According to campaigners, newborn babies are being put at risk by an infection passed down from their mothers, and critical research into how to prevent its spread is jeopardized. Everything you need to know about Strep infection in pregnancy.
Jane Plumb has been advocating for routine prenatal testing since the death of her 17-hour-old son Theo in 1996 as a result of a Group B Strep infection in pregnancy passed on during labor.
Medical research is now being conducted to evaluate the efficacy of such testing, but the trial requires the participation of 80 hospitals, of which only 30 have signed up so far.
Ms Plumb Statement
“It really is a now or never situation,” said Ms Plumb, CEO of Group B Strep Support.
“Policy will not change unless there is robust evidence, and the trial is absolutely the best, and probably the only, chance to get the evidence to affect change.”
Streptococcus group B strep is a type of bacteria.
It is carried by two to four out of every ten women, but there is a small risk that it will spread to the baby during labor, making them ill.
This occurs in approximately 1 in every 1,750 pregnancies.
“Approximately two babies per day develop Group B Strep infection in pregnancy, which typically results in sepsis, pneumonia, or meningitis,” Ms Plumb added.
“Every week, one of those babies dies, and another survives with a lifelong disability. And this is unforgivable because the vast majority of these infections are avoidable.”
The solution, she says, is to give antibiotics to those who test positive for the infection.
Other countries do provide testing, according to Ms Plumb, and the UK “needs to catch up.”
“Most developed countries, including France, Germany, Spain, and the United States, routinely offer pregnant women a Group B strep test during pregnancy and then antibiotics in labor, and their rates of these infections have dropped dramatically,” she added.
‘I remember feeling incredibly guilty,’ she says.
Tune in to Sky News at 10.10 to hear our CEO @JanePlumb talk about #groupBStrep and how important the @GBS3Trial pic.twitter.com/6Kyybw2vtV
— Group B Strep Support (@GBSSupport) April 16, 2022
What happened to her son?
When her son Frank was born five years ago, Kate Rogers sought the group’s assistance. He appeared to be in good health at first, but soon stopped feeding and had a seizure. Doctors informed her that her three-day-old son had meningitis and was critically ill.
It was caused by a Group B Strep infection in pregnancy, which left him with cerebral palsy and epilepsy.
“I remember feeling incredibly guilty that I had carried and passed on an infection to Frank and that I didn’t know about it,” Ms Rogers said.
“I hadn’t read nearly enough. I hadn’t done enough homework. That’s how I remember feeling at the time – completely responsible for passing this on and having no idea.”
She, like Jane, is urging hospitals to participate in the trial, which is being led by researchers at the University of Nottingham, before the deadline at the end of September.
Even though Frank is doing well despite his disability, Ms Rogers is determined to keep other babies safe.
“Frank is incredible and amazing, and we wouldn’t trade him for anything,” she said.
“It’s just difficult to know if this could have been avoided.”
A spokesperson for the Department of Health and Social Care stated that protecting pregnant women and their infants from disease is an “absolute priority.”
“Those identified as being at risk of having a baby infected with this infection are offered antibiotics during labor, allowing priority treatment and care for those we know are most vulnerable,” they said.
“There is currently a lack of evidence regarding the benefits of universal screening about the potential harms,” she says, “but we keep this evidence under review and will consider the results of an ongoing large-scale clinical trial when they report.”
What is Group B strep disease?
According to the Mayo Clinic, Group B strep (streptococcus) is a common bacterium that is commonly found in the intestines or lower genital tract. In most cases, the bacterium is not harmful to healthy adults. However, in newborns, it can cause a serious illness known as group B strep disease.
In adults with chronic medical conditions such as diabetes or liver disease, Group B strep can also cause dangerous infections. Older adults are also more likely to become ill as a result of group B strep.
If you’re a healthy adult, you don’t need to worry about group B strep. Get a group B strep screening test during your third trimester if you’re pregnant. Antibiotic treatment during labor can protect your baby if you have group B strep.
Symptoms of Group B Strip
Infants
The majority of babies born to women who have group B strep are healthy. Those who become infected with group B strep during labor, on the other hand, can become critically ill.
In infants, group B Strep infection in pregnancy can cause illness within six hours of birth (early onset) or weeks or months later (late-onset).
Among the signs and symptoms could be:
- Fever
- Body temperature is too low.
- Feeding Difficulties
- Sluggishness, limpness, or a loss of muscle tone
- Breathing difficulties
- Irritability
- Jitteriness
- Seizures
- Rash
- Jaundice
Adults
Many adults have group B strep in their bodies, usually in the bowel, rectum, vagina, bladder, or throat, with no symptoms.
