Group B Strep Awareness Month

July is International Group B Strep Awareness Month and we’re helping raise awareness about the risks of group B streptococcal (GBS) infection to newborn babies.

GBS is a common bacterium that is carried harmlessly by one in five women, in their vagina or bowel. It is not sexually transmitted and in the majority of cases it causes neither the mother nor baby any harm. However, one in every 2000 newborn babies in the UK and Ireland will be diagnosed with GBS infection. As their immune systems haven’t had time to develop, they will have picked up the infection from their mother around the time of labour and birth. With prompt treatment most babies will make a full recovery, however, GBS infection is serious and can lead to life-threatening complications, such as septicaemia, pneumonia and meningitis. One in ten babies born with GBS will die from the infection and one in five who survive will be left with permanent disability such as cerebral palsy, deafness, blindness and serious learning difficulties.

Early-onset neonatal GBS infection occurs when the baby develops the infection less than seven days after birth. The majority will have symptoms within 12 hours of birth including:

• Being floppy and unresponsive
• Poor feeding
• Grunting
• Abnormally high or low temperature
• Abnormally fast or slow heart rates
• Fast or slow breathing rates
• Irritability
• Low blood pressure
• Low blood sugar

Where the infection develops seven days or more after birth, known as late-onset GBS, the infection is less likely to be associated with pregnancy and has probably been picked up in some other way or from somebody else.

There is currently no standardised screening for GBS infection in pregnant women, as antibiotics are not given routinely in pregnancy to all carriers of GBS. However, those at high risk of having a baby with GBS infection are closely monitored and offered antibiotics once in labour as this has been shown to reduce the risk of the baby developing the infection. Maternal urine infection with GBS during pregnancy should be treated with antibiotics immediately. Antibiotics are also offered to women whose waters break before 37 weeks gestation and to those undergoing caesarean section, although these will cover a wide range of infections, not just GBS.

Newborn babies who are at high risk of developing GBS infection should be closely monitored. High risk factors for babies with GBS infection include:-

• Prematurity – birth before 37 weeks of pregnancy
• A mother who has had a previous baby diagnosed with GBS infection
• Maternal high temperature during labour
• More than 18 hours between waters breaking and the baby’s birth

If a newborn baby develops GBS infection it is vital that they receive urgent antibiotic treatment in hospital. The infection will be confirmed by blood tests or a lumbar puncture to take a sample of spinal fluid and intravenous antibiotics should be given within an hour of the decision to treat. Delays in treatment can lead to devastating injury.

At Boyes Turner we have brought successful claims for several families whose babies have suffered permanent disability as a result of delayed diagnosis and treatment of group B streptococcal infection.

In a recent case our client was left with quadriplegic cerebral palsy, post meningitis hydrocephalus requiring a ventricular peritoneal shunt, hearing and visual impairment, speech and feeding difficulties and epilepsy when the hospital paediatric team failed to recognise over the course of a day that her deteriorating condition was the result of group B streptococcal infection. The baby’s blood tests on admission to the ward had revealed an abnormally high white blood count – a strong indicator of bacterial infection – but were not communicated to the paediatricians who were caring for her. By the time a lumbar puncture and septic screen were ordered by the paediatric registrar she had already suffered a severe brain injury.