• Jaundice

Adults

Many adults carry group B strep in their bodies — usually in the bowel, vagina, rectum, bladder or throat — and have no signs or symptoms.

In some cases, however, group B strep can cause a urinary tract infection or other more-serious infections. Signs and symptoms of infections that may be caused by group B strep include the following.

Urinary tract infection

• A strong, persistent urge to urinate
• A burning sensation or pain when urinating
• Passing frequent, small amounts of urine
• Urine that appears red, bright pink or cola colored — a sign of blood in the urine
• Pelvic pain

Blood infection (bacteremia)

• Fever
• Chills
• Confusion or lack of alertness

Pneumonia

• Fever
• Chills
• Cough
• Shortness of breath
• Chest pain when you breathe or cough

Skin or soft-tissue infection

• Swelling, warmth or redness in the area of the infection
• Pain in the area of the infection
• Lesions with pus or drainage

Bone or joint infection

• Fever
• Chills
• Swelling, warmth or redness over the area of the infection
• Pain in the area of the infection
• Stiffness or inability to use a limb or joint

When to see a doctor

If you have signs or symptoms of group B strep infection — particularly if you’re pregnant, you have a chronic medical condition or you’re older than 65 — contact your doctor right away.

If you notice your infant has signs or symptoms of group B strep disease, contact your baby’s doctor immediately.

Causes

Many healthy people carry group B strep bacteria in their bodies. You might carry the bacteria in your body for a short time — it can come and go — or you might always have it. Group B strep bacteria aren’t sexually transmitted, and they’re not spread through food or water. How the bacteria are spread to anyone other than newborns isn’t known.

Group B strep can spread to a baby during a vaginal delivery if the baby is exposed to — or swallows — fluids containing group B strep.

Risk factors

Infants

An infant is at increased risk of developing group B strep disease if:

• The mother carries group B strep in her body
• The baby is born prematurely (earlier than 37 weeks)
• The mother’s water breaks 18 hours or more before delivery
• The mother has an infection of the placental tissues and amniotic fluid (chorioamnionitis)
• The mother has a urinary tract infection during the pregnancy
• The mother’s temperature is greater than 100. 4 F (38 C) during labor
• The mother previously delivered an infant with group B strep disease

Adults

Adults age 65 and older are at increased risk of group B strep. You’re also at increased risk of if you have a condition that impairs your immune system or other serious diseases, including the following:

• Diabetes
• HIV infection
• Liver disease
• Heart disease
• Cancer or history of cancer

Complications

Group B strep infection can lead to life-threatening disease in infants, including:

• Pneumonia
• Inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis)
• Infection in the bloodstream (bacteremia)

If you’re pregnant, group B strep can cause the following:

• Urinary tract infection
• Infection of the placenta and amniotic fluid (chorioamnionitis)
• Infection of the membrane lining the uterus (endometritis)
• Bacteremia

If you’re an older adult or you have a chronic health condition, group B strep bacteria can lead to any of the following conditions:

• Skin infection
• Bacteremia
• Urinary tract infection
• Pneumonia
• Bone and joint infections
• Infection of the heart valves (endocarditis)
• Meningitis

Prevention

If you’re pregnant, the American College of Obstetricians and Gynecologists recommends a group B strep screening during weeks 36 to 37 of pregnancy. Your doctor will take swab samples from your vagina and rectum and send them to a lab for testing.

A positive test indicates that you carry group B strep. It doesn’t mean that you’re ill or that your baby will be affected, but that you’re at increased risk of passing the bacteria to your baby.

To prevent group B bacteria from spreading to your baby during labor or delivery, your doctor can give you an IV antibiotic — usually penicillin or a related drug — when labor begins.

If you’re allergic to penicillin or related drugs, you might receive clindamycin or vancomycin as an alternative. Because the effectiveness of these alternatives is not well understood, your baby will be monitored for up to 48 hours.

Taking oral antibiotics ahead of time won’t help because the bacteria can return before labor begins.

Antibiotic treatment during labor is also recommended if you:

• Have a urinary tract infection
• Delivered a previous baby with group B strep disease
• Develop a fever during labor
• Haven’t delivered your baby within 18 hours of your water breaking
• Go into labor before 37 weeks and haven’t been tested for group B strep

Vaccine in development

Although it’s not available yet, researchers are working on a group B strep vaccine that could help prevent group B strep infections in the future.

Group B strep infection | March of Dimes

Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria (tiny organisms that live in and around your body) that can cause infection. Usually GBS is not serious for adults, but it can hurt newborns.

Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI).

While GBS may not be harmful to you, it can be very harmful to your baby. If you’re pregnant, you can pass it to your baby during labor and childbirth.