However, in some cases, group B strep can cause a urinary tract infection or other serious infections.
The following are symptoms and signs:
Infection of the urinary tract:
- Urge to urinate that is strong and persistent
- When urinating, you may experience a burning sensation or pain.
- passing small amounts of urine regularly
- Urine that is red, bright pink, or cola-colored — is an indication of blood in the urine.
- Pelvic ache
Infection of the blood (bacteremia):
- Fever
- Chills
- Confusion or a lack of vigilance
Pneumonia:
- Fever
- Chills
- Cough
- Breathing difficulty
- When you breathe or cough, you may experience chest pain.
A skin or soft-tissue infection:
- Swelling, warmth, or redness in the infection’s site
- Pain in the infection’s site
- Pusty or draining lesions
Infection of the bones or joints:
- Fever
- Chills
- Swelling, warmth, or redness over the infection site
- Pain in the infection’s site
- Inability to use a limb or joint due to stiffness
When should you see a doctor?
If you have signs and symptoms of group B Strep infection in pregnancy, contact your doctor right away, especially if you are pregnant, have a chronic medical condition, or are over the age of 65.
If you notice signs and symptoms of group B strep disease in your infant, contact your baby’s doctor right away.
Causes of Group B Strep infection in pregnancy
Many people who are otherwise healthy have group B strep bacteria in their bodies. You could have the bacteria in your body for a short period — it can come and go — or you could have it all the time.
Group B strep bacteria are not transmitted sexually and are not spread through food or water. It is unknown how the bacteria spreads to anyone other than newborns. If a baby is exposed to or swallows group B strep-containing fluids during a vaginal delivery, the bacteria can spread to the baby.
Risk elements
Infants
- An infant is more likely to develop group B strep disease if:
- The mother is infected with group B strep.
- The baby is born too soon (earlier than 37 weeks)
- The mother’s water breaks at least 18 hours before delivery.
- The mother has a placental tissue and amniotic fluid infection (chorioamnionitis)
- During the pregnancy, the mother has a urinary tract infection.
- During labor, the mother’s temperature rises above 100.4 F (38 C).
- The mother had previously given birth to a child infected with group B strep.
Adults
65 and older are at a higher risk of contracting group B strep. You are also more likely to if you have a condition that weakens your immune system or other serious diseases, such as the following:
- Diabetes
- Infection with HIV
- Illness of the liver
- Cardiovascular disease
- Cancer or a family history of cancer
Complications of Strep infection in pregnancy
Infected infants with Group B strep can develop life-threatening diseases such as:
- Pneumonia
- Membranes and fluid surrounding the brain and spinal cord are inflamed (meningitis)
- Infection in the circulatory system (bacteremia)
Group B strep can cause the following complications if you are pregnant:
- Infection of the urinary tract
- Placental and amniotic fluid infection (chorioamnionitis)
- Infection of the uterine lining membrane (endometritis)
- Bacteremia
Group B strep bacteria can cause any of the following conditions if you are an older adult or have a chronic health condition:
- Infection of the skin
- Bacteremia
- Infection of the urinary tract
- Pneumonia
- Infections of the bones and joints
- Inflammation of the heart valves (endocarditis)
- Meningitis
Preventing Strep infection in pregnancy
If you’re pregnant, the American College of Obstetricians and Gynecologists suggests a group B strep test between weeks 36 and 37. Swab samples from your vagina and rectum will be collected by your doctor and sent to a lab for testing.
A positive test indicates that you are infected with group B strep. It doesn’t mean you’ll get sick or that your baby will be harmed, but it does mean you’re more likely to pass the bacteria on to your child.
When labor begins, your doctor can give you an IV antibiotic — usually penicillin or a related drug — to prevent group B bacteria from spreading to your baby.
If you are allergic to penicillin or similar drugs, you may be given clindamycin or vancomycin instead. Because the efficacy of these alternatives is unknown, your baby will be monitored for up to 48 hours.
Taking oral antibiotics before labor will not help because the bacteria can reappear before labor begins.
Antibiotics are also advised during labor if you:
- Have a urinary tract infection
- Gave birth to a baby who had group B strep disease.
- May develop a fever During labor
- Haven’t given birth within 18 hours of your water breaking.
- Go into labor before 37 weeks and haven’t been checked for group B strep, you’re at risk.
Vaccine for Group 2 Strip
Although it is not yet available, researchers are working on a group B strep vaccine that could help prevent future group B strep infections.
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