Strep B

What is Strep B?

Group B streptococcus (GBS) or strep B for short is a common type of the streptococcus bacterium which lives in the body without the carrier knowing. Approximately a third of men and women carry GBS in their intestines and a quarter of women carry it in their vagina. GBS is the UK’s most common cause of life threatening infections in newborn babies.

What are the symptoms of carrying Strep B?

Carrying Strep B, shows no obvious symptoms or problems and so you will not know if you have it or not.

So why is Strep B something to worry about ?  

There is nothing wrong in carrying GBS it can live normally in our bodies. However, in rare cases if a baby is exposed to GBS shortly before, during or after labour it can cause infection and even death. Thousands of babies are exposed to GBS and most will suffer no ill effects, however, around 1 in 1000 babies in the UK develop a GBS infection, that’s 700 babies a year. Sadly around 75 -100 of these babies will die from GBS infection. It isn’t clear why some babies develop an infection and some don’t.

Is my baby at risk of Strep B?

Your baby is more likely to develop GBS infection if:

• You go into premature labour (before 37 weeks).
• Your waters break prematurely (before 37 weeks) with or without other labour signs.
• Your waters break more than 18 hours before you have your baby.
• You have a raised temperature during labour.
• You were found to carry GBS during the current pregnancy.
• GBS was found in your urine during this pregnancy.
• You have had a baby previously infected with GBS.

What are the symptoms of GBS infection in a baby?

Approximately 60% of babies who have got GBS infection will show symptoms at birth and 90% within the first 2 days. This is known as ‘early onset’ GBS infection. This can be treated with intravenous antibiotics, although even with the best possible care the infection can be fatal in 1 in 8 infected babies.

Typical symptoms of ‘early onset’ GBS are as follows:

• Grunting
• Poor feeding
• Lethargy
• Low blood pressure
• Irritability
• Abnormally high or low temperature, heart rate and/or breathing rate.

Around 10% of GBS infections will develop after the baby is 2 days old, usually as meningitis with septicaemia, this is known as late-onset GBS infection. Most babies will survive with treatment although up to 30% will be left with long term problems. Warning signs of late-onset GBS infection include:

• Fever
• Poor feeding
• Drowsiness

Signs of meningitis may include:

• Shrill or moaning cry or whimpering
• Dislike of being held and fretful
• Tense or bulging fontanelle (soft spot on babies head)
• Involuntary body stiffening/ jerking movements
• Floppy body
• Blank staring or trance like expression
• Low or high breathing rate.
• Turns away from bright lights.
• Pale and or blotchy skin.

If your baby shows signs consistent with GBS infection of meningitis then call your doctor immediately. If your doctor isn’t available then go straight to your nearest hospital. For more information on meningitis click here.

How is Strep B carrige diagnosed?

Testing Strep B carriage is not routinely available on the NHS. A doctor can carry out a test if you ask, though they may not agree to it as the test available on the NHS, gives false negative results up to 50% of the time when it should be positive. A more reliable test is the PCR test which can be carried out at about 35-37 weeks of pregnancy.

How can I keep my baby safe from GBS infection?

If you don’t fall into any of the categories given above then its unlikely that your baby will develop GBS infection. However, if your baby is at raised risk, research shows that by giving drugs (antibiotics) through a vein from the start of your labour or from when your waters break (whichever comes first) until your baby is born can help prevent GBS infections in newborn babies in the majority of cases. You should ideally be given the antibiotics for at least 4 hours prior to delivery where possible.

If your baby is at risk then once he/she is born he should be examined by a pediatrician immediately and if you didn’t receive antibiotics for more than 4 hours then the baby should be started on antibiotics until he’s given the all clear. If the baby shows any signs of GBS infection then antibiotics should be started immediately.

Caesarean sections are not recommended to prevent GBS infection.

GBS can also be passed from the hands so everyone should wash their hands when handling a newborn baby. The risk of a baby catching GBS decreases with age, GBS infection is rare after one month of age and virtually unknown after 3 month