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Home arrow Read our Articles arrow Pregnancy arrow Group B Streptococcus (GBS) - What you need to know
Group B Streptococcus (GBS) - What you need to know



The following information is the literally the basics about GBS. For more detailed information and to download information booklets for free please log on to www.gbss.org.uk.

Why do you need to know about GBS?

Helen’s story - My little girl was born at full term with a spontaneous labour. All went well and I gave birth at home. But Holly never took a breath. The post-mortem report concluded that Holly died of an overwhelming Group B Strep (GBS) infection consistent with having been present no more than 24 hours before her birth. I had never heard of GBS but had we known that I was a carrier of GBS, then simple antibiotics given during labour could have saved her life.

Leesa’s Story - Two years ago our first baby was diagnosed with meningitis at only 18 hours old. The first time we’d ever heard of Group B Strep (GBS) was in Group B Strep Support leaflet handed to us by the midwife when our newborn daughter was on a ventilator fighting for her life in intensive care. Isabel survived, but the infection caused permanent brain damage leaving her blind with severe cerebral palsy. At 2 years of age she cannot roll, sit, crawl, stand, walk or even hold her own toys. To read in this leaflet that not only could I have been tested for GBS in the last month of pregnancy but, as an identified GBS carrier, that intravenous antibiotics during labour might have reduced the severity or even prevented her infection was, and remains, simply devastating.

Some health care professionals, doctors and midwives alike, are still ignorant on the subject of GBS. Arm yourself with the facts and then discuss it with them. Do not be fobbed off as GBS can be very serious.

The facts

GBS is a natural bacteria carried by a third of the adult population. One in four women carry GBS in the vagina. GBS infections in babies are almost exclusive to newborn babies (around 80% of cases occur within 48 hours but late onset can occur up to the age of 3 months) – infection rarely occurs in adults.

There are no signs or symptoms which would make you think that you are a carrier. 1 in 1000 babies born in this country (and a 2003 Lancet paper suggested the incidence could be 3-4 times higher) are affected by GBS. This is about 700 babies a year of which 100 die. That’s 2 babies who die per week. Some are left with lifelong disabilities.

Screening

Down’s syndrome, Spina bifida and HIV are now routinely screened for in the UK and yet they are not treatable or preventable conditions. GBS is preventable and yet we currently do not routinely screen for it in the UK.

The NHS test (which you have to ask for) is accurate if the result is positive but it gives a falsely negative result to up to 50% of carriers. The good news is that there is a lab in London that now does the Gold Standard screening test which is used elsewhere in the world to routinely screen women. Many health care professionals do not know of the risks or of the new test.

The test is only available privately and costs £28 by mail order. It involves taking a low vaginal and rectal swab (which you can do yourself) at 35-37 weeks gestation. This is the best time to test as GBS bacteria can come and go in your body. Any earlier and you are more likely to test negative only to have the bacteria come back nearer your due date. Any later and you might give birth before the result is back!  You send the kit back and within 3 days the result is available. You should get your GP or midwife to sign the forms for you so if you are positive your health care professionals can advise you on what to do next.

At present we (Group B Strep Support – the national charity and I) know of only one lab offering the test in this country. I must stress that we have no ties with nor receive any money from this company and would welcome some competition on the market!

The test can be ordered by contacting ‘The Doctors Laboratory’ on 020 7307 7373 or email them at gbs@tldpathology.com. All the info about the lab test can be found at http://www.tdlplc.co.uk/testinfo/lt_GBS.htm or as a pdf from the GBSS website (http://www.gbss.org.uk – go to the ECM test on the right side and in the middle is a link to the pdf).  The kit is free to order and you only pay when you send it back for analysis so there is nothing stopping you getting a kit early in your pregnancy.

If you are positive it does not mean your baby will become ill, but the chance of them being poorly can be dramatically reduced by simple IV antibiotics given to you during labour. Your health care professionals should know what to do and give BUT read the information on www.gbss.org.uk so that you know what to do in the event that they don’t. Carrying GBS is perfectly natural and normal – you just need to be aware what increases the risk of the baby developing GBS infection, and what you can do to minimise that risk. My son was born healthy so there is a happy ending!

Group B Strep Support are campaigning to make Gold Standard screening (using Enriched Culture Media) routine for all women and to reduce the number of needless illness and death by usage of appropriate preventative antibiotics during labour. They have lots of free-to-download information on their website which covers everything from the basics, the signs and symptoms of infection in the newborn baby, right through to what to do if you are a known carrier. They also have people available to discuss your case and/or questions – just phone them on 01444 416176. The charity is very small so this number isn’t manned all the time but if you leave a message I promise someone will get back to you.

Briefly - The Government are finally taking an interest. I went along with GBSS and about 15 other affected families to meet the children’s health minister at the Houses of Parliament back in Nov 2004. He has set the wheels on motion to audit the Gold Standard Test against the risk based approach (this is the best strategy you are likely to be offered at the moment and even then usage between hospitals varies) and has promised that if the results come back in favour of screening, he will make it policy in this country. He has also commissioned a group to look into future technologies which may be even more useful. If you have any questions check out the GBSS website at http://www.gbss.org.uk or you can contact me via olthomas44@hotmail.com

AND PLEASE TRY NOT TO WORRY

I have presented the worst case scenarios here to show you just how devastating GBS can be but you must remember - of those babies who are exposed, very few are susceptible to infection but it is still a real possibility if precautions are not taken.

We don’t want to frighten anyone, we just want to stop what we had to live through happening to anyone else.

 




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