What is Group B Streptococcus and how does it affect pregnancy. How is GBS transmitted to newborns during childbirth. What are the potential complications of GBS infection in newborns. How can GBS infections be prevented during pregnancy and childbirth. What treatment options are available for pregnant women with GBS. How is GBS testing conducted during pregnancy. Can Group B Strep go away on its own.

What is Group B Streptococcus and Its Impact on Pregnancy

Group B Streptococcus (GBS) is a common type of bacteria that can be found in the human body, particularly in the gastrointestinal and genital tracts. While it’s usually harmless in adults, GBS can pose significant risks to newborns if transmitted during childbirth. Understanding the nature of GBS and its potential impact on pregnancy is crucial for expectant mothers and healthcare providers alike.

GBS is present in approximately 25% of pregnant women, often without causing any symptoms. However, the bacteria can be passed to the baby during delivery, potentially leading to severe infections. It’s important to note that carrying GBS doesn’t mean a woman will always have it; the bacteria can come and go over time.

Key Facts About GBS in Pregnancy:

• GBS is a common bacteria found in many adults
• It’s typically harmless in adults but can be dangerous for newborns
• Approximately 1 in 4 pregnant women carry GBS
• GBS can be transmitted to babies during childbirth
• Most babies exposed to GBS during birth do not become ill

Transmission of GBS from Mother to Newborn

The transmission of Group B Streptococcus from mother to newborn typically occurs during the process of childbirth. As the baby passes through the birth canal, it may come into contact with the bacteria if the mother is a carrier. This exposure can lead to colonization or infection in the newborn.

Is the transmission of GBS always guaranteed? No, not all babies exposed to GBS during birth will become infected. In fact, most babies who come into contact with GBS during delivery will not develop any illness. However, for those who do become infected, the consequences can be severe.

Factors Increasing the Risk of GBS Transmission:

• Premature labor (before 37 weeks)
• Prolonged rupture of membranes (18 hours or more before delivery)
• Maternal fever during labor (100.4°F or higher)
• Previous baby with GBS infection
• Urinary tract infections caused by GBS during pregnancy

Potential Complications of GBS Infection in Newborns

While most babies exposed to GBS during birth remain healthy, those who develop an infection can face serious and potentially life-threatening complications. GBS infections in newborns can manifest in various forms, each with its own set of risks and challenges.

What are the primary types of GBS infections in newborns? The most common forms of GBS infection in infants include:

1. Sepsis (blood infection)
2. Pneumonia (lung infection)
3. Meningitis (infection of the membranes surrounding the brain and spinal cord)

These infections can develop rapidly, often within the first week of life. However, some cases may not present symptoms until up to three months after birth, highlighting the importance of ongoing vigilance.

Early-Onset vs. Late-Onset GBS Disease:

GBS infections in newborns are categorized into two types based on when symptoms appear:

• Early-onset disease: Occurs within the first week of life, typically within 24-48 hours after birth
• Late-onset disease: Develops between one week and three months of age

Early-onset disease is directly related to transmission during childbirth, while late-onset disease may be acquired from the mother or other sources after birth.

Prevention Strategies for GBS Infections During Pregnancy and Childbirth

Preventing Group B Streptococcus infections in newborns is a primary concern for healthcare providers and expectant mothers. The most effective prevention strategy involves identifying GBS-positive mothers and administering appropriate treatment during labor.

How can GBS infections be prevented during pregnancy and childbirth? The main prevention strategy is intrapartum antibiotic prophylaxis (IAP), which involves administering antibiotics to GBS-positive women during labor. This approach significantly reduces the risk of transmitting the bacteria to the newborn.

Key Prevention Measures:

• Universal screening of pregnant women for GBS at 35-37 weeks gestation
• Administering intravenous antibiotics during labor to GBS-positive women
• Treating women with unknown GBS status who have risk factors
• Monitoring newborns for signs of infection after birth

It’s important to note that there is currently no vaccine available to protect against GBS. Research is ongoing to develop a vaccine that could potentially provide long-term protection for both mothers and infants.

