Group B Strep

Introduction

July is International Group B Strep Awareness Month, a global initiative to raise awareness and educate people about group B strep, its possible effects and the signs and symptoms of group B strep infection. But what is group B strep? Is it dangerous? How do I know if I have it? And what are the symptoms?

What is group B strep?

Group B strep (GBS) is a type of bacteria known as streptococcal bacteria. Many people carry group B strep in their rectum (back passage), vagina, bowel, bladder or throat without any symptoms, and the bacteria is usually harmless.

Rarely, group B strep can pass to your baby during pregnancy or labour causing your baby to become seriously ill. Group B strep can also cause repeated or severe infections in the elderly or people with chronic medical conditions or weakened immune systems.

How is group B strep spread?

Group B strep is spread by direct skin-to-skin contact such as hand-holding, kissing, and close physical contact. It is not classed as a sexually transmitted infection (STI) but may be passed on during sex.

How will I know if I have group B strep?

Most people with group B strep do not have any symptoms and may be unaware that they carry the bacteria. The infection is often picked up on a test for other things such as a throat swab or urine test. The only way to know for sure whether you have group B strep is to have a strep B test. This may be a swab or a urine test.

Group B strep testing is not routinely offered to pregnant women in the UK. If you are worried about group B strep, talk to your consultant about having a test privately.

Group B strep in pregnancy

About one in four women carry group B strep while they are pregnant. This doesn't usually cause harm to your unborn baby, but in rare cases, it can pass to your baby and lead to serious illness or even death. Very rarely, group B strep can infect the womb or amniotic fluid (the fluid around the baby) and lead to late miscarriage (between 14 and 24 weeks of pregnancy) or stillbirth.

The risk of your baby becoming seriously ill with group B strep during labour is about 1 in 1,750.

The risk of passing group B strep infection to your baby is higher if:

• Your baby is born prematurely
• You have a fever or other signs of infection while you are in labour
• Your labour starts more than 24 hours after your waters break

What happens if I test positive for group B strep during pregnancy?

If you test positive for group B strep while you are pregnant, your consultant may take precautions during your delivery to prevent or minimise the risk to your unborn baby. These measures may include:

• Going to hospital as soon as your labour begins or your waters break
• Giving birth in a hospital
• Having IV antibiotics (antibiotics given into a vein) during labour
• Staying in hospital for around 12 hours after you have given birth so your baby can be monitored for signs of group B strep

Group B strep in babies

There are three types of group B strep (GBS) infection in babies:

• Prenatal-onset GBS infection - occurs before birth
• Early-onset GBS infection - occurs in the first seven days of life (this is the most common type)
• Late-onset GBS infection - occurs from seven days to three months after birth

The most common types of infection caused by group B strep in babies are infection of the blood (sepsis), lung infections (pneumonia) and infection of the fluid and lining of the brain (meningitis) which can lead to long-term health problems like hearing loss or developmental problems. In rare cases, GBS infection in babies can be fatal. Most babies infected with group B strep make a full recovery if treated quickly.

What are the signs and symptoms of group B strep infection in babies?

If you tested positive for group B strep in pregnancy, you may need to stay in hospital for a short time while your baby is monitored for symptoms of group B strep. Though it most commonly occurs on the day of birth, group B strep infection can also occur after your baby is discharged from hospital and can develop up to three months of age.

Signs and symptoms of group B strep infection in babies include:

• Being floppy, limp, lethargic or not responding normally
• Difficulty breathing, fast or slow breathing, or grunting when breathing
• Irritability and agitation
• Fever (high temperature)
• Low body temperature
• Changes in skin colour, rash, blueish or blotchy skin
• Jaundice (yellowing of the skin and the whites of the eyes)
• Difficulty feeding, or vomiting milk
• A fast or slow heart rate
• Seizures (fits)

If your baby has symptoms of group B strep infection, call an ambulance or go to your nearest A&E department immediately.

How is group strep B treated?

Group B strep infection is treated with antibiotics. If you test positive for group B strep during pregnancy, your consultant will prescribe antibiotics to reduce the risk of passing the infection to your baby. If your baby develops group B strep infection, they will be treated with IV antibiotics.

Summary

Group B strep is a common bacteria that many people carry on their bodies. It is normally harmless and doesn't usually cause any symptoms. In rare cases, group B strep can pass to your baby while you are pregnant or during delivery which can result in your baby becoming seriously ill. Most babies infected with group B strep make a full recovery if treated quickly with antibiotics.

If you are worried about group B strep during pregnancy, talk to your consultant about getting a test and what measures you can take to protect your baby.