About 1 out of 4 pregnant women (25 percent) carry GBS bacteria. The best way to know if you have GBS is to get tested. If you do have GBS, though, there’s good news: your health care provider can give you treatment during labor and birth that protects your baby from GBS.

How do you get GBS?

GBS bacteria live in the intestines and the urinary and genital tracts. It lives in the body naturally. As an adult, you can’t get it from food, water or things you touch. You can’t catch it from another person, and you can’t get it from having sex.

How do you know if you have GBS?

Your provider tests you for GBS at 35 to 37 weeks of pregnancy. Testing for GBS is simple and painless. Your provider takes a swab of your vagina and rectum and sends the sample to a laboratory. Your test results are usually available in 1 to 2 days.

Your provider also can use some quick screening tests during labor to test you for GBS. But these should not replace the regular GBS test that you get at 35 to 37 weeks of pregnancy.

How can you protect your baby from GBS?

If your GBS test at 35 to 37 weeks shows you have the infection, your provider gives you medicine called an antibiotic during labor and birth through an IV (through a needle into a vein). You also may be treated if you have any risk factors for GBS and you don’t know your GBS test results or you haven’t been tested yet. Treatment with antibiotics helps prevent your baby from getting the infection.

Penicillin is the best antibiotic for most women. Another antibiotic called ampicillin also can be used. These medicines usually are safe for you and your baby. But some women (up to 1 in 25 women, or 4 percent) treated with penicillin have a mild allergic reaction, like a rash. About 1 in 10,000 women have a serious allergic reaction that needs to be treated right away. If you’re allergic to penicillin, your provider can treat you with a different medicine.

If your test shows you have GBS, remind your health care providers at the hospital when you go to have your baby. This way, you can be treated quickly. Treatment works best when it begins at least 4 hours before childbirth.

If you have GBS and you’re having a scheduled cesarean birth (c-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

It’s not helpful to take oral antibiotics before labor to treat GBS. The bacteria can return quickly, so you could have it again by the time you have your baby.

If you have GBS, what are the chances that you can pass it to your baby?

If you have GBS during childbirth and it’s not treated, there is a 1 to 2 in 100 chance (1 to 2 percent) that your baby will get the infection. The chances are higher if you have any of these risk factors:

• Your baby is premature. This means your baby is born before 37 weeks of pregnancy.
• Your water breaks (also called ruptured membranes) 18 hours or more before you have your baby.
• You have a fever (100.4 F or higher) during labor.
• You’ve already had a baby with a GBS infection.
• You had a UTI during your pregnancy that was caused by GBS.

If you have GBS and you’re treated during labor and birth, your treatment helps protect your baby from the infection.

If your baby gets GBS, do signs of infection or other problems show up right after birth?

Not always. It depends on the kind of GBS infection your baby has. There are two kinds of GBS infections:

1. Early-onset GBS: Signs like fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby. But treatment with antibiotics during labor and birth can help prevent your baby from getting it. About half of all GBS infections in newborns are early-onset.
2. Late-onset GBS: Signs like coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby during or after birth. Treatment with antibiotics during labor and birth does not prevent late-onset GBS. After birth, your baby also can get GBS from other people who have the infection.

What problems can GBS cause in newborns?

Babies with a GBS infection can have one or more of these illnesses:

• Meningitis, an infection of the fluid and lining around the brain
• Pneumonia, a lung infection
• Sepsis, a blood infection

Pneumonia and sepsis in newborns can be life-threatening.

Most babies who are treated for GBS do fine. But even with treatment, about 1 in 20 babies (5 percent) who have GBS die. Premature babies are more likely to die from GBS than full-term babies (born at 39 to 41 weeks of pregnancy).

GBS infection may lead to health problems later in life. For example, about 1 in 4 babies (25 percent) who have meningitis caused by GBS develop:

• Cerebral palsy (A group of disorders that can cause problems with brain development. These problems affect a person’s ability to move and keep their balance and posture.)
• Hearing problems
• Learning problems
• Seizures

If your baby has a GBS infection, how is he treated?

It’s important to try and prevent a newborn from getting GBS. But if a baby does get infected with early-onset GBS or late-onset GBS, he is treated with antibiotics through an IV.

If you’re treated for GBS during labor, does your baby need special treatment?

Probably not. But if you have a uterine infection (an infection in your uterus) during labor and birth, your baby should be tested for GBS. Your baby’s provider can treat your baby with antibiotics while you wait for the test results.

Can GBS cause problems for mom during and after pregnancy?