Treatment Options for Pregnant Women with GBS

When a pregnant woman tests positive for Group B Streptococcus or has risk factors for GBS transmission, appropriate treatment is crucial to protect both the mother and the baby. The primary treatment approach for GBS-positive pregnant women is the administration of antibiotics during labor.

What is the standard treatment for GBS-positive pregnant women? The most common treatment is intravenous antibiotics given during labor. Penicillin is typically the first-choice antibiotic, but alternatives are available for women with penicillin allergies.

Antibiotic Treatment Protocol:

• Intravenous penicillin G is the preferred antibiotic
• Ampicillin is an acceptable alternative
• For penicillin-allergic women, cefazolin, clindamycin, or vancomycin may be used
• Antibiotics are typically administered every 4 hours until delivery

It’s important to note that oral antibiotics taken during pregnancy are not effective in preventing GBS transmission to the newborn. The intravenous administration during labor is crucial for reducing the risk of infection.

GBS Testing Procedures During Pregnancy

Accurate testing for Group B Streptococcus is a critical component of prenatal care. The standard approach involves screening all pregnant women between 35 and 37 weeks of gestation, regardless of their previous GBS status in prior pregnancies.

How is GBS testing conducted during pregnancy? The most common method is a culture test using swabs from the vagina and rectum. The samples are then sent to a laboratory for analysis, with results typically available within a few days.

GBS Testing Process:

1. A healthcare provider collects swab samples from the lower vagina and rectum
2. Samples are cultured in a laboratory to detect the presence of GBS
3. Results are usually available within 24-48 hours
4. Positive results indicate the need for antibiotic treatment during labor

Some healthcare providers may opt for rapid testing methods that can provide results more quickly. However, these tests are generally less sensitive than culture-based methods and may not be as reliable in detecting GBS colonization.

The Persistence and Variability of Group B Strep

One of the challenging aspects of Group B Streptococcus is its ability to persist or fluctuate in the human body over time. This variability can lead to confusion and questions about whether GBS can “go away” on its own.

Can Group B Strep go away on its own? GBS colonization can be transient, meaning that a woman who tests positive for GBS at one point may test negative at a later time. However, this doesn’t necessarily mean the bacteria has permanently “gone away.”

Understanding GBS Colonization:

• GBS colonization can be intermittent or persistent
• A negative test result doesn’t guarantee future negative results
• Women who test positive for GBS are considered carriers for life
• Subsequent pregnancies require retesting due to the possibility of changes in GBS status

It’s important to note that while GBS colonization can fluctuate, a positive test during pregnancy is always treated seriously to protect the newborn from potential infection.

Long-Term Implications of GBS for Mothers and Infants

While the primary focus of GBS prevention and treatment is on protecting newborns during and immediately after birth, it’s also important to consider the long-term implications for both mothers and infants who have been affected by GBS.

Are there lasting effects of GBS infection or colonization? For most mothers, GBS colonization does not cause long-term health issues. However, infants who survive severe GBS infections may face ongoing challenges.

Potential Long-Term Effects in Infants:

• Neurological impairments following meningitis
• Developmental delays
• Hearing or vision loss
• Seizures
• Cognitive disabilities

For mothers who have had a GBS-positive pregnancy, future pregnancies will require careful monitoring and testing. While a previous GBS-positive status doesn’t guarantee future colonization, it does increase the likelihood of recurrence.

Advancements in GBS Research and Future Prevention Strategies

As medical science continues to advance, researchers are exploring new ways to prevent and treat Group B Streptococcus infections. These efforts aim to improve outcomes for both mothers and newborns while reducing the reliance on antibiotic use during labor.

What new approaches are being developed to combat GBS? Several promising areas of research are currently underway:

Emerging GBS Prevention Strategies:

• Development of GBS vaccines for pregnant women
• Improved rapid diagnostic tests for more accurate and timely detection
• Novel antibiotic alternatives to reduce the risk of antimicrobial resistance
• Exploration of probiotic interventions to reduce GBS colonization

While these advancements are still in various stages of research and development, they offer hope for more effective and targeted approaches to GBS prevention in the future.

