One baby a week in the UK dies from Group B Strep usually within hours of being born, while 75 babies each year with the infection survive birth but are left with a disability.
The disease is in the headlines today as the failures in maternity services at Shrewsbury and Telford Hospital are revealed to be the biggest NHS maternity scandal of all time.
Group B Strep causes life-threatening infections in newborn babies, causing sepsis, pneumonia and meningitis.
Some of the women whose babies died or were left with lifelong disabilities had the infection and passed it on unknowingly to their children, the Ockenden review has said.
Group B Strep is the most common cause of meningitis in babies under three months of age - yet so many families only know about it when it is too late.
Jane Plumb, chief executive of charity Group B Strep Support, told the Mirror: “It is heartbreaking to read of such poor care, where if only things had been done differently, babies and their mothers may not have died or suffered life-long disabilities.
"Group B Strep is a leading cause of serious infection in newborn babies. We could and should be preventing most of these awful infections - these brave families' experiences show change is long overdue.”
The UK does not routinely test pregnant women for Group B Strep - also referred to as GBS or Strep B - unlike most wealthy countries such as the USA, Canada and much of Europe.
Yet if the test was carried out routinely as part of the maternity care women receive it would cost the NHS just £11.
What is Group B strep?
Group B Strep is a bacteria carried by 20 to 25% of adults in the UK, typically in the gut or vagina.
Carrying GBS doesn’t mean you have an infection or illness, it rarely causes any symptoms to the carrier, and does not need to be treated.
GBS can cause infection in newborn babies when the bacteria are transmitted to the baby, typically around labour or after birth.
In very rare cases, GBS causes infection during pregnancy, in adults whose immune system is depressed, the elderly, and women during pregnancy and after childbirth.
How do you get Group B Strep?
Like many bacteria, GBS may be passed from one person to another through skin-to-skin contact, for example, hand contact, kissing, close physical contact, etc.
As it is often found in the vagina and rectum of colonised women, it can be passed through sexual contact.
However, it’s important to note there are no known harmful effects of having GBS itself and the bacteria do not cause genital symptoms or discomfort.
GBS carriage is not a sexually transmitted disease, nor is GBS carriage a sign of ill health or poor hygiene.
How do I know if I have Group B Strep?
Most women carrying group B Strep have no symptoms, so it is often found by chance through a vaginal or rectal swab test or a urine test.
The NHS does not routinely test all pregnant women for group B Strep.
Women who carried group B Strep in a previous pregnancy and whose baby were not ill can have a test on the NHS.
If a pregnant woman wants to know if she carries group B Strep or not, she can buy a test designed specifically to find GBS carriage privately for around £40.
Charity Group B Strep Support has a page listing private test companies who provide 'gold standard' tests for group B Strep.
What if I do have Group B Strep? Will my baby die?
Many babies come into contact with Group B Strep during labour, or around or after birth and the vast majority will not become ill.
There is a small chance that your newborn baby will develop group B Strep infection and become seriously ill, or even die, and this chance is increased if you are carrying GBS.
The infections that group B Strep most commonly causes in newborn babies are:
- Sepsis - infection of the blood
- Pneumonia - infection in the lungs
- Meningitis - infection of the fluid and lining around the brain
Around 1 in every 1,750 babies in the UK and Ireland is diagnosed with early-onset group B Strep infection when babies are between 0 and 6 days old.
And around 1 in every 2,700 babies in the UK and Ireland is diagnosed with late-onset group B Strep infection when babies are between 7 and 90 days.
While group B Strep infection can make your baby very unwell, with prompt treatment most babies will fully recover.
Are some babies more likely to get Group B Strep?
Any baby can develop a group B Strep infection, but early-onset group B Strep infection - developing in the first 6 days of life, and usually on the first day- is more likely if:
- your baby is born preterm (before 37 weeks of pregnancy) – the earlier your baby is born, the greater the risk
- you have previously had a baby who developed a group B Strep infection
- you have had a high temperature (or other signs of infection) during labour
- you have had any group B Strep positive urine or swab test in this pregnancy
- your waters have broken more than 24 hours before your baby is born
I'm pregnant and tested positive for Group B Strep - what happens now?
Midwife Alison Stanley, who works at University Hospitals Sussex, told the Mirror: "There are two different scenarios.
"If a pregnant woman has tested positive through a urine sample then the woman needs to have oral antibiotics at that point in the pregnancy and that would clear up the infection.
"If a woman tests positive with a vaginal swab then she needs to be treated at the time she is in established labour or her water breaks.
"We give IV antibiotics, and then further antibiotics every four hours through the labour."
When asked if antibiotics are harmful to the baby Ms Stanley added: "They are safe for the mother and their baby and will prevent their baby dying of group B strep."
I think my baby has Group B Strep - what do I do?
If you are worried your baby might have a group B Strep infection then seek an immediate medical review, mentioning your concerns about group B Strep.
Most babies will make a good recovery from group B Strep infection, but quick identification and escalation is vital for early diagnosis and treatment.
Most group B Strep infections are apparent at or within the first 12 hours after birth so will often be identified at the maternity unit.
Typical signs of early-onset GBS infection include:
- Grunting, noisy breathing, moaning, seems to be working hard to breathe when you look at the chest or tummy, or not breathing at all.
- Be very sleepy and/or unresponsive
- Inconsolable crying
- Be unusually floppy
- Not feeding well or not keeping milk down
- Have a high or low temperature (if parents have a thermometer), and/or be hot or cold to the touch
- Have changes in their skin colour (including blotchy skin)
- Have an abnormally fast or slow heart rate or breathing rate
- Have low blood pressure (identified by tests done in hospital)
- Have low blood sugar (identified by tests done in hospital)
Babies can also develop late-onset GBS infection - after the baby’s first 6 days of life.
This is uncommon after a baby’s a month old, and very rare after three months old.
These are more likely to develop when a baby is back at home, so it’s important to be on the lookout for signs of infection, which are similar to those associated with early-onset GBS infection and include:
- Being irritable with high pitched or whimpering cry, or moaning
- Blank, staring or trance-like expression
- Floppy, may dislike being handled, be fretful
- Tense or bulging fontanelle (soft spot on babies’ heads)
- Turns away from bright light
- Involuntary stiff body or jerking movements
- Pale, blotchy skin