GBS can cause a uterine infection during and after pregnancy. Symptoms of a uterine infection include:

• Fever
• Pain in your belly
• Increased heart rate (During pregnancy, it also can cause your baby’s heart rate to increase.)

If you have a uterine infection, your provider can give you antibiotics, and the infection usually goes away in a few days. Some women have no symptoms, so they don’t get treatment. Without treatment, infection during pregnancy may increase your chances of:

• Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts
• Preterm labor – Labor that happens too early, before 37 weeks of pregnancy
• Stillbirth – When a baby dies in the womb after 20 weeks of pregnancy

If you’re treated for GBS during labor and birth, you probably won’t get a uterine infection after your baby is born.

GBS also can cause a UTI during pregnancy. A UTI can cause fever or pain and burning when you urinate. Sometimes a UTI doesn’t have any symptoms. If you have a UTI, you may find out about it from a urine test during one of your prenatal visits.

If you have a UTI caused by GBS, your provider gives you antibiotics to take by mouth during pregnancy. You also get antibiotics through an IV during labor and birth, because you may have high levels of GBS in your body.

Is there a vaccine for GBS?

No. But researchers are making and testing vaccines to prevent GBS infection in mothers and their babies.

More information

Centers for Disease Control and Prevention (CDC)

Last reviewed: November, 2013

Streptococcal infection in a pregnant woman

“It’s not a sexually transmitted infection, although it is commonly believed,” says Karlina Elksne and explains that sexually transmitted diseases can be contracted through sexual contact, but streptococcus is a common household microbe that can be transmitted anyone. If a pregnant woman is diagnosed with this infection, “this is not an infection to be afraid of. It is important to know that it is present and it is important to report it to the maternity facility so that they can take appropriate action.”

What exactly is this scourge of young mothers – streptococcus?

The full name of the infection is group B hemolytic streptococcus. This is a microorganism that lives in the gastrointestinal tract in 5-30% of people. During pregnancy, when the rate of bowel movement changes and the fullness of the blood vessels in the pelvic vessels increases, streptococcus can enter the vaginal mucosa. It is very quiet, inconspicuous and does not cause any harm to a woman, so the presence of streptococcus is detected using targeted tests.

At 35-37 weeks of pregnancy, all mothers-to-be are swabbed from the lower part of the vagina, perineum and around the anus with a special swab.

Why is this analysis so important?

As already mentioned, group B hemolytic streptococcus is very silent and does not harm the woman, her partner, or the child still in her abdomen. But for a newborn, streptococcus can even be deadly.
If this microorganism enters the baby during childbirth, it can cause neonatal sepsis or blood poisoning, meningitis (inflammation of the lining of the brain), and pneumonia in the newborn. According to the Centers for Disease Prevention and Control, 0.5-4 out of 1000 newborns can develop severe infections in the first days of life, and this is the main cause of childhood morbidity and mortality in Europe and other countries of the world.

If a mother is diagnosed with group B hemolytic streptococcus, there is a 30–70% chance that the baby will also be infected during labor as it moves down the birth canal.

Therefore, in many countries of the world, including Latvia, it is determined whether a pregnant woman is a carrier of this microorganism.

Streptococcus is present. What’s next?

When tests confirm the presence of streptococcus in a woman’s body, the gynecologist usually makes an appropriate entry in the mother’s passport and instructs the woman on what to do next. “You don’t need to take any medication, just go to the hospital in time for the onset of childbirth. There, the expectant mother will receive antibiotics as a preventive measure,” says Karlina Elksne.

The medicine is given intravenously every four hours during labor and passes through the placenta into the baby’s bloodstream, thus protecting the baby from infection during birth. Antibiotics paralyze this microorganism, preventing it from being active during childbirth.

Do I need to be treated after this?

“Not at all,” the doctor says, and repeats: “No.”

Streptococcus is dangerous for a child, not for a pregnant woman: “A woman can live with this microorganism for the rest of her life.”

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However, the gynecologist notes that often women want to undergo treatment in order to be cured of streptococcus, but, according to Karlina Elksne, there are quite a lot of studies that confirm that the potential harm from an incorrectly treated infection more than from the presence of streptococcus in a woman’s body. “We have heard a lot about antibiotic resistance, side effects, etc. It makes no sense to treat something that does absolutely no harm to a woman,” the specialist says.

2 more questions and 2 answers

1. If this infection was found once, will it be present in the next pregnancy?
   No, the streptococcus may disappear. Although this infection is not treated in any particular way, nevertheless, the microorganism may disappear after undergoing antibiotic treatment for some other reason.
2. Can men also carry streptococcus?
   They can, but they can live their whole lives without even suspecting the presence of a microorganism in their body. As in women, streptococcus does not cause any complaints in men.