The Role of Healthcare Providers in GBS Management

Healthcare providers play a crucial role in managing Group B Streptococcus during pregnancy and childbirth. Their expertise and vigilance are essential for ensuring the best possible outcomes for both mothers and newborns.

How do healthcare providers manage GBS in pregnant women? Healthcare professionals follow established guidelines and protocols to screen for, prevent, and treat GBS infections:

Healthcare Provider Responsibilities:

1. Conducting timely GBS screening tests
2. Educating patients about GBS and its implications
3. Administering appropriate antibiotic treatment during labor
4. Monitoring newborns for signs of infection
5. Providing follow-up care and support for affected families

Effective communication between healthcare providers and patients is crucial for ensuring that all aspects of GBS management are understood and followed correctly.

Emotional and Psychological Impact of GBS on Expectant Parents

While the medical aspects of Group B Streptococcus are well-documented, it’s equally important to consider the emotional and psychological impact that a GBS diagnosis can have on expectant parents. Learning about GBS and its potential risks can be a source of anxiety and stress during pregnancy.

How can expectant parents cope with the emotional challenges of a GBS diagnosis? It’s important to recognize that these feelings are normal and that support is available:

Coping Strategies for Parents:

• Educate yourself about GBS from reliable sources
• Communicate openly with your healthcare provider
• Share your concerns with your partner or support system
• Focus on the high success rate of GBS prevention measures
• Consider joining support groups for expectant parents dealing with GBS

Remember that while GBS is a serious concern, the vast majority of GBS-positive pregnancies result in healthy outcomes when proper preventive measures are taken.

Global Perspectives on GBS Prevention and Management

Group B Streptococcus is a global health concern, but approaches to prevention and management can vary across different countries and healthcare systems. Understanding these differences can provide valuable insights into best practices and areas for improvement in GBS care worldwide.

How do GBS prevention strategies differ around the world? While many developed countries follow similar guidelines, there are notable variations:

International Approaches to GBS Management:

• Universal screening approach (e.g., United States, Canada)
• Risk-based approach (e.g., United Kingdom, Netherlands)
• Combination of screening and risk-based strategies
• Limited or no formal GBS prevention programs in some developing countries

These differences in approach are often based on factors such as healthcare resources, cost-effectiveness analyses, and local epidemiology of GBS infections.

The Importance of Ongoing Research and Education in GBS Prevention

As our understanding of Group B Streptococcus continues to evolve, ongoing research and education play crucial roles in improving prevention and treatment strategies. Staying informed about the latest developments in GBS management is essential for healthcare providers, researchers, and expectant parents alike.

Why is continued research and education on GBS important? Advances in this field can lead to more effective prevention methods, improved treatment options, and better outcomes for mothers and newborns:

Key Areas for Ongoing Research and Education:

• Development of more accurate and rapid diagnostic tests
• Exploration of non-antibiotic prevention methods
• Investigation of the long-term effects of GBS exposure on infant health
• Improvement of public awareness and understanding of GBS
• Enhancement of healthcare provider training and protocols

By fostering a culture of continuous learning and improvement, we can work towards minimizing the impact of GBS on maternal and infant health worldwide.

Group B streptococcus – pregnancy Information | Mount Sinai

GBS – pregnancy

GBS Infection in Newborn Babies

Most of the time, GBS is harmless. However, GBS can be passed to a newborn during birth.

Most babies who come in contact with GBS during birth will not become sick. But the few babies who do become ill can have severe problems.

After your baby is born, GBS can lead to infections in:

• The blood (sepsis)
• The lungs (pneumonia)
• The brain (meningitis)

Most babies who get GBS will start having problems during their first week of life. Some babies will not get sick until later. Symptoms can take as long as 3 months to appear.

The infections caused by GBS are serious and can be fatal. Yet prompt treatment usually leads to complete recovery.

Preventing GBS Infections in Babies

Women who carry GBS often don’t know it. You are more likely to pass the GBS bacteria to your baby if:

• You go into labor before week 37.
• Your water breaks before week 37.
• It has been 18 or more hours since your water broke, but you haven’t had your baby yet.
• You have a fever of 100.4°F (38°C)or more during labor.
• You have had a baby with GBS during another pregnancy.
• You have had urinary tract infections that were caused by GBS.

When you are 35 to 37 weeks pregnant, your doctor may do a test for GBS. The doctor will take a culture by swabbing the outer part of your vagina and rectum. The swab will be tested for GBS. Results are often ready in a few days.

Some doctors do not test for GBS. Instead, they will treat any woman who is at risk for having their baby be affected by GBS.

Treating and Preventing GBS Infections in Pregnant Women

There is no vaccine to protect women and babies from GBS.

If a test shows that you carry GBS, your doctor will give you antibiotics through an IV during your labor. Even if you are not tested for GBS but have risk factors, your doctor will give you the same treatment.

There is no way to avoid getting GBS.

• The bacteria are widespread. People who carry GBS often have no symptoms. GBS can come and go.

• Testing positive for GBS does not mean you will have it forever. But you will still be considered a carrier for the rest of your life.

Note: Strep throat is caused by a different bacterium. If you have had strep throat, or got it while you were pregnant, it does not mean that you have GBS.

Duff WP. Maternal and perinatal infection in pregnancy: bacterial. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 58.

Esper F. Postnatal bacterial infections. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin’s Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 48.

Pannaraj PS, Baker CJ. Group B streptococcal infections. In: Cherry J, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 83.

Verani JR, McGee L, Schrag SJ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease–revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010;59(RR-10):1-36. PMID: 21088663 pubmed.ncbi.nlm.nih.gov/21088663/.

Last reviewed on: 4/19/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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

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

Mother holding baby

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Photo

• 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 serious if passed to the baby during pregnancy, at the stage of childbirth 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 co-authored the report, “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, as well as the development of neurological disorders such as cerebral palsy, hearing and vision loss, which can occur after GBS-associated infections.

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

“Infection with group B streptococcus is fraught with 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 each 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 at birth 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 newborn 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 Coordinator of the National Multisectoral Program on Maternal, Newborn and Child Mortality Control at the Ministry of Public Health of Cameroon, Dr. Martina Lukong Baye , who also contributed to the preparation of 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 would 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 highlights the lack of a number of important data that do not allow a reliable assessment 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.

In the words of Debbie Forwood , whose daughter Ada was stillborn as a result of GBS infection, “It is difficult to describe the severity and depth of grief that comes with the death of your own child, the guilt that comes with it and how it changes you, 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 aims 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 joint post-embargo 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

Detailed information about the articles in the supplement to the journal Clinical Infectious Diseases after the lifting of the embargo: 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

90,004 40,000 infants living with neurological impairment after GBS-associated infections

Information about the report and related publications 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,” by 61 authors from countries on six continents, was published in the Clinical Infectious Diseases Supplement. 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.

About ISSAD

ISSAD2021 (International Symposium on Diseases Caused Streptococcus agalactiae ) 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 continuing education 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 Medical Research Council universities in the Gambia and Uganda, and was awarded University of the Year by The Sunday Times in 2016. Our mission is to promote health and health equity in the UK and around the world; collaboration with partners to effectively study public and global health issues and apply the knowledge gained in policy and practice.

Follow us on @LSHTM on Twitter and listen to the LSHTM Viral podcast.

www.lshtm.ac.uk

About WHO

Founded in 1948, WHO is a United Nations agency that brings countries, partners and people together to promote health, keep the world safer and service coverage for vulnerable populations so that everyone can achieve the highest possible level of health.

www.who.int

Streptococcal infection in a pregnant woman

“This is not a sexually transmitted infection, although it is commonly believed,” says Karlina Elksne and explains that sexually transmitted diseases can be transmitted 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 expectant mothers are swabbed with a special swab from the lower part of the vagina, perineum and around the anus.

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 detected 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.