Mom of two experiences

“During my second pregnancy, I was diagnosed with streptococcus. I was very surprised because I didn’t even think that I could have something like that. I’m clean, no complaints

My first thought was that I would have to take antibiotics because I associate strep infection with severe inflammation , something purulent, but the doctor reassured me that there is nothing like it. 0004

I don’t need to take anything other than when I go into labor (I gave birth to both of my babies in Stradini because of the risk of heavy bleeding) go straight to the hospital and tell the staff that I have a streptococcal infection. The gynecologist also noted this in my maternal passport.

At the hospital, after a check-up, they put a catheter in a vein in my upper arm, through which I then received a dose of antibiotics every four hours to ensure a safe delivery for my baby. My second labor was also long, so I was given antibiotics five or six times, but I did not feel any discomfort. My daughter was born healthy and everything is fine. Because I haven’t taken antibiotics for other illnesses, it’s possible that the streptococcus is still in my system, but I don’t feel it or even think about it, because everything is fine.”

Vaccine urgently needed to prevent deadly group B streptococcus

Vaccine urgently needed to prevent deadly Group B Streptococcus

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• Vaccine urgently needed to prevent deadly group B streptococcus

London School of Hygiene and Tropical Medicine

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• The global burden of group B streptococcus disease is significantly higher than previously thought; each year, the infection causes more than half a million preterm births, 100,000 newborn deaths, at least 46,000 stillbirths, and significant disability.
• The bacterium is harmless to most pregnant women who carry it, but can be extremely severe if passed to the baby during pregnancy, at birth or in the first weeks of life.
• New vaccines are urgently needed to reduce deaths associated with group B streptococci and protect the lives and health of infants around the world.

A new report from the World Health Organization (WHO) and the London School of Hygiene and Tropical Medicine (LSHTM) reveals disappointing data on the global health effects of group B streptococcus (GBS), a common bacterium that can be passed to the baby in the womb mother, at birth or in the first weeks of life, and each year causes approximately 150,000 infant deaths, more than half a million preterm births, and a significant number of chronic disabilities.

To reduce these complications, the report’s authors call for the urgent development of vaccines for maternal immunization against GBS, emphasizing their potentially high cost-effectiveness and significant health benefits in all regions of the world.

According to WHO Department of Immunization, Vaccines and Biologicals Medical Officer Dr Philip Lambach , who is one of the report’s authors, “a new study has found that group B streptococcus is a serious and underestimated threat to survival and the well-being of newborns, with dire consequences for countless families around the world. WHO and partners are calling for the rapid development of a vaccine for maternal immunization against GBS that will bring enormous benefits to countries around the world.”

This new study quantifies for the first time GBS as a significant factor in preterm birth and the development of neurological disorders such as cerebral palsy, hearing and vision loss that can occur after GBS-associated infections.

Several vaccine candidates for GBS are currently under development, but none have yet been registered, although the search for vaccines began several decades ago.

“Infection with group B streptococcus has serious consequences for every affected family in any country. In the coming years, maternal vaccination could save the lives of hundreds of thousands of babies, but since it was proposed 30 years ago, no vaccine has been released worldwide. Now is the time to protect the most vulnerable people in the world with the GBS vaccine,” says director of the Center for Maternal, Adolescent, Reproductive and Child Health (MARCH) at LMCT, Professor Joy Lone , which participated in the preparation of the report.

The GBS bacterium is present in the vagina in an average of 15% of pregnant women – that’s almost 20 million pregnant women every year – and usually does not show any symptoms. Subsequently, it can be transmitted from a pregnant woman to a fetus in the womb or to a newborn during labor.

Antibiotic prophylaxis is currently the main way to prevent GBS-induced diseases in newborns when the bacterium is detected during pregnancy. However, because this intervention fails to prevent most GBS-associated stillbirths, preterm births, and diseases caused by the bacterium after birth, significant health risks remain even in regions where high prevention coverage has been achieved.

It is important to note that the greatest burden of GBS occurs in low- and middle-income countries, where infection screening and prevention during childbirth are the most difficult to organize, and the need for a vaccine is greater than anywhere else. Maternal GBS is highest in sub-Saharan Africa (accounting for about half of the global burden of infection) and in East and Southeast Asia.

“A new maternal GBS vaccine would dramatically reduce neonatal and maternal deaths in the most disadvantaged countries, especially in sub-Saharan Africa, where the burden of such deaths is most worrisome. We urge all stakeholders to consider this as a moral imperative,” said Dr. Martina Lukong Baye , National Multisectoral Program on Maternal, Newborn and Child Mortality Control, Ministry of Public Health of Cameroon, who also contributed to the report.

The report urges researchers, vaccine developers and donors to accelerate the development of an effective GBS vaccine that can be given to pregnant women during routine antenatal exams.

It is estimated that covering more than 70% of pregnant women with GBS vaccination will prevent more than 50,000 GBS-related deaths and 170,000 preterm births each year. According to the report, making vaccines affordable could result in an annual net economic benefit from maternal GBS vaccination of $17 billion over several years.

The report notes a number of important data gaps that do not provide a reliable estimate of the total burden of GBS-related mortality and morbidity. Thus, in a number of countries, thorough investigations into the infectious causes of stillbirths are often not always carried out, and therefore the real contribution of GBS to stillbirth statistics may be even greater.

According to Debbie Forwood , whose daughter Ada was stillborn as a result of GBS infection, “it is difficult to describe the depth and severity of the grief that comes with the death of your own child, the guilt that comes with it and how it changes you and your family forever and your relationship. Only a GBS vaccine could save Ada. When the widespread introduction of the vaccine begins, I will cry from a sense of injustice: it came too late for her and for other babies who suffer and die innocently every year while waiting for a vaccine. But it will also be tears of joy and hope that in the future many more babies will survive, and their families will not be touched by the horror that the death of a child brings.

The paper was presented at the ISSAD Global Conference on GBS, hosted by WHO and LSHGTM from Wednesday, November 3 to Friday, November 5, 2021. The conference is designed to mobilize researchers to close the gap in data and accelerate scientific developments aimed at reducing the burden of this deadly dangerous bacterial infection worldwide.

For further information and to arrange an interview, please contact Tilly Haynes, [email protected] LSHGTM.ac.uk, and Laura Keenan, [email protected] and [email protected].

Multimedia

Photos and materials on this report and the ISSAD conference are available here.

Publication data

Details of the post-embargo joint report by WHO and SHGTM: http://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/vaccine -impact-value/group-b-streptococcus-full-value-of-vaccine-assessment– in English

Details of the articles in the supplement to Clinical Infectious Diseases after the embargo was lifted: https://academic.oup.com /cid/pages/strep-b-worldwide – English

During the embargo, the report and articles in the supplement to Clinical Infectious Diseases can be found here (in English).

R Notes to editors

2020 annual GBS burden rates

• 19,700,000 pregnancies with vaginal colonization with group B streptococcus
• 518,000 cases of GBS-associated preterm birth
• 390,000 cases of GBS in infants
• 91,000 newborn deaths
• 46,000 or more stillbirths
• 40,000 infants living with neurological impairment after GBS-associated infections

global value of Group B streptococcus vaccine” ( Global value of group B streptococcus vaccine) provides an update on the current global GBS burden estimates first published by WHO and GMTM in 2017 and funded by the Bill & Melinda Gates Foundation. With new data coming from Denmark and five low- and middle-development countries (Argentina, India, Kenya, Mozambique, and South Africa), these new estimates include for the first time data on GBS-related preterm births as well as the risk of neurodevelopmental disorders among GBS survivors. patients.

Accompanying the report, a series of nine articles, “Every Country, Every Family: Group B Streptococcal Diseases in the World,” was published in the supplement of Clinical Infectious Diseases by 61 authors from countries on six continents. The articles provide additional details on GBS, as well as emergency family expenses due to GBS-related illnesses. Two WHO-led articles analyze the readiness of existing programs to introduce a vaccine and provide additional information on the size of the market and the sustainability of demand for vaccines.

The report is the first outcome of the Roadmap to Achieve the 2030 Meningitis Control Goals, developed by WHO and its partners, including LMTM.

Information about ISSAD

ISSAD2021 Group B: Accelerating Evidence-Based Action for Every Family Worldwide.” The conference is organized by the World Health Organization and the Center for Vaccines and the Center for Maternal, Adolescent, Reproductive and Child Health (MARCH) at the London School of Hygiene and Tropical Medicine. The conference runs from Wednesday, November 3rd to Friday, November 5th; Registration for the conference is open to everyone at ISSAD.org.

About LSHHTM

The London School of Hygiene and Tropical Medicine (LSHHTM) is the world’s leading center for research, postgraduate education and advanced training in public and global health surveys. With more than 3,500 employees in the UK and abroad, LSHGTM has approximately 5,000 students, raises £180 million in research funding annually and operates worldwide.

LSHGTM is one of the UK’s top rated research institutions, works in partnership with two MRC universities in the Gambia and Uganda and was awarded the 2016 University of the Year award by The Sunday Times.